DOI QR코드

DOI QR Code

The effects of Cox distraction manipulation on functional assessment measures and disc herniation index in patients with L4-5 herniated disc

칵스 신연교정이 L4-5 추간판 탈출증 환자의 기능적 평가측정과 추간판탈출지수에 미치는 효과

  • Received : 2012.06.15
  • Accepted : 2012.07.08
  • Published : 2012.07.31

Abstract

The purpose of the present study was to determine the effect of a 4 week course of Cox distraction manipulation (CDM) combined with therapeutic modalities on the treatment of patients with L4-5 herniated nucleus pulposus (HNP). A total of 15 patients with L4-5 HNP (mean age, 37.76 years; age range 20-50years) participated in the study. A 4 week course of CDM combined with therapeutic modalities was delivered to the patients for 6 days per week for the first two weeks, and three times per week for two additional weeks. The entire treatment consisted of 18 visits over 4 week period. Comparisons of changes in the muscle strengthening (MS), straight leg raise (SLR), and oswestry disability index (ODI) at pre-intervention, after two weeks treatment sessions, and at discharge (after 18 treatment sessions) were analyzed. Comparisons of changes in the disc herniation index (DHI) at pre-intervention and at discharge were analyzed using the paired t-test. There were significant improvements in the outcome measures of MS Ibs, SLR test, and ODI score after 2 weeks and 4 weeks sessions of CDM combined with therapeutic modalities as compared with the pre-intervention. However, no significant different pre-test and post-test DHI. CDM combined with therapeutic modalities appears to be a safe and efficacious, noninvasive treatment modality for patients with L4-5 HNP.

Keywords

Cox distraction manipulation;disc herniation index;herniated nucleus pulposus

References

  1. Avramov, A. I., Cavanugh, J. M., Ozaktay, C. A., Gretchell, T. V. and King, A. I. (1992). The effect of controlled mechanical loading on group II, , and IV afferent units from the lumbar facet joint and III surrounding tissue. Journal of Bone and Joint Surgery American, 74, 1464-1471. https://doi.org/10.2106/00004623-199274100-00005
  2. Bailey, W. M. (2006). A paractical guide to the application of AJNR guidelines for nomenclature and classification of lumbar disc pathology in magnetic resonance imaging(MRI). Radiography, 12, 175- 182. https://doi.org/10.1016/j.radi.2005.05.004
  3. Beira, R. and Peers, A. (1998). A study of the effects of chiropractic therapy on the diameter of the spinal canal in patients with low back pain and radiculopathy. Journal of Neuromusculoskel System, 6, 114- 126.
  4. Bulbulian, R., Burke, J. and Dishman, J. D. (2002). Spinal reflex excitability changes after lumbar spine passive flexion mobilization. Journal of Manipulative and Physiological Therapeutics, 25, 526-532. https://doi.org/10.1067/mmt.2002.127073
  5. Cox, J. M. (1998). Chiropractic and distraction adjustments today. In Low Back Pain: Mechanisms, Diagnosis and Treatment, 5th Ed., edited by J. M. Cox, Lippincot Williams & Wilkins, Philadelphia, 1-16.
  6. Cox, J. M. (2000). A review of biomechanics of the central nervous system. Part I: Spinal canal deformations caused by changes in posture. Journal of Manipulative and Physiological Therapeutics, 23, 211-217. https://doi.org/10.1016/S0161-4754(00)90252-5
  7. Cox, J. M. (2012). Chiropractic management of a patient with lumbar spine pain due to synovial cyst: A case report. Journal of Chiropractic Medicine, 10, 255-210.
  8. Cox, J. M. and Cox II, J. M. (2005). Chiropractic treatment of lumbar spine synovial cysts: A report of two cases. Journal of Manipulative and Physiological Therapeutics, 28, 143- 147. https://doi.org/10.1016/j.jmpt.2005.01.011
  9. Fagerlund, M. K., Thelander, U. and Friberg, S. (1990). Size of lumbar disc hernias measured using computed tomography and related to sciatic symptoms. Acta Radiologica, 31, 555-8. https://doi.org/10.3109/02841859009173096
  10. Gay, R. E., Bronfort, G. and Evans, R. L. (2005). Distraction manipulation of the lumbar spine : A review of the literature. Journal of Manipulative and Physiological Therapeutics, 28, 266-73. https://doi.org/10.1016/j.jmpt.2005.03.012
  11. Gay, R. E., Ilharreborde, B., Zhao, K. D., Berglund, L. J., Bronfort, G. and An, K. N. (2008). Stress in lumbar intervertebral discs during distraction: A cadaveric study. The Spine Journal, 8, 982-990. https://doi.org/10.1016/j.spinee.2007.07.398
  12. Goh, K. J., Khalifa, W., Anslow, P., Cadoux, H. T. and Donaghy, M. (2004). The clinical syndrome associated with lumbar spinal stenosis. European Neurology, 52, 242-249. https://doi.org/10.1159/000082369
  13. Gong, W. T., Cheun, H. J. and Lee, K. M. (2010). The effect of cervical stabiliazed exercise and joint mobilization on maximum muscle strength and static muscle endurance of cervical region. Journal of the Korean Data & Information Science Society, 21, 33-42.
  14. Gudavalli, M. R. (1999). Biomechanics research on flexion-distraction procedure. In Low Back Pain: Mechanisms, Diagnosis and Treatment, 6th Ed., edited by J. M. Cox, Lippincot Williams & Wilkins, Philadelphia, 263-268.
  15. Hasegawa, T., Mikawa, Y., Watanabe, R. and An, H. S. (1996). Morphometirc analysis of the lumbosacral nerve roots and dorsal toot ganglia by magnetic resonance imaging. Spine, 21, 1005-1009. https://doi.org/10.1097/00007632-199605010-00001
  16. Hides, J. A., Richardson, C. A. and Jull, G. A. (1996). Multifidus muscle recovery is not automatic after resolution of acute, first episodes low back pain. Spine, 21, 2763-2769. https://doi.org/10.1097/00007632-199612010-00011
  17. Joung, K. H. and Chung, S. S. (2011). Health-related quality of life among home-dwelling people with arthritis in Korea: Comparative study of osteoarthritis and rheumatoid arthritis. Journal of the Korean Data & Information Science Society, 22, 555-563.
  18. Kim, D. Y., Lee, S. H., Lee, H. Y., Lee, H. J., Chang, S. B., Chung, S. K. and Kim, H. J. (2005). Validation of the Korean version of the Oswestry disability index. Spine, 30, 123-127. https://doi.org/10.1097/01.brs.0000157172.00635.3a
  19. Kruse, R. A. and Cambron, J. A. (2011a). Cox decompression chiropractic manipulation of a patient with postsurgical lumbar fusion: A case report. Journal of Chiropractic Medicine, 10, 255-260. https://doi.org/10.1016/j.jcm.2011.01.011
  20. Kruse, R. A. and Cambron, J. A. (2011b). Chriopractic management of postsurgical lumbar spine pain: A retrospective study of 32 case. Journal of Manipulative and Physiological Therapeutics, 34, 408-412. https://doi.org/10.1016/j.jmpt.2011.05.011
  21. Kruse, R. A., Gudavalli, S. and Cambron, J. A. (2007). Chiropractic treatment of a pregnant patient with lumbar radiculopathy. Journal of Chiropractic Medicine, 6, 153-158. https://doi.org/10.1016/j.jcme.2007.08.005
  22. Ma, S. Y. (2010a). The effects of mulligan manual therapy on pain and muscle assessment questionnaire in female elders with osteoarthritis of the knee. Journal of the Korean Data & Information Science Society, 21, 641-650.
  23. Ma, S. Y. (2010b). Effect of whole body cryotherapy with spinal decompression on lumbar disc herniation by functional assessment measures. Journal of the Korean Data & Information Science Society, 21, 1101-1108.
  24. Macario, A., Richmond, C., Auster, M. and Perglizzi, J. V. (2008). Treatment of 94 outpatients with chronic discogenic low back pain with the DRX9000: A retrospective chart review. Pain Practice, 8, 11-17. https://doi.org/10.1111/j.1533-2500.2007.00167.x
  25. Manison, A. M. (2011). Chiropractic management using Cox cervical flexion-distraction technique for a disk herniation with left foraminal narrowing in a 64-year-old man. Journal of Chiropractic Medicine, 10, 316-321. https://doi.org/10.1016/j.jcm.2011.04.004
  26. McLain, R. F. (1994). Mechanoreceptor endings in human cervical facet joints. Spine, 19, 495-501. https://doi.org/10.1097/00007632-199403000-00001
  27. Milette, P. C. (2000). Classification, diagnostic imaging, and imaging characterization of a lumbar herniated disk. Radiologic Clinic of North America, 38, 1267-92. https://doi.org/10.1016/S0033-8389(08)70006-X
  28. Nakagawa, H., Kamimura, M., Takahara, K., Hashidate, H., Kawaguchi, A., Uchiyama, S. and Miyasaka, T. (2007). Optimal duration of conservative treatment for lumbar disc herniation depending on the type of herniation. Journal of Clinical Neuroscience, 14, 104-109. https://doi.org/10.1016/j.jocn.2006.08.001
  29. Patterson, M. M. and Steinmetz, J. E. (1986). Long lasting alterations of spinal reflexes: A potential basis for somatic dysfunction. Manual Medicine, 2, 38-42.
  30. Schaible, H. G. and Grubb, B. D. (1993). Afferent and spinal mechanism of joint pain. Pain, 55, 5-54. https://doi.org/10.1016/0304-3959(93)90183-P
  31. Troup, J. D. G. and Videman, T. (1989). Inactivity and the aetiopathogenesis of musculoskeletal disorders. Clinical Biomechanics, 4, 173-178. https://doi.org/10.1016/0268-0033(89)90022-3
  32. Waddell, G., Somerville, D., Henderson, I. and Newton, M. (1992). Objective clinical evaluation of physical impairment in chronic low back pain. Spine, 17, 617-628. https://doi.org/10.1097/00007632-199206000-00001
  33. Wheeler, A. H. and Hanley, E. N. (1995). Nonoperative treatment for low back pain rest to restoration. Spine, 20, 375-378. https://doi.org/10.1097/00007632-199502000-00023
  34. Zusman, M. (1988). Prolonged relief from articular soft tissue pain with passive joint movement. Manual Medicine, 3, 100-102.

Cited by

  1. Effects of Manual Therapy on Pain and Function of Patients with Chronic Low Back Pain vol.29, pp.2, 2017, https://doi.org/10.18857/jkpt.2017.29.2.85