Aly MM1, Saleh M1, Abdulmajeed S1
1Faculty of Physical Therapy - Cairo University, Physical Therapy for Neuromuscular Disorders, Cairo, Egypt
Background: Internal disc disruptions of lower lumbar intervertebral discs commonly L4-5 and L5-S1 may either causes compression on travelling and or exiting nerve roots. Numerous manual therapy approaches are used to enhance nerve root decompression by rotatory and or translatory manipulative techniques.
Purpose: The purpose of this study is to compare the effect of ipsilateral and contralateral trunk rotation on the exiting and travelling nerve roots in lumbosacral radiculopathy. To investigate which direction of trunk rotation is more specific to promote travelling and exiting nerve root decompression.
Methods: A purposive sample of 168 patients with (L4-5) and (L5-S1) paramedian disc protrusion with unilateral scitica participated in the study. Their age ranged from 22 to 50 years, their body mass ranged from 65 to 91 kg and their height ranged from 160 to 185 cm. level of nerve root compression was confirmed by MRI , H Reflex and physical examination. They were divided into two groups, group
(A) represent travelling nerve root compression on the paramedian zone and group
(B) represent exiting root compression on the foraminal zone.
Each group underwent pre and post positioning and mobilization measurements for H reflex , VAS and 6 minutes' walk test for two separate trails of treatment each trail for one week, trail one in the direction of ipsilateral trunk rotation and trail two in the direction of contralateral trunk rotation.
Results: Mixed design MANOVA revealed that the H-Reflex, VAS and 6 minutes' walk test increased significantly (p 0.05) after trail two of treatment n the direction of contra lateral trunk rotation in group (A). However, the H-reflex, VAS and 6 minutes' walk test post treatment values after trail one of treatment in the direction of ipsilateral trunk rotation treatment values increased significantly (p > 0.05) in patients within group (B).
Conclusion(s): Ipsilateral trunk rotation direction is more specific for exiting nerve root decompression whereas contralateral trunk rotation direction is more specific for traveling nerve root decompression when applying manual therapy positioning and mobilization techniques.
Implications: Determining the compromised nerve root either travelling or exiting may direct more specific use of manual therapy techniques.
Keywords: Trunk rotation, Nerve root, Lumbosacral Radiculopathy
Funding acknowledgements: No fund
Purpose: The purpose of this study is to compare the effect of ipsilateral and contralateral trunk rotation on the exiting and travelling nerve roots in lumbosacral radiculopathy. To investigate which direction of trunk rotation is more specific to promote travelling and exiting nerve root decompression.
Methods: A purposive sample of 168 patients with (L4-5) and (L5-S1) paramedian disc protrusion with unilateral scitica participated in the study. Their age ranged from 22 to 50 years, their body mass ranged from 65 to 91 kg and their height ranged from 160 to 185 cm. level of nerve root compression was confirmed by MRI , H Reflex and physical examination. They were divided into two groups, group
(A) represent travelling nerve root compression on the paramedian zone and group
(B) represent exiting root compression on the foraminal zone.
Each group underwent pre and post positioning and mobilization measurements for H reflex , VAS and 6 minutes' walk test for two separate trails of treatment each trail for one week, trail one in the direction of ipsilateral trunk rotation and trail two in the direction of contralateral trunk rotation.
Results: Mixed design MANOVA revealed that the H-Reflex, VAS and 6 minutes' walk test increased significantly (p 0.05) after trail two of treatment n the direction of contra lateral trunk rotation in group (A). However, the H-reflex, VAS and 6 minutes' walk test post treatment values after trail one of treatment in the direction of ipsilateral trunk rotation treatment values increased significantly (p > 0.05) in patients within group (B).
Conclusion(s): Ipsilateral trunk rotation direction is more specific for exiting nerve root decompression whereas contralateral trunk rotation direction is more specific for traveling nerve root decompression when applying manual therapy positioning and mobilization techniques.
Implications: Determining the compromised nerve root either travelling or exiting may direct more specific use of manual therapy techniques.
Keywords: Trunk rotation, Nerve root, Lumbosacral Radiculopathy
Funding acknowledgements: No fund
Topic: Musculoskeletal: spine
Ethics approval required: Yes
Institution: Faculty of Physical Therapy, Cairo University, Egypt
Ethics committee: Ethical Committee of Faculty of Physical Therapy
Ethics number: P.T. REC/010/001580
All authors, affiliations and abstracts have been published as submitted.
