Effects of foot massage on relieving pain, anxiety and improving quality of life of patients undergone a cervical spine surgery.

BACKGROUND: Long-term recovery of patients undergone cervical spine surgery is of paramount importance to improve their quality of life. In this study we aimed to evaluate the effects of foot massage on relieving pain and anxiety of patients with anterior cervical discectomy and fusion (ACDF). METHODS: Enrolled patients undergone ACDF and diagnosed with anxiety disorder at least six months before surgery were treated with 10-min foot massage on a daily basis for four weeks using sweet almond oil. Patients were assessed by neck pain visual analog pain scale (NP-VAS), neck disability index (NDI) and self-rating anxiety scale. RESULTS: More significant relief in NP-VAS was observed in patients who received foot massage treatment. No significant difference in NDI reduction was seen in patients with or without the treatment. Intervention group demonstrated less anxiety during follow-up (p = 0.021) compared to the control group and more reduction compared to baseline (p = 0.046). In terms of quality of life, while both groups demonstrated improvement in pain relief (p = 0.015 for the intervention group and p = 0.037 for the control group), only the intervention group showed improved mental function (p = 0.031). CONCLUSION: This study found that foot massage was effective in alleviating pain and anxiety, while improving quality of life in patients undergone ACDF, indicating that this intervention should be considered in the clinical management of these patients.

New approach for evaluating the effectiveness of whole-body magnetic field therapy in the rehabilitation of patients with lumbar discectomy.

OBJECTIVE: Magnetic field therapy involves the application of low-intensity magnetic fields (1-3.5 mT) to a patient's whole body. The purpose of this study was to assess the effectiveness of whole-body magnetic field (WBMF) therapy in the early rehabilitation of patients after lumbar discectomy. METHODS: A convenience sample of 73 patients who underwent lumbar discectomy within 1 month previously participated in the study. All patients were randomly assigned to one of two groups and received either a course of conventional rehabilitation (control group) or conventional rehabilitation together with 10 sessions of WBMF therapy (WBMF group). Participants were evaluated before and after the rehabilitation course by using the Visual Analog Scale for Pain (VAS) and thermal infrared imaging. The latter was used to detect pathological changes in temperature (hyperthermia and thermal asymmetry) of the surface of the skin overlying the lumbar spine and lower extremities. RESULTS: The VAS score of the WBMF group decreased from 6.2 ± 0.3 cm before to 3.2 ± 0.2 cm after rehabilitation (p< 0.01), compared to 6.1 ± 0.4 cm before to 4.3 ± 0.2 cm after rehabilitation for the control group (p< 0.05). Reduction of the area of lumbar hyperthermia was observed in 88% of WBMF and 35% of control group patients. CONCLUSIONS: When combined with conventional rehabilitation, WBMF therapy was effective in reducing lumbar pain, temperature, and, possibly, inflammation. Results of this study will be used for designing a large-scale clinical trial.

Manipulative rehabilitation applied soon after lumbar disc surgery improves late post-operative functional disability: A preliminary 2-year follow-up study.

BACKGROUND: Studies have shown late post-operative physical disability and residual pain in patients following lumbar disc surgery despite growing evidence of its beneficial effects. Therefore, rehabilitation is required to minimise the late post-operative complications. OBJECTIVE: To assess the feasibility of manipulative rehabilitation to improve late post-operative outcomes. METHODS: Twenty-one patients aged 25-65 years undergoing lumbar microdiscectomy were randomly assigned to the rehabilitation group (n= 14) or active control group (n= 7) by simple randomisation. Eight rehabilitation sessions were initiated 2-3 weeks after surgery. Thirty-minute sessions were conducted twice weekly for four weeks. Post-operative physical disability and pain were assessed at baseline and at the two-year follow-up. RESULTS: Post-operative physical disability improved more in patients who had undergone rehabilitation than in those who had received control care (63% vs. -23%, P< 0.05). Post-operative residual low back and leg pain were alleviated in the treatment group (26% and 57%, respectively), but intensified in the control group (-5% and -8%, respectively). CONCLUSIONS: This study demonstrated the potential of manipulative rehabilitation and importance of post-operative management after lumbar disc surgery. Definitive trials with larger sample sizes are required to confirm the feasibility and potential therapeutic effectiveness of this approach.

The effect of prior lumbar surgeries on the flexion relaxation phenomenon and its responsiveness to rehabilitative treatment.

BACKGROUND CONTEXT: Abnormal pretreatment flexion-relaxation in chronic disabling occupational lumbar spinal disorder patients has been shown to improve with functional restoration rehabilitation. Little is known about the effects of prior lumbar surgeries on flexion-relaxation and its responsiveness to treatment. PURPOSE: To quantify the effect of prior lumbar surgeries on the flexion-relaxation phenomenon and its responsiveness to rehabilitative treatment. STUDY DESIGN/SETTING: A prospective cohort study of chronic disabling occupational lumbar spinal disorder patients, including those with and without prior lumbar spinal surgeries. PATIENT SAMPLE: A sample of 126 chronic disabling occupational lumbar spinal disorder patients with prior work-related injuries entered an interdisciplinary functional restoration program and agreed to enroll in this study. Fifty-seven patients had undergone surgical decompression or discectomy (n=32) or lumbar fusion (n=25), and the rest had no history of prior injury-related spine surgery (n=69). At post-treatment, 116 patients were reevaluated, including those with prior decompressions or discectomies (n=30), lumbar fusions (n=21), and no surgery (n=65). A comparison group of 30 pain-free control subjects was tested with an identical assessment protocol, and compared with post-rehabilitation outcomes. OUTCOME MEASURES: Mean surface electromyography (SEMG) at maximum voluntary flexion; subject achievement of flexion-relaxation (SEMG≤3.5 µV); gross lumbar, true lumbar, and pelvic flexion ROM; and a pain visual analog scale self-report during forward bending task. Identical measures were obtained at pretreatment and post-treatment. METHODS: Patients entered an interdisciplinary functional restoration program, including a quantitatively directed, medically supervised exercise process and a multimodal psychosocial disability management component. The functional restoration program was accompanied by a SEMG-assisted stretching training program, designed to teach relaxation of the lumbar musculature during end-range flexion, thereby improving or normalizing flexion-relaxation and increasing lumbar flexion ROM. At 1 year after discharge from the program, a structured interview was used to obtain socioeconomic outcomes. RESULTS: At pre-rehabilitation, the no surgery group patients demonstrated significantly better performance than both surgery groups on absolute SEMG at maximum voluntary flexion and on true lumbar flexion ROM. Both surgery groups were less likely to achieve flexion-relaxation than the no surgery patients. The fusion patients had reduced gross lumbar flexion ROM and greater pain during bending compared with the no surgery patients, and reduced true lumbar flexion ROM compared with the discectomy patients. At post-rehabilitation, all groups improved substantially on all measures. When post-rehabilitation measures were compared with the pain-free control group, with gross and true lumbar ROM corrected by 8° per spinal segment fused, there were no differences between any of the patient groups and the pain-free control subjects on spinal ROM and only small differences in SEMG. The three groups had comparable socioeconomic outcomes at 1 year post-treatment in work retention, health-care utilization, new injury, and new surgery. CONCLUSIONS: Despite the fact that the patients with prior surgery demonstrated greater pretreatment SEMG and ROM deficits, functional restoration treatment, combined with SEMG-assisted stretching training, was successful in improving all these measures by post-treatment. After treatment, both groups demonstrated ROM within anticipated limits, and the majority of patients in all three groups successfully achieved flexion-relaxation. In a chronic disabling occupational lumbar spinal disorder cohort, surgery patients were nearly equal to nonoperated patients in responding to interdisciplinary functional restoration rehabilitation on measures investigated in this study, achieving close to normal performance measures associated with pain-free controls. The responsiveness and final scores shown in this study suggests that flexion-relaxation may be a useful, objective diagnostic tool to measure changes in physical capacity for chronic disabling occupational lumbar spinal disorder patients.

[The effect of rehabilitation with therapeutic Akhtala muds and electromagnetic radiation of millimeter range on biochemical indices in patients with post discectomy syndrome].

The impact of therapeutic Akhtala muds and electromagnetic radiation of millimeter range on biochemical indices in patients with post discectomy syndrome has been investigated. The research showed that medical rehabilitation with Akhtala medical muds and electromagnetic radiation of millimeter range stimulates sympathetic-adrenal system, adrenocorticotrophic function of the hypophysis and glucocorticoid function of adrenal cortex, induces a weakening/removal of an inflammatory process in the operated area, enhances antioxidant defense of the organism, oppresses calcium metabolism and peroxide oxidation of lipids. The noted positive process was manifested in the increase up to upper limit of the norm of daily excretion of adrenalin and noradrenalin, the content of adrenocorticotrophic hormone and cortisol in blood plasma and in the decrease of the amount of malonic dialdehyde in it, also in the increase of antioxidative activity of blood plasma, in the decrease of the content of "С"-reactive protein, haptoglobin, seroglicoids, common and ionic calcium in blood serum.

[Postoperative physiotherapy in acute care--when, what and how much?]. / Postoperative Physiotherapie im Akutbereich--wann, welche und wieviel?

This article documents the role of early musculoskeletal rehabilitation in acute care after orthopaedic surgery involving the hip, knee or spine. It discusses the open questions of the type, time and intensity of physiotherapeutic intervention. The role of standardized quality management to define clinical pathways is discussed.

[Orthopedic hippotherapy in postoperative rehabilitation of lumbar intervertebral disk patients. A prospective, randomized therapy study]. / Die Orthopädische Hippotherapie in der postoperativen Rehabilitation von lumbalen Bandscheibenpatienten. Eine prospektive, randomisierte Therapiestudie.

In a prospectively randomized therapy study the influence of a new therapeutical approach, called "Orthopedic Horseback-Riding-Therapy (OHRT)", was evaluated on the postoperative rehabilitation after lumbal discectomie in 16 patients against an identical numbered control group. In comparison with the reference group the utilization of OHRT not only produced an improvement in the patients' self evaluation of their postoperative condition (McNab Score). Also a significant reduction of postoperative work disablement could be achieved. Compared with the reference group influences of previously detected negative psychic predictors (Hs and Hy scales of MMPI) could be reduced. Thus the OHRT is a serious therapy concept in postoperative treatment of patients with lumbal disc herniation.