COMPARISON OF THE EFFECT OF TWO REHABILITATION PROGRAMS ON SPINAL MOBILITY AND PAIN INTENSITY IN PATIENTS WITH SPINAL DISCOPATHY

Abstract

Introduction. Approximately 80% of people experience back pain throughout their lives. A common problem of patients with low back pain is a significant limitation of mobility. Rehabilitation programs are usually recommended. Programs should include exercises that build flexibility, endurance, and strength. Kinesiotherapy is complemented by physiotherapy procedures, which are mainly aimed at analgesic and relaxing effects.
 The aim of the study was to compare the effect of two rehabilitation programs that differ in the type of kinesiotherapy on the mobility of the lumbar spine and the level of pain intensity in people with L5-S1 segment discopathy.
 Materials and methods. The study involved 30 patients undergoing 14 days of rehabilitation treatment. The criterion for dividing the subjects into groups was the method of kinesitherapy. The first group (Gr1) consisted of 15 patients who did gymnastics in the pool twice a day, and the second group (Gr2) consisted of 15 patients who attended therapeutic gymnastics classes in the gym twice a day. The exercises were aimed at improving the range of motion of the spine, strength and endurance of postural muscles. A visual analog scale was used to assess the intensity of pain. The distance between standard anthropometric points in the resting position and in the extreme position of movement was measured to assess the range of spinal movements.
 Results. After rehabilitation, the amplitude of movements of the lumbar spine increased in most patients. In Gr1, an increase in the range of forward spinal flexion by 9.2 cm (p = 0.001), rotation to the right by 0.63 cm (p = 0.03), and to the left by 1.33 cm (p = 0.007) was detected. In Gr2, the range of forward flexion increased by 12.6 cm (p = 0.005), left rotation by 0.94 cm (p = 0.035), and right flexion by 1.41 cm (p = 0.002). In the case of other movements, no statistically significant changes were found.
 In Gr1, the average pain intensity according to the VAS was 4.9 ± 2.3 points before the start of the physiotherapy program and 3.6 ± 1.7 points after its completion (p = 0.04). In Gr2, the VAS values were 5.1 ± 2.5 points and 3.9 ± 1.8 points, respectively (p = 0.03). The magnitude of changes in pain intensity was similar (-1.3 points and -1.2 points) for both programs.
 Conclusions. 1. The applied rehabilitation programs increased the mobility of the lumbar spine and reduced pain in patients with L5-S1 segment discopathy. 2. Both the hydrokinesitherapy program and the gym program were equally effective in increasing the range of motion of the spine and reducing the intensity of pain.