Extension Exercise Research Articles

COMPREHENSIVE PHYSIOTHERAPY MANAGEMENT IN PIVD PATIENT

Back pain from prolapsed intervertebral disc is a common reason for physiotherapy management. Therefore, the objective of this case study was to define and address the use of electrotherapy modalities with the lumbar exercises and core stabilization workout with a lumbar herniated disc patient. Patient information and diagnosis: A 37 year old women patient consulted to the physiotherapy treatment with scan confirmed by MRI of prolapsed intervertebral disc (L5-S1). The key symptoms of the patient was pain in the back region and radiating ache in the right buttock followed by numbness and tingling sensation in the right leg. Therapeutic interventions: The first therapeutic initial weeks composed of modalities (TENS) with back muscles exercises and core stabilization exercises. As an addendum to the extension exercises, mechanical traction and strengthening and stability exercises were added for the following weeks. Outcome indicators include the functional scale for back pain and the numerical pain assessment scale (NPRS). Outcomes from initial assessment to discharge the functional back pain scale 34/60 to 58/60 and NPRS 7/10 to 0/10) showed that the patient no longer suffered from low back pain and enhanced functional status. The patient no longer worried of numbness and tingling in the right leg and the patient's objectives were achieved. The evidence from this case report indicates back muscles exercises and core stabilization exercises with modalities that encouraged the patient's pain improvement and return to the previous function stage.

The Effect of Cervical Stabilization Exercises with Thoracic Spine Extension Exercises on Forward Head Posture

This study was aimed at comparing the effects of cervical stabilization exercises with thoracic spine extension exercises and cervical stabilization exercises with breathing exercises on head posture in subjects with the forward head posture (FHP). FHP is a poor habitual neck posture that is defined by the forward translation of the cervical vertebrae and hyperextension of the upper cervical vertebrae. Continuous FHP adds the load to posterior cervical structures, for instance, ligament, and transforms scapular kinetics and kinematics, and affects the quality of life and activities of daily living. The study included 30 adults with FHP, with 15 participants in each group. The experimental group was asked to perform cervical stabilization exercises with thoracic spine extension exercises, and the control group was asked to perform cervical stabilization exercises with breathing exercises. After 4 weeks of exercise, the changes in head posture (cranial rotation angle and craniovertebral angle) were measured again. Craniovertebral angle and craniovertebral angle were assessed using digital, lateral-view photographs of the subjects in their usual standing postures. The results showed that there was a significant difference between experimental group and control group before and after exercise (p < 0.05). In between-group comparison, there were significant differences noted in craniovertebral angle and cranial rotation angle in the experimental group compared to the control group (p < 0.05). Both two groups affect cranial rotation angle, craniovertebral angle, and postural alignment, but it is believed that cervical stabilization exercises with thoracic spine extension exercises directly affect the thoracic and cervical spines. As a result, cervical stabilization exercises and thoracic spine extension exercises are recommended to improve postural alignment.

Effects of a combination of scapular stabilization and thoracic extension exercises for office workers with forward head posture on the craniovertebral angle, respiration, pain, and disability: A randomized-controlled trial.

Objectives This study aims to investigate how exercise programs not directly applied to the cervical spine affect office workers with forward head posture (FHP). Patients and methods Between March 2018 and June 2018, a total of 32 office workers with FHP (13 males, 19 females; mean age 36.63 years; range, 23 to 57 years) were randomized either to experimental (n=16) or control groups (n=16). Scapular stabilization and thoracic extension exercises were applied to the experimental group and cervical stabilization and stretching exercises to the control group. The results of the pre-intervention and after six weeks measurement of the craniovertebral angle (CVA), respiration, pain, and disability were compared and analyzed. Results For intra-group comparison, both groups showed significant differences (p<0.05) in CVA, forced expiratory volume at 1 sec (FEV1), Visual Analog Scale (VAS), and neck disability index at pre- and post-intervention, while only the experimental group showed a significant difference (p<0.05) in maximum inspiratory pressure, maximum expiratory pressure, and forced vital capacity. For inter-group comparison, a significant difference (p<0.05) between FEV1 and VAS was observed. Conclusion The combination of scapular stabilization and thoracic extension exercises, not directly applied to the cervical spine, has an effect on improving the posture, respiration, neck pain, and disability in office workers with FHP.

The Effects of Cervical Stabilization Exercises with Breathing Exercises on Respiratory Function in Subjects with Forward Head Posture

This study aimed to compare the effects of cervical stabilization exercises with breathing exercises and cervical stabilization exercises with thoracic spine extension exercises on respiratory function in subjects with forward head posture (FHP). The study included 30 adults with FHP. They were divided into two groups—experimental (EG) and control (CG)—with 15 participants in each group. The EG was asked to perform cervical stabilization exercises with breathing exercises, and the CG was asked to perform cervical stabilization exercises with thoracic spine extension exercises. After 4 weeks of exercise, the changes in respiratory function were measured again. The results showed significant differences in the EG before and after exercise in terms of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and forced vital capacity/vital capacity max (FVC/VCmax%) (p &lt; 0.05). The CG showed only a significant increase in FVC, FEV1, and FVC/VCmax% after the experiment (p &lt; 0.05). In the between-group comparison, there were significant differences noted in FVC, FEV1, PEF, and FVC/VCmax% in the EG compared to the CG (p &lt; 0.05). As a result, cervical stabilization exercises with breathing exercises are recommended to promote respiratory function.

Drop-Set Training Elicits Differential Increases in Non-Uniform Hypertrophy of the Quadriceps in Leg Extension Exercise

The study aimed to compare the effects of drop set resistance training (RT) versus traditional RT on markers of maximal muscle strength and regional hypertrophy of the quadriceps femoris. Sixteen recreationally active young men had one leg randomly assigned to the drop-set method (DS) and the other to training in a traditional manner (TRAD). Participants performed unilateral seated leg extensions using a periodized approach for eight weeks. Rectus femoris (RF) and vastus lateralis (VL) muscle thickness (MT), estimated one repetition maximum (RM) in the unilateral knee extension, and peak and average isokinetic knee extension torque at 60°/s angular velocity were measured pre- and post-study. Both conditions increased muscle thickness of the RF and VL from pre- to post-intervention. DS showed statistically greater increases in the RF at 30% and 50% of muscle length, whereas no MT differences were detected at 70% muscle length nor at any aspect of the VL. Both DS and TRAD increased estimated one RM from pre- to post-study (+34.6% versus +32.0%, respectively) with no between-condition differences noted. Both conditions showed similar increases in peak torque (DS: +21.7%; TRAD: +22.5%) and average torque (DS: +23.6%; TRAD: +22.5%) from pre- to post-study. Our findings indicate a potential benefit of the drop-set method for inducing non-uniform hypertrophic gains in the RF muscle pursuant to leg extension training. The strategy did not promote an advantage in improving hypertrophy of the VL, nor in strength-related measures, compared to traditional training.

Comparison of Hamstrings and Quadriceps Femoris Muscle Thickness Increment between Agonist-Antagonist Paired Set and Traditional Set Resistance Training in Untrained Healthy Subjects

Background: Resistance training is an effective way to increase muscle mass. Resistance training with agonist-antagonist paired set method can be an alternative to increase muscle mass within a relatively short training time.Aim: To compare the increase in hamstrings and quadriceps femoris muscle thickness between agonist-antagonist paired set (APS) and traditional set (TS) resistance training in untrained healthy subjects.Material and Methods: This study was an experimental study on 16 untrained healthy men which were randomly assigned to the APS and the TS group. Each group got leg curl and leg extension exercises with equal training volume for 6 weeks. For the APS group, 1 set of leg curls was followed by 1 set of leg extensions, repeated for 3 sets. For the TS group, 3 sets of leg curls were followed by 3 sets of leg extensions. Muscle thickness was compared from pre- to post-training and between the intervention groups using B-mode ultrasound.Results: Muscle thickness of the hamstrings and quadriceps femoris increased significantly from pre- to post-training in both groups (p&lt;0.05). The increase in muscle thickness between the two groups was not significantly different (p&gt; 0.05).Conclusion: Resistance training with the APS method did not give a higher increment of hamstrings and quadriceps femoris muscle thickness compared to the TS method in healthy untrained subjects.

Comparison of Inter- and Intra-Individual Neuromuscular Patterns of Responses During Moderate-Load Bilateral Leg Extension Exercise

Introduction: This study examined the electromyographic (EMG) and mechanomyographic (MMG), amplitude (AMP) and mean power frequency (MPF) responses during bilateral, leg extension exercise performed to failure at a moderate (70% one-repetition maximum [1RM]) load.&#x0D; Methods: Eleven men completed a 1RM and repetitions to failure at 70% 1RM of the leg extension. The EMG and MMG signals were recorded from the right and left vastus lateralis. Polynomial regression analyses were used to determine individual and composite, normalized neuromuscular responses for both limbs.&#x0D; Results: For EMG AMP, both limbs demonstrated positive, quadratic relationships. For EMG MPF, the right limb demonstrated a negative, cubic relationship and the left limb demonstrated a negative, quadratic relationship. For MMG AMP, the right limb demonstrated a positive, quadratic relationship and the left limb demonstrated a positive, linear relationship. For MMG MPF, both limbs demonstrated negative, linear relationships. 18-45% of the subjects demonstrated the same responses as the composite for the EMG and MMG signals. 14% of the subjects demonstrated the same direction and pattern of response for the right and left limb intra-individual responses.&#x0D; Conclusions: The variability in the inter- and intra-individual responses highlight the necessity to report individual neuromuscular responses when examining fatiguing resistance exercise.

Revealing Sex Differences During Upper and Lower Extremity Neuromuscular Fatigue in Older Adults Through a Neuroergonomics Approach.

Background: Sex differences in neuromuscular fatigue is well-documented, however the underlying mechanisms remain understudied, particularly for the aging population. Objective: This study investigated sex differences in fatigability of the upper and lower extremity of older adults using a neuroergonomics approach. Methods: Thirty community-dwelling older adults (65 years or older; 15 M, 15 F) performed intermittent submaximal fatiguing handgrip and knee extension exercises until voluntary exhaustion on separate days. Muscle activity from prime muscles of the hand/arm and knee extensors were monitored using electromyography, neural activity from the frontal, motor, and sensory areas were monitored using functional near infrared spectroscopy, and force output were obtained. Results: While older males were stronger than females across both muscle groups, they exhibited longer endurance times and greater strength loss during knee extension exercises. These lower extremity findings were associated with greater force complexity over time and concomitant increase in left motor and right sensory motor regions. While fatigability during handgrip exercises was comparable across sexes, older females exhibited concurrent increases in the activation of the ipsilateral motor regions over time. Discussion: We identified differences in the underlying central neural strategies adopted by males and females in maintaining downstream motor outputs during handgrip fatigue that were not evident with traditional ergonomics measures. Additionally, enhanced neural activation in males during knee exercises that accompanied longer time to exhaustion point to potential rehabilitation/exercise strategies to improve neuromotor outcomes in more fatigable older adults.

An Uncommon Cause Of Persistent Back Pain In A Dancer

HISTORY: A 16-year-old dancer presented with 3 months of lower back pain that gradually increased with time without any clear inciting events. Pain was greater on the right, worse with extension and relieved with flexion. Quality was sharp and aching without radicular symptoms. PHYSICAL EXAM: Spine alignment was normal. There was no midline, paraspinal, nor SI joint tenderness. Spine flexion was painless. Spine extension, facet loading, and stork test bilaterally provoked pain. Motor strength was grossly 5/5 and sensation was intact at all dermatomes. Faber was positive. DIFFERENTIAL DIAGNOSIS: 1 Spondylolysis 2 Disc herniation 3 Baastrup’s disease 4 Spinous process apophysitis TESTS AND RESULTS: MRI lumbar spine was negative for spondylolysis, spondylolisthesis, and disc herniation. Interspinous bursitis and facet arthropathy were found at L4-5 and L5-S1. FINAL/WORKING DIAGNOSIS: Baastrup’s disease typically affects older adults. However, as this case demonstrates, young athletes who perform repetitive spinal extension such as gymnasts and dancers may also suffer from this. Patients present with midline tenderness, pain exacerbated by extension and relief with flexion. Young athletes may be frustrated by negative workups since few providers actively evaluate for this. Repetitive stress on interspinous ligaments and spinous processes can lead to instability and pain from abutting hypertrophic spinous process and adventitious bursas. In adults, imaging may show approximation and sclerosis of spinous processes. In young athletes, MRIs may show only interspinous bursal fluid. Conservative treatment with rest from spine extension, therapy, and spine flexion exercises has some success. It is difficult to treat in athletes because of the extensive rest time required for bursitis to improve. It may require interventional injections if chronic. TREATMENT AND OUTCOME: NSAIDS were prescribed and dance was modified to avoid spine extension. PT was done for core stabilization and to correct biomechanics. Her pain remained unchanged after 1 year. She completely refrained from dance and continued core strengthening for an additional 2 months before resumption of dance with some improvement. She was offered but deferred injections to the interspinous ligamentous bursa, choosing to continue to modify her dance.

Inter- And Intra-individual Differences In Neuromuscular Responses During Submaximal Leg Extension Exercise

Inter- And Intra-individual Differences In Neuromuscular Responses During Submaximal Leg Extension Exercise

Higher strength gain after hypoxic vs normoxic resistance training despite no changes in muscle thickness and fractional protein synthetic rate.

Acute hypoxia has previously been suggested to potentiate resistance training-induced hypertrophy by activating satellite cell-dependent myogenesis rather than an improvement in protein balance in human. Here, we tested this hypothesis after a 4-week hypoxic vs normoxic resistance training protocol. For that purpose, 19 physically active male subjects were recruited to perform 6 sets of 10 repetitions of a one-leg knee extension exercise at 80% 1-RM 3 times/week for 4weeks in normoxia (FiO2 : 0.21; n=9) or in hypoxia (FiO2 : 0.135, n=10). Blood and skeletal muscle samples were taken before and after the training period. Muscle fractional protein synthetic rate was measured over the whole period by deuterium incorporation into the protein pool and muscle thickness by ultrasound. At the end of the training protocol, the strength gain was higher in the hypoxic vs the normoxic group despite no changes in muscle thickness and in the fractional protein synthetic rate. Only early myogenesis, as assessed by higher MyoD and Myf5 mRNA levels, appeared to be enhanced by hypoxia compared to normoxia. No effects were found on myosin heavy chain expression, markers of oxidative metabolism and lactate transport in the skeletal muscle. Though the present study failed to unravel clearly the mechanisms by which hypoxic resistance training is particularly potent to increase muscle strength, it is important message to keep in mind that this training strategy could be effective for all athletes looking at developing and optimizing their maximal muscle strength.

Acute effects of breaking up sitting time with isometric exercise on cardiovascular health: Randomized crossover trial.

The objective of this study was to analyze the acute effects of breaking up prolonged sitting with isometric exercise on the cardiovascular health of sedentary adults. This is a three-condition randomized crossover trial. The sample was comprised of 17 subjects (11 women; 29±10years old; 25,1±5,1kg/m2 ). The participants completed, in randomized order, three experimental conditions (control, breaks with isometric leg extension exercise, and breaks with walking), with the order of the conditions determined through simple automatic randomization. All the conditions had in common a sitting period of 3h. During the conditions with isometric exercise and walking breaks the participants performed breaks with isometric leg extension exercise and with walking every 30min, while in the control condition they remained seated with no breaks. Before and after this period, vascular function (primary outcome), blood pressure, and cardiac autonomic modulation (secondary outcomes) were measured. Generalized estimated equations were used to analyze the data. The results did not indicate significant interaction effects for vascular function among experimental conditions (p>0,05 for all). We also did not find significant interaction effects for systolic or diastolic blood pressure among the conditions (p>0,05 for all). The heart rate variability parameters did not present significant interaction effects among conditions (p>0,05 for all). In conclusion, breaking up sitting with isometric exercise does not seem to lead to significant effects on the cardiovascular health of sedentary adults.

Comparison of linea alba length and core-muscles engagement during core and lower back orientated exercises

BackgroundA comparison of Linea Alba (LA) length and engagement of the Transverse Abdominis (TrA), External Oblique (EO) and Internal Oblique (IO) between core-orientated and lower back orientated exercises (e.g. glute bridge and hip extension) is lacking. Therefore, the aim of this study was to compare the length of the LA and the engagement of TrA, EO and IO when performing the prone plank, bird dog, dead bug, lateral plank, glute bridge and hip extension. MethodsThirteen apparently healthy participants volunteered to this study. Ultrasound scanning of the anterior and antero-lateral abdominal walls at baseline and whilst performing prone plank, bird dog, dead bug, lateral plank, glute bridge and hip extension exercises was performed. LA length and thickness of the TrA, EO and IO were measured from ultrasound images. ResultsLA length (p = 0.77) and TrA thickness (p = 0.23) were not different between exercises. EO thickness was larger for the lateral plank compared to the bird dog (p = 0.01, d = 1.73), glute bridge (p < 0.01, d = 2.64), and hip extension (p < 0.01, d = 1.89). The dead bug was also larger in comparison to the glute bridge (p < 0.01, d = 2.05) and to the hip extension (p = 0.01, d = 1.45). For the IO thickness, the lateral plank was larger than the bird dog (p = 0.03, d = 1.21) and the dead bug (p = 0.04, d = 1.12). ConclusionNo difference was observed between exercises for the length of the LA or for the thickness of the TrA, which suggests that this muscle is similarly engaged in the assessed exercises, leading to a consistent stretch for the LA.

Volume Reduction: Which Dose is Sufficient to Retain Resistance Training Adaptations in Older Women?

We compared the effects of different resistance training (RT) volume reduction strategies on muscular strength and lean soft-tissue (LST) in older women. Fifty-seven physically independent women (>60 years) performed a 20-week pre-conditioning phase of a standardized whole-body RT program (eight exercises, three sets, 8-12 repetitions, three sessions a week), and were then randomly assigned to one of the following conditions: reduced volume for a single set (RV1, n=20) or two sets (RV2, n=19), or maintained volume of three sets (MV, n=18) for 8 weeks (specific training phase). Muscular strength in the chest press, leg extension, and preacher curl exercises was determined by one-repetition maximum tests. A dual-energy X-ray absorptiometry device was used to estimate LST. An increase in muscular strength (16.3-32.1%) and LST (3.2-7.9%) was observed after the pre-conditioning phase. There was an increase in chest press for all groups (9.4-16.7%) after the specific training phase. In contrast, only MV increased significantly in the leg extension (4.4%). No between-group differences were revealed for LST in the specific training phase. Our results suggest that reduced RT volume from three to one set per exercise for 8 weeks seems sufficient to retain neuromuscular adaptations in older women.

The role of exercise selection in regional Muscle Hypertrophy: A randomized controlled trial

ABSTRACT There is emerging evidence suggesting that muscle growth is not homogeneous through the muscle. The aim of the present study was to analyse the role of exercise selection in regional hypertrophy. Two randomly allocated groups with equal training volume and intensity performed squats in the smith machine (SMTH group) or the leg extension exercise (LEG group). Growth in proximal, central and distal regions of the rectus femoris (RF) and vastus lateralis (VL) muscles, jump height and body composition were analysed. Results show that the three regions of RF grew significantly in the participants of the LEG group (p < 0.05), while only the central region of VL grew significantly in the SMTH group (p < 0.05). In summary, this study confirms that exercise selection plays a role in regional hypertrophy. Whilst there may be still other factors that determine how muscles grow, it seems that the chosen exercises may be responsible of the differences observed in this study.

The effect of leg preference on mechanical efficiency during single-leg extension exercise.

To investigate how leg preference affects net efficiency (ηnet), we examined central and peripheral hemodynamics, muscle fiber type, activation and force of preferred (PL) and nonpreferred (NPL) leg. Our hypothesis was that PL greater efficiency could be explained by adaptations and interactions between central, peripheral factors, and force. Fifteen young participants performed single-leg extension exercise at absolute (35 W) and relative [50% peak power-output (Wpeak)] workloads with PL and NPL. Oxygen uptake, photoplethysmography, Doppler ultrasound, near-infrared-spectroscopy deoxyhemoglobin [HHb], integrated electromyography (iEMG), maximal isometric force (MVC), rate of force development (RFD50-100), and muscle biopsies of both vastus lateralis were studied to assess central and peripheral determinants of ηnet. During exercise executed at 35 W, ηnet was 17.5 ± 5.1% and 11.9 ± 2.1% (P < 0.01) in PL and NPL respectively, whereas during exercise at the 50% of Wpeak was in PL = 18.1 ± 5.1% and in NPL = 12.5 ± 1.9 (P < 0.01). The only parameter correlated with ηnet was iEMG, which showed an inverse correlation for absolute (r = -0.83 and -0.69 for PL and NPL) and relative workloads (r = -0.92 and -0.79 for PL and NPL). MVC and RFD50-100 were higher in PL than in NPL but not correlated to ηnet. This study identified a critical role of leg preference in the efficiency during single-leg extension exercise. The whole spectrum of the central and peripheral, circulatory, and muscular determinants of ηnet did not explain the difference between PL and NPL efficiency. Therefore, the lower muscle activation exhibited by the PL is likely the primary determinant of this physiological phenomenon.NEW & NOTEWORTHY This study examined the impact of leg preference on efficiency during single-leg exercise. The results revealed lower efficiency of the nonpreferred leg during exercises performed at absolute and relative workloads. Central (cardiac output) and peripheral (fiber typing) determinants of efficiency did not explain the difference between the legs. However, the lower muscle activation of the preferred leg that was inversely correlated with efficiency is likely the primary determinant of this physiological feature.

Effects of knee extension exercise starting within 4h after total knee arthroplasty.

To determine the beneficial effects of knee extension exercise applied from 4h after TKA. Patients undergoing TKA for osteoarthritis were assigned to early rehabilitation (n = 41) and control rehabilitation (n = 39) groups. Rehabilitation of knee extension exercise was started within 4h postoperative in the early group and 2days after surgery in the control group. Joint range of motion and pain were assessed before surgery and at 3days to 12months after surgery. Muscle strength and gait parameters were assessed before and 3weeks after surgery. Extension range of motion was significantly increased in the early group than the control at 3days, 3weeks and 6months after surgery. In gait parameters, peak knee flexion and extension angles during stance phase were significantly improved in the early group than the control group at 3weeks after surgery. Flexion range of motion was increased in the early group than the control at 12months after surgery. Starting knee extension exercise within 4h after TKA reduced the early loss of extension range of motion and improved gait pattern and seemed to contribute to be better functional outcome one year after surgery.

The Effect of Back Extension Exercise on H Reflex in Patients with Lumbosacral Radiculopathy

Background: McKenzie back extension exercises from prone position has been widely prescribed forpatients with lumbosacral radiculopathy (LSR). It has been reported to reduce radicular symptoms. Suchreduction might indicate that decompression effect of this exercise on the compromised nerve root. The aimof this study was to evaluate the effect of McKenzie back extension exercise from prone position on soleusH-reflex of patients with LSR.Patient and Method: Seventeen male and Thirteen female patients (46.27±10.13 years) with confirmedchronic unilateral LSR participated in the study. All patients had done thirty repetitions of McKenzieback exercise from prone position. The soleus H-reflex was measured before and after the exercise. TheHreflex was elicited by electrical stimulation of the tibial nerve on the popliteal fossa of each legs. Thenon-involved leg of the patient was used as a control. Subjective pain intensity and sit-to-stand performancewere additionally measured before and after back extension exercise using numerical pain analog scale anda stopwatch respectively.Results: The H-reflex latency within the affected leg showed significant difference after the exercise (p&lt;0.05). The pain intensity and the sit-to-stand test had shown significant changes following exercise (p &lt;0.05).Conclusion: This study could indicate that the McKenzie repeated back extension exercises the mannerperformed in this study had improved the H-reflex, pain intensity or functional level of the patients.

Small Finger Flexor Tendon Rerupture Occurred 4 Months after Tendon Graft Surgery: A Case Report

Case report: A right-handed man in his 60s sustained a subcutaneous rupture of the flexor tendon of the left small finger while playing golf. At one month after the injury, a bridge tendon graft was performed using the ipsilateral palmaris longus tendon. A dorsal extension block splint was fabricated the day after surgery, and early mobilization programs were initiated. Referring to previous reports, active finger flexion and extension exercises were performed under wearing the splint until 4-6 postoperative weeks, and full power grip was not allowed until 12 postoperative weeks. However, at 16 postoperative weeks, the moment he swung a golf club, the tendon rerupture occurred. Discussion: No studies have been reported on rerupture after 12 postoperative weeks. The author considered three factors of tendon rerupture. Firstly, it is weakening of the tendon due to steroid injection. Secondly, it is delayed tendon healing due to blood flow disturbance caused by synovial hyperplasia. Thirdly, it is the stress on the small finger flexor tendon of swinging a golf club. Conclusion: Therapists need to plan rehabilitation programs based on analysis of not only past reports but the patients’ background and lifestyle.

Effectiveness of Spinal Mobilization with Leg Movement Versus McKenzie Back Extension Exercises in Lumbar Radiculopathy

Background: Lumbar Radiculopathy is characterized as radiating pain along with some sensory and motor deficits in lower back and hip into the leg. Manual therapy techniques like Spinal mobilization with leg movement and McKenzie Extension exercise seems to be effective in treating and managing the symptoms associated with Radiculopathy. Aim: To make comparison between effects of Spinal mobilization with leg Movement versus McKenzie Extension exercise to manage the Lumbar Radiculopathy. Methods: The present Randomized Control Trial included 60 patients of age 28-50 years with Lumbar radiculopathy were grouped into two by sealed envelope method; the first group (A) was Experimental Group, while the other group (B) was the control Group and were selected from City hospital Multan from February 2018 to June 2018. The study participants were requested to complete the protocol for 4 weeks (3 days per week, 30 repetitions in one session). All the subjects were examined before and after the tests, for pain intensity (NPRS), functional Mobility measured by MODI and range of motion by goniometry. Results: Results of the study showed significant decrease in pain intensity on NPRS (P&lt; 0.05) and MODI Scoring (P&lt;0.05) with noticeable improvement in Functions and range of motion measured by Goniometry. (Readings were taken at 1st session and at the end of the completion of the session). Pain was equally reduced in both groups while improvement in MODI scoring and Range of motion was more significant in experimental group (A) with respect to the control group (B). Conclusion: Study showed that both techniques SMWLW and McKenzie Extension Exercises were effective in improving the pain, decreasing the severity and MODI Scoring while SMWLM is more effective in improving range of motion. Keywords: Lumbar Radiculopathy, Spinal mobilization with leg movement, McKenzie Extension Exercises