Early Strengthening Versus Stretching after Surgical Management of Disc Prolapse and its Relation with Daily Activities

Abstract

Background and purpose: Injuries to the intervertebral discs of the lumbosacral spine are invoked as a causative factor in one of the most common health problems. This study was conducted to evaluate two training programs, both of which started immediately after lumbar surgery. Subjects and methods: The study included fourty patients, age ranged from 25 to 40 year and divided into two groups. The first group with mean age 30.2±4.79 years followed a physical therapy program of exercises in the form of strengthening exercises for back, gluteus maximus and abdominal muscles with postural instructions, three sessions per week for 6 weeks. The second group with mean age 31.8±5.23 years, submitted to a physical therapy program of exercises in the form of isolated stretching of back muscles, and hamstrings muscles; and strengthening exercises for the abdominal muscles with postural instructions, three sessions per week for 6 weeks. Outcome measures were lateral view of loading x-ray, to detect any change in lordotic curve by measuring lumbo-sacral angle (LS), tape measurement to detect range of motion of trunk flexion, and visual analogue scale to measure the pain. Results: There was a significant difference in the first group (t of pain = 0.005, t of ROM = 0.009, but no significant difference in L.S angle where t = 0.04) than in the second group, there was a significant difference in pain, t = 0.01, but no significant difference in relation to ROM, where t = 0.06, and L/S angle where t = 0.07. Discussion and Conclusion: This study showed that patients rehabilitated according to the early stretching exercise is better than strengthening exercises in pain and ROM, and both of them had no effect on L/S angle which is the pathomechanics after surgical management of disc prolapse patients.