A biomechanical study of intervertebral foraminal narrowing during simulated automotive head-forward and head-turned rear impacts. The objective of this study was to quantify foraminal width, height and area narrowing during head-forward and head-turned rear impacts, and evaluate the potential for nerve root and ganglion impingement. Muscle weakness and paresthesias, documented in whiplash patients, have been associated with neural compression within the cervical intervertebral foramen. Rotated head posture at the time of rear impact has been correlated with increased frequency and severity of chronic radicular symptoms, as compared to facing forward. No studies have quantified dynamic changes in foramen dimensions during head-forward or head-turned rear impacts. Six whole cervical spine specimens with muscle force replication and surrogate head underwent simulated whiplash at 3.5, 5, 6.5 and 8 g, following non-injurious baseline 2 g acceleration. Continuous dynamic foraminal width, height and area narrowing were recorded, and the peaks were determined during each impact and statistically compared to baseline narrowing. During head-forward rear impacts, significant increases (P<0.05) in average peak foraminal width narrowing above baseline were observed at C5-C6 beginning with 3.5 g impact. No significant increases in average peak foraminal height narrowing were observed, while average peak foraminal areas were significantly narrower than baseline at C4-C5 at 3.5, 5 and 6.5 g. During head-turned rear impacts, significant increases (P<0.05) in average peak foraminal width narrowing above baseline of up to 1.8 mm in the left C5-C6 foramen at 8 g were observed. Average peak dynamic foraminal height was significantly narrower than baseline at right C2-C3 foramen at 5 g and 6.5 g, while no significant increases in foraminal area were observed. Extrapolation of the present head-forward rear impact results indicated that the greatest potential for ganglia compression injury was at the lower cervical spine, C5-C6 and C6-C7. The present head-turned rear impact results indicated that the greatest potential ganglia compression injury exists at C5-C6 and C6-C7. Greater potential for ganglia compression injury exists at C3-C4 and C4-C5 due to head-turned rear impact, as compared to head-forward rear impact. Acute ganglia compression may produce a sensitized neural response to repeat compression leading to chronic radiculopathy following head-forward and head-turned rear impacts. Dynamic ganglion or nerve root compression may also lead to chronic radiculopathy.

Philosophiae Doctor - PhD / Lumbo-sacral radiculopathy (LSR) is clinically defined as low back and referred leg symptoms accompanied by an objective sensory and/or motor deficit due to nerve root compromise. LSR is a common condition encountered by physiotherapists in clinical practice and the assessment and diagnosis remains a challenge owing to the complex anatomy of the lumbo-sacral spine segment and the various differentials. Moreover, LSR imposes a significant impact on patients’ health, functional ability, socio-economic status and quality of life. There are several diagnostic tools and procedures which are commonly utilised in practice, including diagnostic neuropathic pain screening questionnaires, clinical neurological tests, electro-diagnostics and imaging. However, the diagnostic utility and correlation of these tests have not been fully explored and remains debatable among clinicians and researchers in the fields of musculo-skeletal health and neurology. The aim of this study was to determine a correlation of the S-LANSS score, clinical neurological examination (CNE) findings and magnetic resonance imaging (MRI) reports in the diagnosis of LSR among patients who presented with low back and referred leg symptoms. The study was conducted in three phases. In phase one, two systematic literature reviews were conducted; firstly, to establish the evidence-based accuracy of CNE in diagnosing LSR, and secondly, to establish the evidence-based accuracy of MRI in diagnosing LSR. In both systematic literature reviews, the diagnostic tests accuracy (DTA) protocol was used in planning, design and execution of literature search, selection of relevant studies, quality assessment, data analysis and presentation of the results. In phase two, clinical validation of an adopted S-LANSS scale and lumbar MRI reporting protocol were established, and a standardised evidence based lumbar CNE protocol developed.The face and content validity of the original S-LANSS score was established among a sample of Kenyan physiotherapists and patients who presented with low back and referred leg symptoms, using both quantitative and qualitative research designs. This was followed by a test-re-test reliability study on the adapted version of the S- LNASS score. The face and content validity of the adopted lumbar MRI reporting protocol was established among a sample of Kenyan radiologists followed by an inter-rater reliability. An evidence-based lumbar CNE protocol was developed; standardised and inter-examiner reliability was also examined among a sample of Kenyan physiotherapists. Finally, in phase three, a cross-sectional blinded validity study was conducted in six different physiotherapy departments. Participants (patients, physiotherapists and radiologists) were recruited using strict in- and exclusion criteria and data was collected using a pain and demographic questionnaire, the S-LANSS scale, the CNE protocol, the Oswestry Disability Index (ODI) and the MRI lumbar spine reporting protocol. Data was captured, cleaned and analysed using SPSS version 21. Descriptive analysis was done using frequencies, means and percentages, while inferential analysis was conducted using Spearman’s rank correlation coefficient test r to establish the correlation between the diagnostic tests. Cross tabulations, receiver operating curves (ROC) and scatter plots were used to establish the sensitivity and/or specificity of S-LANSS scale and individual CNE tests as defined by MRI. In phase three, which formed the main study of the research project, a total of 102 participants were recruited in this study with a gender distribution of 57% females and 43% males. The majority (67%) had neuropathic pain according to the S-LANSS scale and their pain intensity ranged from moderate (4-6) to severe (7-9) as recorded on a Numeric Pain rating Scale (NPRS), and was more common among manual workers. Similarly, patients whose pain had a neuropathic component had moderate to severe disability. The S-LANSS scale and lower limb neuro-dynamic tests were the most sensitive tests 0.79 and 0.75 respectively, while deep tendon reflexes were the most specific tests (0.87). The S-LANSS and CNE correlated fairly but significantly with MRI (r=0.36, P=0.01).LSR is a common condition and its assessment and diagnosis remains a clinical challenge among physiotherapists. MRI is a high-cost diagnostic tool but is being used by many clinicians in making decisions regarding the management of patients. Rapid and low-cost neuropathic pain screening by the use of the S-LANSS scale, together with use of evidence-based CNE of neuro-conduction and neuro-dynamic tests may be used in confirming nerve-root related MRI findings. These may be used in making a decision on whether to manage a patient conservatively using pharmacological agents and manual physiotherapy and therapeutic exercise, or consider surgery in the initial management of patients with clinical suspicion of LSR. This is especially valuable in the resource-poor settings like Kenya and other sub-Saharan African countries where MRI is costly or unavailable.

Šiame darbe tirta skirtingų kineziterapijos metodikų vandenyje įtaka radikulopatiniam juosmens skausmui. Juosmeninės stuburo dalies struktūrinių ir funkcinių pakitimų sukeltas skausmas – tai multifaktorinė patologija, dėl kurios gydymo vieningos nuomonės kol kas nėra. Šiuo metu pagrindinė medicinos užduotis – efektyviai kontroliuoti skausmą ir kuo greičiau grąžinti sutrikusias funkcijas, kad žmogus vėl būtų darbingas. Tokios užduoties įgyvendinimui pasitelkiamos įvairios priemonės, nuo medikamentų iki chirurginių intervencijų. Pastaruoju metu išskirtinis dėmesys skiriamas reabilitacijai, pabrėžiant kineziterapijos svarbą. Moksliniuose straipsniuose vyrauja nuomonė, kad ypa����� efektyvi gydant patologinių stuburo pakitimų sukeltą skausmą yra kineziterapija vandenyje. Juose minimos įvairios vandenyje naudojamos metodikos, tačiau tiek užsienio, tiek lietuvių autorių šaltiniuose nebuvo išskirtinai pabrėžiamas vienos ar kitos metodikos pranašumas. Šio darbo tikslas – nustatyti tempimo-atsipalaidavimo ir stabilumo-jėgos pratimų įtaką radikulopatiniam juosmens skausmui. Tyrimo metu buvo vertinama skirtingų metodikų įtaka pacientų funkciniam pajėgumui, bei tiesios kojos kėlimo testo rezultatams. Taip pat stebimas trumpalaikis ir ilgalaikis kineziterapijos vandenyje poveikis radikulopatiniam juosmens skausmui. Pagal pradinę hipotezę buvo manoma, kad tempimo-atsipalaidavimo pratimai turėtų labiau įtakoti radikulopatinį juosmens skausmą negu stabilumo-jėgos pratimai. Atlikus... [toliau žr. visą tekstą] / This paper describes research of different aquatic physiotherapy programs on the low back pain with radiculopathy. The pain of low back that is induced by structural and functional changes is multifactorial pathology that doesn’t have a unique treatment opinion. Nowadays the main task of medicine is to control the pain effectively and to restore disordered functions. In order to realize such task different treatment means are invoked, such as medicaments, surgery and etc. Nowadays preferential treatment is appointed to rehabilitation, especially physiotherapy. The dominant research opinion proposes that physical therapy in the water is very effective treatment of the pathological low back pain. It is mentioned a lot of methods used in the water, but there isn’t excluded any advantages of one or another method. The main task of this research is to define the influence of two different physical therapy methods in water to the low back pain with radiculopathy. There is estimated influence of different physical therapy methods to the functional ability and straight leg test results. There is also observed short-term and long-term physical therapy influence to the low back pain with radiculopathy. In primary hypothesis there is considered that stretching-relaxing exercises should have more impact for low back pain than stability–strength exercises. The result of the research showed that both physical therapy methods are effective in the low back pain treatment. Significant... [to full text]

Background: Neck pain is a major public health with great effects on both the individual and society. Cervical radiculopathy is a relatively common form of neck pain with neurological symptoms. Physical therapy is often the first treatment but there is paucity in literature reviews investigating the effects of physical therapy. Objective: To assess the effects of physical therapy for cervical radiculopathy. Methods: A literature search was conducted in PubMed, CINAHL, PEDro and Web of Science. A total of 12 RCT articles were included in the study. The articles were reviewed based on the aims of the study and the PEDro scale. Results: Eight studies of moderate quality and four high quality. Most studies used the same outcome measures. Most common interventions were traction and manual therapy. Outcomes were varied with some reporting positive effects and others no change. Treatment periods, number of sessions and follow-up varied. In most cases, the positive results wore off at follow-up and differences between groups less pronounced. Conclusions: The quality of RCTs investigating cervical radiculopathy is variable. There is limited evidence suggesting that physical therapy treatment can have a measurable and significant long-term effect on cervical radiculopathy. / Bakgrund: Nacksmärta är ett allvarligt folkhälsoproblem med stor effekt på både den enskilde och samhället. Cervikal radikulopati är en relativt vanlig form av nacksmärta med neurologiska symtom. Fysioterapi är ofta den första behandlingen för detta tillstånd men det är brist på litteraturstudier som undersöker fysioterapins effekter. Syfte: Att undersöka effekterna av fysioterapi för cervikal radikulopati. Metod: Litteratursökningar gjordes i PubMed, CINAHL, PEDro och Web of Science. Totalt inkluderades 12 RCT artiklar i studien. Artiklarna granskades utifrån studiens frågeställningar samt PEDro kvalitetsgranskningsmall. Resultat: Åtta studier var av måttlig kvalitet och fyra hög kvalitet. De flesta studier använde samma utfallsmått och alla uppmätte smärta, funktionshinder och funktion. De två vanligaste behandlingarna var traktion och manuell terapi. Resultaten av insatserna varierade då vissa rapporterade positiva effekter och andra ingen förändring. Behandlingsperioder, antal sessioner samt uppföljning varierade. I de flesta fall, så avtog de positiva resultaten vid uppföljning och skillnaden mellan grupperna blev mindre uppenbara. Konklusion: Denna litteraturöversikt påvisade att kvaliteten på de RCT studier som undersöker cervikal radikulopati varierar. Resultaten visar att det finns begränsad evidens som tyder på att fysioterapi kan ha en mätbar och betydande inverkan på cervikal radikulopati i längden.

ABSTRACT Whiplash associated disorders (WAD) is one of the most debated musculoskeletal conditions. Sensory disturbances including hypersensitive responses to mechanical, thermal and electrical stimulation have been consistently shown to be a feature of both the acute and chronic stages of the whiplash condition. More importantly, such dysfunctions have also been found to be associated with higher risk of poor functional recovery. It is apparent that better understanding of the sensory disturbances in WAD is needed in order to elucidate mechanisms underlying the pain and disability of this recalcitrant condition and to facilitate the development of more effective management strategies. Comprehensive Quantitative Sensory Testing (QST) combining sensory detection and pain threshold measures is proving to be a valuable tool to advance the classification and illuminating the underlying mechanisms of an array of musculoskeletal pain disorders but such protocol has never been undertaken in a WAD cohort. In order to fill this gap in knowledge, the series of studies in the thesis aimed to utilize comprehensive QST to investigate the presence of somatosensory dysfunction in chronic WAD and to compare the somatosensory profile of WAD to cervical radiculopathy and idiopathic (non-traumatic) neck pain. Once a better understanding of the potential underlying mechanisms in chronic WAD was established, the research then focused on documenting the presence of such somatosensory disturbances soon after whiplash injury and its temporal development over a 6 months period. The results have provided a number of significant insights into some of the potential underlying mechanisms of the somatosensory dysfunction in WAD as well as other neck pain conditions of different aetiology. It is clear that generalised sensory hypoaesthesia coexisted with sensory hypersensitivity in chronic WAD and a combination of pain and detection measures best discriminated patients with WAD and controls. Similar sensory presentation was also found in patients with cervical radiculopathy but not in idiopathic neck pain patients. This finding indicates that different mechanisms underlie various musculoskeletal conditions with disordered central processes contributing to a greater degree in some conditions. Patients with whiplash and those with cervical radiculopthy may share similar underlying pain mechanisms involving the central nervous system and the discrepant findings in the idiopathic neck pain group may be due to the magnitude of nociceptive input required to induce/maintain altered central adaptive changes. Another important observation from the studies was that sensory hypoaesthesia was present in the majority of patients with whiplash injury in the acute stage. However, it persisted only in individuals who initially reported higher levels of pain and disability levels and sign of hypersensitivity. It was this group of individuals who predominantly developed persistent symptoms at six months post injury. The longitudinal findings indicate that such sensory impairments can be identified very early on and treatment interventions directed at these sensory disturbances (both sensory hypersensitivity and hypoaesthesia) should aim to reduce the nociceptive input and this may improve recovery post whiplash injury. The findings in this thesis demonstrated the clear association between sensory hypersensitivity and other sensory disturbances and their potential influence on recovery. Furthermore, the heterogeneity of the whiplash condition highlighted the importance of the early identification of “low-risk and “high-risk” patients in order to assist the clinicians to make clinical decisions on the best management approach. It cannot be overemphasised that the early assessment of whiplash injured patients should aim to identify features associated with poor recovery and a better classification system will be an important step. Implications for assessment and management of whiplash are vital in the acute stage of injury and may well go some way toward preventing the transition to chronicity, particularly in those with a more complex clinical presentation involving somatosensory disturbances. Further research directions have also been identified in order to improvement management of this complex clinical condition.

Tyrimo problema: Juosmeninės stuburo dalies radikulopatija yra vienas iš labiausiai paplitusių sveikatos sutrikimų. Radikulopatijos metu juosmens srityje jaučiamas skausmas, mažėja stuburo paslankumas, vystosi neurologiniai sutrikimai, funkcinė negalia, pacientai tampa nedarbingi. Pakitusi sveikatos būklė – nemažai finansinių išlaidų reikalaujanti problema. Šiame darbe analizuojama, kaip kineziterapijos pratimai ir pratimai su „Red-cord” įranga veikia darbingo amžiaus žmonių nugaros skausmo intensyvumą ir funkcinę būklę. Tyrimo objektas: Skausmo ir funkcinės būklės pokyčiai taikant pratimus su „Red-cord” įranga. Tikslas: Įvertinti pratimų su „Red-cord” įranga veiksmingumą esant juosmeninės stuburo dalies radikulopatijai. Tyrimo uždaviniai: 1. Įvertinti kineziterapijos be įrangos poveikį tiriamųjų skausmo intensyvumui ir funkcinei būklei. 2. Įvertinti pratimų su „Red-cord” įranga poveikį tiriamųjų skausmo intensyvumui ir funkcinei būklei. 3. Palyginti kineziterapijos be įrangos ir pratimų su „Red-cord” įranga poveikį. Išvados: 1. Tiriamiesiems, kurie atliko kineziterapijos pratimus be įrangos, skausmo intensyvumas, nervinių šaknelių spaudimo požymis ir funkcinė negalia sumažėjo, o stuburo paslankumas ir liemens raumenų statinė ištvermė padidėjo. 2. Tiriamiesiems, kurie atliko pratimus su „Red-cord” įranga, skausmo intensyvumas, nervinių šaknelių spaudimo požymis ir funkcinė negalia sumažėjo, o stuburo paslankumas ir liemens raumenų statinė ištvermė padidėjo. 3. Pratimai su... [toliau žr. visą tekstą] / Problem of study: Radiculopathy of the lumbar spine is one of the most common illnesses. Patients with radiculopathy of lumbar spine feel pain in the lumbar area of the spine, the mobility of spine decreases, neurologic disorders are developing, patients become invalid. Back pain becomes not only health’s, but also an economical problem. In this study there will be analyzed, how common physical therapy exercises and exercises with the “Red-cord” equipment will affect back pain intensity and functional condition of working–age people. Object of study: Changes of pain and functional condition performing exercises with „Red-cord“ equipment. Aim of the study: Evaluate the effectiveness of exercises with „Red-cord” equipment for patients with spinal lumbar radiculopathy. Goals of study: 1. To assess the effect of physical therapy on pain intensity and functional condition for the patients. 2. To assess the effect of exercises with “Red-cord” equipment on pain intensity and functional condition for the patients. 3. To compare the effect of physical therapy exercises with and without “Red-cord” equipment. Conclusions: 1. For the subjects, who performed physiotherapy without equipment, pain intensity, neurological symptoms and negative effect on every day activity significantly decreased, and spine mobility together with muscle static endurance significantly increased. 2. For the subjects, who performed exercises on “Red-cord” equipment, pain intensity, neurological symptoms... [to full text]

Tyrimo objektas: lazerio terapijos poveikis. Tyrimo problema: Šiuo metu auga tyrimų poreikis, kurie mažintų individualią bei socialinę naštą esant stuburo kaklines dalies radikulopatijai, todėl mums yra būtina surasti efektyviausią kaklinės stuburo dalies radikulopatijos gydymo programą, techniką ar metodą (Gross et al., 2007). Daugumoje mokslinių straipsnių, kuriuose vertinamas fizikinių veiksnių poveikis kaklinės stuburo dalies radikulopatijos gydymui, teigiama, kad trūksta tyrimų su placebo efektu, kurie pateiktų dar tikslesnių rezultatų gydymo programų efektyvumui įvertinti (Leaver et al., 2010). Hipotezė: Esant kaklinės stuburo dalies radikulopatijai, pacientams, kuriems taikyta lazerio terapija, reabilitacija turėtų būti efektyvesnė, nei pacientams, kuriems taikytas placebo efektas. Tyrimo tikslas: Įvertinti lazerio terapijos poveikį skausmo intensyvumui ir kaklinės stuburo dalies judėjimo funkcijai esant kaklinės stuburo dalies radikulopatijai. Tyrimo uždaviniai: 1. Įvertinti lazerio terapijos, kineziterapijos bei masažo poveikį skausmo intensyvumui ir kaklinės stuburo dalies judėjimo funkcijai esant kaklinės stuburo dalies radikulopatijai. 2. Įvertinti placebo efekto, kineziterapijos bei masažo poveikį skausmo intensyvumui ir kaklinės stuburo dalies judėjimo funkcijai esant kaklinės stuburo dalies radikulopatijai. 3. Palyginti lazerio terapijos ir placebo efekto poveikį skausmo intensyvumui ir kaklinės stuburo dalies judėjimo funkcijai esant kaklinės stuburo dalies... [toliau žr. visą tekstą] / The object of the research: laser therapy effect. Problem of the research: Demand for research to reduce individual and social burden in upper cervical spine radiculopathy is currently growing, so it is necessary for us to identify the most effective cervical spine radiculopathy treatment program, technique or method (Gross et al., 2007). In many scientific articles that evaluate physical factors effects on upper cervical spine radiculopathy treatment it is stated a lack of studies using placebo effect that would provide even more accurate results to evaluate the effectiveness of treatment programs (Leaver et al., 2010). Hypothesis: In upper cervical spine radiculopathy rehabilitation of the patients undergoing laser therapy should be more effective than rehabilitation of the patients treated with placebo effect. Aim of the research: To evaluate laser therapy effect on pain intensity and upper cervical spine motor function in upper cervical spine radiculopathy. Tasks of the research: 1. To evaluate effect of laser therapy, physical therapy and massage on pain intensity and upper cervical spine motor function in upper cervical spine radiculopathy. 2. To evaluate effect of placebo, physical therapy and massage on pain intensity and upper cervical spine motor function in upper cervical spine radiculopathy. 3. To compare effects of laser therapy and placebo on pain intensity and upper cervical spine motor function in upper cervical spine radiculopathy. Research organization and... [to full text]

<p>Uvod: Radikulopatija je obično praćena bolovima i drugim senzornim i motornim poremećajima, uz smanjenje kvaliteta života u različitom obimu. Algometrija kao visokosenzitivna metoda pruža objektivan uvid u stepen bola, dok se upotrebom upitnika na jednostavan način mogu proceniti karakteristike bola i biopsihosocijalni status pacijenta. Cilj: Istraživanje je sprovedeno kako bi se izmerili prag bola i prag tolerancije na bol kod pacijenata sa cervikalnom i lumbalnom radikulopatijom i utvrdila moguća povezanost bola sa biopsihosocijalnim faktorima. Materijal i metode: Studijom je pre započinjanja i posle zavr&scaron;avanja terapijskog ciklusa ispitano 60 pacijenata sa dijagnostikovanom cervikalnom radikulopatijom (30 mu&scaron;karaca i 30 žena) i 60 pacijenata sa dijagnostikovanom lumbalnom radikulopatijom (30 mu&scaron;karaca i 30 žena). Svi pacijenti su bili hospitalno lečeni u okviru Klinike za medicinsku rehabilitaciju, Kliničkog centra Vojvodine u Novom Sadu, a terapijski ciklus je u proseku trajao 14-21 dan. U istraživanju su kori&scaron;ćenitest za detekciju bola (Pain Detect Test), kratki upitnik o bolu (Brief Pain Inventory), indeks onesposobljenosti zbog bolova u vratu (Neck Disability Index), Kvebekova skala onesposobljenosti kod lumbalnog sindroma (Quebec Back Pain Disability Scale), bolnička skala za anksioznost i depresiju (Hospital Anxiety and Depression Scale), upitnik za procenu prisustva straha od fizičke aktivnosti/posla i njihovog izbegavanja (The Fear-Avoidance Beliefs Questionnaire)&nbsp; i skala katastrofizma bola (Pain Catastrophizing Scale). Rezultati: Nije uočena statistički značajna razlika algometrijskih vrednosti između pacijenata sa cervikalnom radikulopatijom i pacijenata sa lumbalnom radikulopatijom. Ustanovljeno je da osobe ženskog pola imaju niži prag bola i nižu toleranciju na bol od osoba mu&scaron;kog pola. Poređenjem algometrijskih vrednosti pre započinjanja i posle zavr&scaron;avanja terapijskog ciklusa zapaža se da je program rehabilitacije povoljno uticao na pacijente sa lumbalnom radikulopatijom, dok je kod pacijenata sa cervikalnom radikulopatijom do&scaron;lo do pogor&scaron;anja tegoba. Prisutna je negativna korelacija između vrednosti izmerenih algometrom i skorova za anksioznost, depresiju i strah od fizičke aktivnost i posla, &scaron;to znači da biopsihosocijalni faktori u velikoj meri utiču na bolnost. Zaključci: Kvantifikovanje i mapiranje bola uz pomoć algometra i utvrđivanje biopsihosocijalnog statusa putem upitnika će omogućiti primenu adekvatne terapije kod pacijenata, koja je zasnovana na individualnom pristupu. Istovremeno bi primenjenom metodologijom bila postignuta bolja verifikacija rezultata rehabilitacionog programa.</p> / <p>Introduction: Radiculopathy is usually accompained by pain and other sensory and motor disorders, with reducing the quality of life in different extent. Algometry as a highly sensitive method provides objective insight into the degree of pain, while the use of questionnaires in a simple way can estimate the characteristics of pain and the patient&#39;s biopsychosocial status. Objective: The study was conducted in order to measure the pressure pain threshold and pressure pain tolerance threshold in patients with cervical and lumbar radiculopathy and found a possible association of pain with the biopsychosocial factors. Materials and methods: The study examined 60 patients with cervical radiculopathy (30 men and 30 women) and 60 patients with lumbar radiculopathy (30 men and 30 women) before starting and after finishing treatment cycle. All patients were hospitalized in the Clinic for Medical Rehabilitation, Clinical Center of Vojvodina in Novi Sad, and a treatment cycle lasted an average of 14-21 days. Research was conducted using Pain Detect Test, Brief Pain Inventory, Neck Disability Index, Quebec Back Pain Disability Scale, Hospital Anxiety and Depression Scale, The Fear-Avoidance Beliefs Questionnaire and Pain Catastrophizing Scale. Results: There was no statisticallly significant difference in algometric values between patients with cervical radiculopathy and patients with lumbar radiculopathy. It was found that females have a lower pressure pain threshold and lower tolerance to pain than males. Comparing algometric values before starting and after finishing treatment cycle can be noted that the program of rehabilitation favorable influence on patients with lumbar radiculopathy, while in patients with cervical radiculopathy occured deterioration in subjective symptoms. There is a negative correlation between values measured by algometer and scores for anxiety, depression and fear of physical activity and work, which means that biopsychosocial factors greatly affect the pain. Conclusions: Quantification and mapping the pain by algometer and determination of biopsychosocial status through questionnaires will provide the implementation of appropriate therapy for patients, which is based on individual approach. At the same time, the applied methodology would be achieved better verification of the results in rehabilitation program.</p>

Tyrimo problema: nugaros skausmai — pagrindinė nedarbingumo ir negalios priežastis industrinėje visuomenėje. Sergant juosmens-kryžmens radikulopatija, kamuoja skausmas, apsunkinama kasdieninė veikla, mažėja pilvo ir nugaros raumenų jėga ir ištvermė. Siekdami padėti spręsti šią problemą, analizavome, kaip tradicinė kineziterapijos programa ir fiziniai pratimai su TerapiMaster įranga veikia darbingo amžiaus žmonių, sergančių juosmens-kryžmens radikulopatija, pilvo ir nugaros raumenų statinę ištvermę, skausmo intensyvumą bei jo įtaką kasdieninei žmogaus veiklai. Tyrimo objektas: skausmo, raumenų ištvermės ir nugaros skausmų įtakos tiriamųjų kasdieninei veiklai kaita, taikant skirtingas kineziterapijos programas. Tyrimo tikslas: palyginti tradicinės kineziterapijos ir pratimų su TerapiMaster įranga poveikį asmenims, sergantiems juosmens-kryžmens radikulopatija. Tyrimo uždaviniai: 1. Įvertinti tradicinės kineziterapijos poveikį tiriamųjų skausmo intensyvumui ir kasdieninei veiklai. 2. Įvertinti tradicinės kineziterapijos poveikį tiriamųjų pilvo ir nugaros raumenų statinei ištvermei. 3. Įvertinti pratimų su TerapiMaster įranga poveikį tiriamųjų skausmo intensyvumui ir kasdieninei veiklai. 4. Įvertinti pratimų su TerapiMaster įranga poveikį tiriamųjų pilvo ir nugaros raumenų statinei ištvermei. 5. Palyginti abiejų kineziterapijos metodų poveikį. Išvados: 1. Po 16 tradicinės kineziterapijos procedūrų tiriamųjų skausmo intensyvumas ir neigiama nugaros skausmo įtaka kasdieninei... [toliau žr. visą tekstą] / Problem of study: low back pain is the main cause of absenteeism and disability in every industrialized society. People, who have lumbar-sacral radiculopathy, suffer from pain, it becomes hard for them to perform daily activities, and the abdominal and back muscles strength and endurance are also decreased. The effect of conventional physiotherapy program and physical exercises with TerapiMaster equipment on abdominal and back muscles static endurance, pain intensity and every day activities of middle-aged people, who have lumbar-sacral radiculopathy, were analyzed in this study. Object of study: the change of pain, muscle endurance and back pain influence on daily activities, applying different physiotherapy programs. Aim of study: to compare the influence of conventional physiotherapy and exercises with TerapiMaster equipment for patients with lumbar-sacral radiculopathy. Goals of study: 1. To evaluate effect of conventional physiotherapy on pain intensity and daily activities. 2. To evaluate effect of conventional physiotherapy on the abdominal and back muscles static endurance. 3. To evaluate effect of physical exercises with TerapiMaster equipment on pain intensity and daily activities. 4. To evaluate effect of physical exercises with TerapiMaster equipment on the abdominal and back muscles static endurance. 5. Compare the effect of both physiotherapy methods. Conclusions: 1. After 16 procedures of conventional physiotherapy the pain intensity and negative influence... [to full text]

Author: Bc. Veronika Valášková Title of thesis: Physiotherapy after cervical spine surgery - literature research. Aims: The aim of my diploma thesis is to give an overview of physiotherapeutic care after cervical intervertebral disc herniation surgery. Methods: The diploma thesis is processed as a research of literacy sources. Fifteen studies were selected that met the required study selection criteria. All studies focused on postoperative physiotherapy in patients after cervical spine surgery by the anterior approach. The diploma thesis is divided into two parts. The first part is theoretical, deals with anatomy, kinesiology, biomechanics of the cervical spine, surgical techniques and subsequent complications that may occur after surgery. The second part is the methodology itself, which processes the available information about postoperative physiotherapy. Results: The results of the diploma thesis show that in the early phase after the operation, active exercise in the shoulder joints, respiratory physiotherapy, strengthening the deep flexors of the cervical spine are most recommended. In the long term, emphasis is placed on strengthening the muscles of the cervical spine, increasing the stability of the cervical spine and increasing the overall condition. The cervical collar is not primarily...