Effects of physical therapy on improving disc height index, postural stability, pain and function in persons with discogenic low back pain

Abstract

Objective: To determine if physical therapy is capable of improving disc height index, pain, functional disability, lumbar range of motion, postural stability and gait in persons with discogenic low back pain.

Methods: The quasi-experimental study was conducted at the Foundation University College of Physical Therapy, Foundation University, Islamabad, and Radiology Department, Fauji Foundation Hospital, Rawalpindi, Pakistan, from May 2022 to June 2023, and comprised patients of either gender having postero-lateral disc prolapse and discogenic low back pain. Pain was assessed using the Visual Analogue Scale, disc height index was measured via magnetic resonance imaging, postural stability was evaluated using the Biodex Balance System, lumbar range of motion was measured via inclinometer, and functional disability was assessed using the Oswestry Disability Index. Treatment protocol spanned 2 weeks and consisted of 5 supervised sessions per week. The protocol included interferential therapy combined with heating pack, Mckenzie’s extension bias protocol, manual lumbar traction and rotational mobilisation. Data was collected at baseline and post-intervention. Data was analysed using SPSS 21.

Results: Of the 22 patients, 18(81.8%) were males and 4(18.2%) were females. The overall mean age was 40.13±10.08 years, mean weight was 70.54±11.38kg and mean height was 160.58±13.52cm. A significant improvement was noted in terms of all outcome measures post-intervention compared to baseline values (p<0.05) except for cadence (p>0.05).

Conclusion: Physical therapy showed promising results in terms of improving disc height index in subjects with discogenic low back pain, along with pain, functional disability, lumbar range of motion, postural stability and gait.

Clinical Trial Number: https://clinicaltrials.gov/study/NCT05326594.

Key Words: Disc height, Disc herniation, Disc protrusion, Disc prolapse, Low-back pain, Lumbar radiculopathy, Physical therapy, Physiotherapy, Postural stability.