EFFECTIVENESS OF MANUAL THERAPY IN PHYSICAL THERAPY OF PEOPLE WITH LUMBAR SPINE PAIN
DOI:
https://doi.org/10.32782/2221-1217-2025-1-01Keywords:
pain, therapeutic exercises, quality of life, functional status, spineAbstract
Pain in the lumbar spine is one of the most common reasons for middle-aged people seeking medical help. They significantly affect the quality of life of patients, limit physical activity and work capacity, and also lead to significant socio-economic costs. Purpose of the study: to determine the effectiveness of manual therapy in physical therapy of people with pain in the lumbar spine. The work used theoretical research methods: analysis, comparison, induction, deduction, medical and biological, sociological, pedagogical, mathematical statistics methods. Patients who used the developed program showed significant progress in improving functioning, reducing pain compared to the comparison group, which indicates a high level of effectiveness of manual therapy in the physical therapy program. The importance of an individual approach in the development of rehabilitation programs is emphasized, taking into account the characteristics of patients, their condition and physical capabilities. After the intervention, the total score on the Back Pain Function Scale questionnaire decreased by 17.83 points (p<0.05) to 11.42 points, indicating a statistically significant improvement in the functional state of the patients. A significant decrease in the indicator indicates an improvement in the patients’ ability to perform daily and professional duties. In the patients of the comparison group, the initial level of limitations was also high and amounted to 29.98 points. After the intervention, the indicator decreased by 8.66 points (p<0.05), however, this decrease is less pronounced compared to the main group. After the completion of the physical therapy program, the Roland-Morris Disability Questionnaire indicator decreased by 8.83 points (p<0.05) in the main group, indicating a significant improvement in the patients’ condition, while in the comparison group its decrease occurred only by 3.66 points (p>0.05). The presented results of the experimental study are convincing evidence of the effectiveness of the developed physical therapy program in reducing pain, improving functioning and quality of life.
References
1. Cherkin D.C., Sherman K.J., Kahn J., Wellman R., Cook A.J., Johnson S.P., Erro J., Delaney K., Deyo R.A. A comparison of the effects of 2 types of massage and usual care on chronic low back pain: A randomized, controlled trial. Annals of nternal Medicine. 2011. Vol. 155. P. 1–9. DOI: https://doi.org/10.7326/0003-4819-155-1-201107050-00002
2. Childs J.D., Cleland J.A., Elliott J.M., Teyhen D.S., Wainner R.S., Whitman J.M. Manual physical therapy and exercise for mechanical low back pain: A randomized controlled trial. Journal of Orthopaedic & Sports Physical Therapy. 2019. Vol. 49. P. 122–136.
3. Coulter I.D., Adams A.H., Hays R., Shekelle P.G., Schaffer D.M. The role of chiropractic care in managing chronic low back pain: A systematic review. Journal of Chiropractic Medicine. 2019. Vol. 18. P. 58–67.
4. Farooqui S.I., Siddiqui P.Q.R., Ansari B., Farhad A. Effects of spinal mobilization techniques in the management of adolescent idiopathic scoliosis–A meta-analysis. Int. J. Health Sci. 2018. Vol. 12. P. 44-54.
5. Flynn T.W., Wainner R.S., Whitman J.M., Manske R.C., George S.Z. Manual therapy for low back pain: A systematic review. Journal of Manual & Manipulative Therapy. 2017. Vol. 25. P. 42–49.
6. Fritz J.M., Cleland J.A., Childs J.D. Subgrouping patients with low back pain: Evolution of a classification approach to physical therapy. Journal of Orthopaedic & Sports Physical Therapy. 2020. Vol. 50. P. 425–435.
7. Furlan A.D., Imamura M., Dryden T., Irvin E. Manual and manipulative therapy for low back pain: Updated systematic review and meta-analysis. Spine. 2018. Vol. 43. P. 166–172.
8. Goertz C.M., Long C.R., Vining R.D., Pohlman K.A., Walter J., Coulter I., Hondras M.A., Owens E.F., Schultz M., Meeker W.C. Effect of usual medical care plus chiropractic care vs usual medical care alone on pain and disability among US service members with low back pain: A comparative effectiveness clinical trial. JAMA Network Open. 2018. Vol. 1. e180105. DOI: https://doi.org/10.1001/jamanetworkopen.2018.0105
9. Gross A.R., Paquin J.P., Dupont G., Graham N., Goldsmith C.H., Burnie S.J. Manipulation or mobilization for neck pain: A systematic review. Spine. 2020. Vol. 45. P. 283–292.
10. Hahne A.J., Ford J.J., McMeeken J.M. Conservative management of lumbar disc herniation with associated radiculopathy: A systematic review. Spine. 2018. Vol. 43. P. E218–E225.
11. Hidalgo B., Hall T., Bossert J., Dugeny A., Cagnie B., Pitance L. Effectiveness of manual therapy in treating nonspecific chronic low back pain: A systematic review and meta-analysis. Journal of Manipulative and Physiological Therapeutics. 2020. Vol. 43. P. 506–517.
12. Licciardone J.C., Gatchel R.J., Phillips N., Eisenberg E., King L.N. Osteopathic manual therapy for chronic low back pain: A randomized controlled trial. Journal of the American Osteopathic Association. 2018. Vol. 118. P. 77–84.
13. Paige N.M., Miake-Lye I.M., Booth M.S., Beroes-Severin J.M., Chan J.M., Shekelle P.G. Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: Systematic review and meta-analysis. JAMA. 2017. Vol. 317. P. 1451–1460. DOI: https://doi.org/10.1001/jama.2017.3086
14. Peterson C.K., Haas M., Schneider M.J., Jüni P. Spinal manipulative therapy for chronic low back pain: A systematic review and meta-analysis. Spine Journal. 2018. Vol. 18. P. 1313–1323.
15. Posadzki P., Ernst E. Manual therapy for the treatment of chronic pain conditions: A systematic review. Pain. 2019. Vol. 160. P. 1905–1913.
