The Immediate Effects of Two Different Exercises on Clinical Outcomes and H-reflex in Patients With Acute Lumbosacral Radiculopathy

Abbas  Fatehi Peykani; Maryam Saadat; Davood Kashipazha; Mohammad Pouretezad; Hossein Safari

doi:10.18502/jmr.v16i1.8557

Abbas Fatehi Peykani Department of Physiotherapy, School of Rehabilitation, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Maryam Saadat Department of Physiotherapy, School of Rehabilitation, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Davood Kashipazha Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Mohammad Pouretezad Department of Physiotherapy, School of Rehabilitation, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Hossein Safari Department of Neurosurgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

DOI: https://doi.org/10.18502/jmr.v16i1.8557

Keywords: Lumbosacral radiculopathy, Exercise, Electrodiagnosis, H-reflex, Physical examination

Abstract

Introduction: The evidence has shown that specific exercises effectively treat acute low back pain. This study aimed to investigate the effects of lumbar spinal loading in both directions in the sagittal plane in patients with acute lumbosacral radiculopathy.

Materials and Methods: A total of 20 patients with unilateral acute lumbosacral radiculopathy voluntarily participated in the study. The patients randomly performed flexion or extension back exercise ten times in three sets with 1-min rest between each set. Pain intensity, range of forward bending and straight leg raising (SLR), time of sit to stand, and soleus H-reflex were measured before and after the exercise.

Results: This study showed that flexion compared to extension loading exercises significantly improved pain intensity, SLR degree of freedom, forward bending range of motion, time of sit to stand, and H-reflex latency (P˂0.05). There was no significant improvement in the H-reflex amplitude of the patients doing either of the exercises (P=0.07).

Conclusion: Flexion loading exercises are recommended for reducing pain intensity and improving spinal mobility and neurophysiological function of the nerve root functional status in patients with acute lumbosacral radiculopathy. It seems that flexion exercises with the flatting of lumbar lordosis and opening intervertebral space reduce disk pressure and neural tissue tension.