1. EFFECTIVENESS OF SCIATIC NERVE MOBILIZATION VERSUS TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION IN LUMBOSACRAL RADICULOPATHY IN A TERTIARY CARE HOSPITAL
Umesh Kumar, Nabila Soomro, Syed Shahzad Ali
Institute of Physical Medicine & Rehabilitation, Dow University of Health Sciences Karachi, Pakistan.
Results:
The study results employed Wilcoxon signed ranked test to identify any difference in pain score. Post treatment evaluation median pain scores in neural mobilization (4) and TENS (6). P-Value is than 0.05 which was significant that nerve mobilization is more effective as compare to TENS in the management of lumbar disc disease. Pre and Post treatment median pain Scores in Nerve Mobilization and TENS groups. It can be easily noted that post treatment median pain scores in nerve mobilization is lesser than in TENS group.
Background:
BACKGROUND: Globally among various health disorders lower back pain is considered a major health problem. Lumbo-sacral radiculopathy is a clinical condition that involves irritation of nerve roots which causes pain that radiate down to the corresponding dermatome. Lumbo-sacral radiculopathy rehabilitation commonly includes physical therapy interventions such as, Neurodynamics, manual therapy, exercise therapy, traction, acupuncture, acupressure and Transcutaneous electrical nerve stimulation. Nervous system composed of physiological and mechanical components and its interconnections.
Table 1: Subjects Age and Gender distribution between Nerve Mobilization and TENS group.
STUDY GROUPS n
AGE
GENDER
Male
Female
Nerve Mobilization 30
45.03 (7.294)
17 (56.7%)
13 (43.3%)
TENS
45.93(6.902)
15 (50%)
Objective:
To find out the efficacy of sciatic nerve mobilization versus Transcutaneous Electric Nerve Stimulation in Lumbosacral Radiculopathy in tertiary care hospital.
Table 2: Pre and post treatment evaluation for pain using NPRS in Nerve Mobilization Group
 Study variable
Pre treatment
Median (Range)
Post treatment
P-value
NPRS
8 (4)
4 (6)
< *
P-values are obtained by using Wilcoxon signed ranked test
*P-values < 0.05 are considered as significant
Table 2: Pre and post treatment evaluation for pain in TENS Group
Study Variable
Pre treatment
Median (Range)
Post treatment
P-value
NPRS
7 (4)
6 (5)
< *
P-values are obtained by using Wilcoxon signed ranked test
*P-values < 0.05 are considered as significant
MATERIAL & METHOD:
This study was conducted at IPMR, DUHS Karachi Pakistan. Sixty patients with sciatic lumbosacral radiculopathy, were selected on voluntary basis those who fulfill the inclusion criteria. Patient were assessed and referred by physiatrist of Institute of Physical Medicine & Rehabilitation (IPM&R) and consultant Neurologist and Neuro-surgeon of civil hospital Karachi. All the patients were randomly assigned and equally divided into group A and group B, using simple purposive sampling technique. Group A received neural mobilization technique along with standard care and group B received TENS along with standard care (stabilization exercises & Postural advise). Patients in both groups received total eight treatment sessions, three treatment sessions on alternative day for three consecutive weeks .Assessment was performed to evaluate the outcome of initial session and final session of treatment using Numerical Pain Rating Scale.
Table 3: Post treatment evaluation for pain in Nerve mobilization group and TENS group
STUDY VARIABLE
NERVE MOBILIZATION GROUP
TENS GROUP
P-VALUE
MEDIAN (RANGE)
NPRS (Pain)
4(6)
6 (5)
0.001*
P-values are obtained by using Mann-Whitney Test
*P-values < 0.05 are considered as significant
Figure 1: Pre and post treatment median pain scores in nerve mobilization and TENS groups.
Figure 3 shows pre and post treatment median pain scores in nerve mobilization and TENS groups. It can be easily noted that post treatment median pain scores in nerve mobilization is much lesser than in TENS group.
Conclusion:
Both groups shown significant improvement. However neural mobilization group shown relatively more improvement than TENS group.
KEY WORDS:
Neurodynamics, Nerve mobilization, Lumbosacral radiculopathy, sciatica, TENS