Motor control exercise for symptomatic lumbar disc herniation: protocol for a systematic review and meta-analysis

Abstract

IntroductionLumbar disc herniation (LDH) is a common condition in adults and can impose a heavy burden on both the individual and society. It is defined as displacement of disc components beyond the intervertebral disc space. Various conservative treatments have been recommended for the treatment of LDH and physical therapy plays a major role in the management of patients. Therapeutic exercise is effective for relieving pain and improving function in individuals with symptomatic LDH. The aim of this systematic review is to evaluate the effectiveness of motor control exercise (MCE) for symptomatic LDH.Methods and analysisWe will include all clinical trial studies with a concurrent control group which evaluated the effect of MCEs in patients with symptomatic LDH. We will search PubMed, SCOPUS, PEDro, SPORTDiscus, CINAHL, CENTRAL and EMBASE with no restriction of language. Primary outcomes of this systematic review are pain intensity and functional disability and secondary outcomes are functional tests, muscle thickness, quality of life, return to work, muscle endurance and adverse events. Study selection and data extraction will be performed by two independent reviewers. The assessment of risk of bias will be implemented using the PEDro scale. Publication bias will be assessed by funnel plots, Begg's and Egger's tests. Heterogeneity will be evaluated using the I2 statistic and the χ2 test. In addition, subgroup analyses will be conducted for population and the secondary outcomes. All meta-analyses will be performed using Stata V.12 software.Ethics and disseminationNo ethical concerns are predicted. The systematic review findings will be published in a peer-reviewed journal and will also be presented at national/international academic and clinical conferences.Trial registration numberCRD42016038166.

Changes in the macroscopic morphology of hip muscles in low back pain

“…Macroscopic trunk muscle degeneration is characterized by a decrease in the cross‐sectional area (CSA; Fortin & Macedo, ), smaller functional CSA (FCSA), also referred to as lean muscle mass (Pourahmadi et al. ), an altered FCSA/CSA ratio (Pourahmadi et al. ), and an increase in the amount of fat content of the lumbar erector spinae muscles (Mengiardi et al.…”

“…), an altered FCSA/CSA ratio (Pourahmadi et al. ), and an increase in the amount of fat content of the lumbar erector spinae muscles (Mengiardi et al. ; Yanik et al.…”

“…Trunk muscle degeneration is a common feature in patients with LBP (Parkkola et al 1993;Danneels et al 2000). Macroscopic trunk muscle degeneration is characterized by a decrease in the cross-sectional area (CSA; Fortin & Macedo, 2013), smaller functional CSA (FCSA), also referred to as lean muscle mass (Pourahmadi et al 2016), an altered FCSA/CSA ratio (Pourahmadi et al 2016), and an increase in the amount of fat content of the lumbar erector spinae muscles (Mengiardi et al 2006;Yanik et al 2013). Fortin & Macedo (2013) reported that the erector spinae muscles are significantly smaller in patients with chronic LBP than in control patients.…”

Efeito agudo da estimulação elétrica nervosa transcutânea (TENS) na lombalgia

“…A lombalgia decorrente da degeneração do disco intervertebral lombar é uma das doenças degenerativas da coluna vertebral mais comuns que podem levar a dor lombar e radicular irradiada para os membros inferiores. 11 Essa condição gera incapacidade motora de vários graus para o desenvolvimento de diversas atividades e leva a um comprometimento relevante da qualidade de vida desses individuos. 12 Observou-se, no presente estudo, um número maior de participantes do gênero feminino, o que é facilmente justificável, pois as mulheres apresentam uma maior prevalência de dor crônica e também uma maior percepção quanto aos sintomas e sinais das doenças.…”

A narrative review of non-operative treatment, especially traditional Chinese medicine therapy, for lumbar intervertebral disc herniation

“…It is a pathological condition that is defined as a displacement of disc components (nucleus pulposus or annulus fibrosis) beyond the intervertebral disc space (2). LIDH is one of the most common causes of lower-back pain and sciatica.…”