Effects of proprioceptive neuromuscular facilitation techniques in treating chronic nonspecific low back pain patients

Chronic low back pain (CLBP) is a prevalent musculoskeletal condition characterized by persistent discomfort in the lumbosacral region lasting beyond 12 weeks. Individuals with CLBP often experience limitations in range of motion and compromised performance of affected body parts. Core muscle weakness/delayed activation and impaired lumbar proprioception are established contributors to CLBP. And influence balance dysfunction in CLBP patients. Exercise therapy is a cornerstone in the management of CLBP, aimed at enhancing muscular endurance, strength, and flexibility of the back muscles and soft tissues. However, the efficacy of exercise interventions depends on various factors including the type, intensity, frequency, and duration of exercises. This case report presents the rehabilitation of a corporate employee with a non-specific CLBP. The rehabilitation goals focused on improving balance, reducing disability, and alleviating pain. An integrated approach combining proprioceptive neuromuscular facilitation (PNF) with Consecutive Loop TheraBand (CLX) (The Hygenic Corporation, Akron, USA) along with traditional physical therapy techniques was implemented. PNF, a well-established technique, was chosen for its effectiveness in reducing disability and LBP while enhancing balance. The integration of PNF alongside conventional physiotherapy resulted in notable improvements, including increased lumbar flexion range following the rehabilitation period. This case underscores the importance of early initiation of comprehensive rehabilitation in CLBP patients to preserve strength, alleviate pain, reduce functional disability, and enhance balance. By addressing both the muscular and proprioceptive aspects of CLBP, this integrated approach aims to optimize outcomes in CLBP management.

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An Integrated Approach to Chronic Low Back Pain: Evaluating the Impact of Consecutive Loop TheraBand Training Combined With Proprioceptive Neuromuscular Facilitation and Conventional Physiotherapy

Tikhile,

Patil,

Jaiswal

2024

“…According to a study by Fouda et al neuromuscular control through stimulation of muscle and joint proprioceptors as well as sensory inputs from peripheral organs, affects the CNS motor outputs and encourages functional activity of daily living. The authors recommended that patients with CLBP be treated with a combination of isotonic exercises and the rhythmic stabilisation training technique of PNF [ 24 ]. Sipko et al evaluated how PNF affected people with persistent LBP on the tandem, one-leg standing and centre of pressure tests.…”

Section: Reviewmentioning

confidence: 99%

Unveiling the Efficacy of Physiotherapy Strategies in Alleviating Low Back Pain: A Comprehensive Review of Interventions and Outcomes

Tikhile,

Patil

2024

Low back pain (LBP) presents a significant burden globally, affecting individuals of all ages, but it is more common in adults aged 30-60 years old and demographics including race, ethnicity, and socioeconomic status. Physiotherapy interventions are commonly employed to manage LBP due to their non-invasive nature and potential for addressing underlying biomechanical dysfunctions. This comprehensive review aims to evaluate the efficacy of various physiotherapy strategies in alleviating LBP, considering a range of interventions and their associated outcomes. Through a thorough examination of existing literature from January 2017 to October 2023, this review synthesises evidence on the effectiveness of interventions such as manual therapy, exercise therapy, electrotherapy modalities, and education-based approaches. The review also scrutinizes the comparative effectiveness of different physiotherapy modalities and their suitability for specific patient populations, considering factors such as chronicity, severity, and underlying pathology. By critically evaluating the evidence base, this review aims to provide insights into the most effective physiotherapy strategies for alleviating LBP, chronic low back pain (CLBP) and chronic nonspecific low back pain (CNLBP) and guiding clinical practice toward evidence-based interventions. The Visual Analogue Scale and Numerical Pain Rating Scale for pain, Oswestry Disability Index and Roland-Morris Disability Questionnaire for disability, Modified-Modified Schober Test for measurement of lumbar flexion and extension and static and dynamic balance for assessing postural stability and balance were among the measures used to foresee enhancements in pain, disability, balance, and LBP symptoms. Twenty-one studies that fulfilled the criteria for inclusion (aged 20 to 50 years and of both genders) were added to the review. Exercises for core stability, strengthening, orthosis (a medical device designed to support, align, stabilise, or correct musculoskeletal structures and functions), transcutaneous electrical nerve stimulation, heat massage therapy, interferential current (a form of electrical stimulation used in physical therapy), Mulligan’s mobilization (a manual therapy technique), low-level laser therapy, and McGill stabilization exercises (core exercises) were among the therapeutic strategies. The McKenzie method (back exercises), ultrasound, sensory-motor training, Swiss ball exercises, and other techniques reduced pain and enhanced strength, balance, and ease of daily activities. Every therapeutic approach has an impact on recovery rates ranging from minimal to maximal. Conventional physical therapy is less effective than most recent advanced techniques like mobilisation and exercises. In summary, the integration of manual techniques, orthoses and alternative intervention strategies with conservative therapeutic approaches can effectively alleviate pain, enhance function and yield better overall outcomes. To get more information about the optimal dos...

“…Physical therapy plays a pivotal role in addressing neuromuscular issues, with this study utilizing a combination of isotonic and proprioceptive neuromuscular facilitation (PNF) to enhance functionality [ 11 ]. Muscle groups are contracted concentrically, eccentrically, and statically without relaxing [ 12 ], and PNF-based exercise regimens prove beneficial in improving patients' functionality [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Targeting Weakness With a Combination of Isotonic Exercises in Dermatomyositis With Polyneuropathy: A Case Report

Waghe,

Sasun,

Raghumahanti

2024

Dermatomyositis, an autoimmune inflammatory myositis commonly linked to polymyositis, is marked by inflammatory and degenerative transformations impacting muscles, skin, limb girdles, the neck, and the pharynx. These changes result in symmetrical weakness and diverse levels of muscle atrophy. Uncommonly, the condition may impact the esophagus, lungs, and heart. While dermatomyositis is believed to involve genetic, immunological, and environmental factors, its precise etiology remains elusive. Typically, the classical presentation involves a symmetrical proximal myopathy alongside dermatological manifestations such as a purplish-red rash affecting the face, arms, hands, legs, and other areas. Additional symptoms may include dysphagia, myalgia, fever, and weight loss. The primary objectives of managing dermatomyositis are to address muscular weakness, skin manifestations, and any underlying health concerns. Integral to this management is the utilization of physical therapy and rehabilitation interventions. This study introduces a 23-year-old female patient with a noteworthy medical history covering a duration of two months. The patient reported a chief complaint of persistent thigh pain and a concurrent complaint concerning bilateral weakness in upper and lower extremities. Furthermore, the patient faced the additional challenge of difficulty swallowing. Intriguingly, the patient's clinical presentation was marked not only by the aforementioned symptoms but also by the development of a distinctive facial rash. This facial rash was accompanied by symptoms of stiffness in both small and large joints and a reduction in the range of affected joints. The physiotherapeutic assessment revealed quadriparesis of bilateral upper and lower limbs. The rehabilitation programme for the patient was planned by targeting proprioceptors to increase dynamic trunk balance in patients with DM. The Proprioceptive Neuromuscular Facilitation (PNF) technique employs diagonal movement patterns, thereby proving instrumental in enhancing the patient's daily activities. This methodology serves to optimize the individual's capacity to execute routine daily tasks, promoting independence in their daily life. An investigation like the Nerve Conduction Velocity (NCV) report shows the absence of motor excitation, suggesting motor axonal neuropathy. This approach, comprising isometric, concentric, and eccentric contraction exercises, demonstrated efficacy in mitigating muscular weakness, enhancing motor function, and alleviating the diverse symptoms associated with this condition.