Clinical and electromyographic evaluation of the effectiveness of the use of interference currents and traction therapy in the treatment of patients with vertebral radiculopathy

Abstract

Background. Relevance of elaboration of lumbosacral radiculopathy (LSR) treatment methods is сonditioned by widespread of this pathology. Pain syndrome (PS) reducing activity and life quality of workable patients is the most prevailing clinical manifestation of this disease. Сonservative treatment methods of LSR directed to decrease pain, oedema and compression of nerve roots as well as contributing to сonductivity improvement include medication, physiotherapeutic and orthopaedic treatment.

Aims: Clinical neurophysiological justification of combined use of interference therapy (IT) and spine traction (ST) in complex treatment of vertebral LSR.

Materials and methods. The first-control group (n=32) who were treated by using ST as a treatment. The second ― treatment group (n=32) included those who were treated by using the IT and ST on the same day. All patients had radicular syndromes. All patients passed the lumbar MRI scan. PS was estimated according to the visual-analogic scale (VAS) and McGill’s questionnaire. Estimation of life quality of patients was based on Roland-Morris questionnaire. Electromyography registered dynamics of impulse conduction on motor fibres, as well as parametеrs of compound muscle action potential and H-reflex.

Results. Positive effect of combined use of interference therapy with spine traction in complex treatment of vertebral radiculopathy patients are proved. It has been established that the therapeutic effect of the complex application of IT and ST lies in the improvement in the afferent and efferent links of the neuromotor apparatus, as well as the functional state of the spinal alpha-motoneurons associated with the acceleration of the regenerative processes.

Conclusion. Results of the clinical neurophysiological investigation, carried out before and after rehabilitative treatment allow to recommend combined therapy of IT and ST for treatment of vertebral LSR.

Keywords

radiculopathy / pain syndrome / interference therapy / spine traction / electroneuromyograhy

References

[1] Dadasheva MN, Agafonov BV. Radiculopathy, modern tactics of patient management. RMZH. 2016;(3):163–165. (In Russ).

[2] Дадашева М.Н., Агафонов Б.В. Радикулопатии, современная тактика ведения пациентов // РМЖ. 2016. № 3. С. 163–165.

[3] Kadykov AS, Chernikova LA, Shakhparonova NV. Rehabilitation of neurological patients. Moscow: MEDpress-inform; 2008. Р. 223–248. (In Russ).

[4] Кадыков А.С., Черникова Л.А., Шахпаронова Н.В. Реабилитация неврологических больных. Москва: МЕДпресс-информ, 2008. С. 223–248.

[5] Berry JA, Elia C, Saini HS, et al. A review of lumbar radiculopathy, diagnosis, and treatment. Cureus 2019;11(10):e5934.

[6] Berry J.A., Elia C., Saini H.S., et al. A review of lumbar radiculopathy, diagnosis, and treatment // Cureus. 2019. Vol. 11, N 10. Р. e5934. doi: 10.7759/cureus.5934

[7] doi: 10.7759/cureus.5934

[8] Frymoyer J. Lumbar disc disease: epidemiology // Instr Course Lect. 1992. Vol. 41. Р. 217–223.

[9] Frymoyer J. Lumbar disc disease: epidemiology. Instr Course Lect. 1992;41:217–223.

[10] Skouen J.S., Brisby H., Otani K., et al. Protein markers in cerebrospinal fluid in experimental nerve root injury. A study of slow-onset chronic compression effects or the biochemical effects of nucleus pulposus on sacral nerve roots // Spine (Phila Pa 1976). 1999. Vol. 24, N 21. Р. 2195–2200. doi: 10.1097/00007632-199911010-00004

[11] Skouen JS, Brisby H, Otani K. et al. Protein markers in cerebrospinal fluid in experimental nerve root injury. Spine (Phila Pa 1976). 1999;24(21):2195–2200. doi: 10.1097/00007632-199911010-00004

[12] Coster S., de Bruijn S., Tavy D.L. Diagnostic value of history, physical examination and needle electromyography in diagnosing lumbosacral radiculopathy // J Neurology. 2010;257(3):332–337. doi: 10.1007/s00415-009-5316-y

[13] Coster S, de Bruijn S, Tavy DL. Diagnostic value of history, physical examination and needle electromyography in diagnosing lumbosacral radiculopathy. J Neurology. 2010;257(3):332–337. doi: 10.1007/s00415-009-5316-y

[14] Бабанов С.А., Татаровская Н.А., Бараева Р.А. Профессиональная хроническая пояснично-крестцовая радикулопатия // Трудный пациент. 2013. № 12. С. 23–30.

[15] Babanov SA, Tatarovskaya NA, Baraeva RA. Occupational chronic lumbosacral radiculopathy. A difficult patient. 2013;(12):23–30. (In Russ).

[16] Kostova V., Koleva M. Back disorders (low back pain, cervicobrachial and lumbosacral radicular syndromes) and some related risk factors // J Neurol Sci. 2001. Vol. 192, N 1-2. Р. 17–25. doi: 10.1016/s0022-510x(01)00585-8

[17] Kostova V, Koleva M. Back disorders (low back pain, cervicobrachial and lumbosacral radicular syndromes) and some related risk factors. J Neurol Sci. 2001;192(1-2):17–25. doi: 10.1016/s0022-510x(01)00585-8

[18] Левин О.С., Мосейкин И.А. Комплекс витаминов группы в лечении дискогенной пояснично-крестцовой радикулопатии // Журнал неврологии и психиатрии им. С.С. Корсакова. 2009. № 10. C. 30–35.

[19] Levin OS, Moseikin IA. Complex of group vitamins in the treatment of discogenic lumbosacral radiculopathy. Journal of Neurology and Psychiatry S.S. Korsakov's. 2009;(10):30–35. (In Russ).

[20] Подчуфарова Е.В., Яхно Н.Н. Боль в спине. Москва: ГЭОТАР-Медиа, 2013. 368 с.

[21] Podchufarova EV, Yakhno NN. Back pain. Moscow: GEOTAR-Media; 2013. 368 p. (In Russ).

[22] Мусаев A.В., Набиев Н.Н. Тракционная терапия больных с вертеброгенной паталогией нервной системы // Азербайджанский журнал курортологии, физиотерапии и реабилитации. 2011. № 2. Р. 97–106.

[23] Musaev AV, Nabiyev NN. Traction therapy of patients with vertebrogenic pathology of the nervous system. Azerbaijan Journal of Balneology, Physiotherapy and Rehabilitation. 2011;(2):97–106. (In Russ).

[24] Гусейнова С.Г., Имамвердиева С.С., Мустафаева Э.Э., и др. Эффективность применения интерференцтерапии в комплексе с пиримидиновыми нуклеотидами у больных вертеброгенными радикулопатиями // Физиотерапия, бальнеология и реабилитация. 2017. Т. 16, № 5. С. 325–330.

[25] Huseynova SG, Imamverdieva SS, Mustafayeva EE, et al. The effectiveness of interference therapy in combination with pyrimidine nucleotides in patients with vertebrogenic radiculopathies. Physiotherapy, balneology and rehabilitation. 2017;16(5):325–330 (In Russ).

[26] Ходарев C.B., Гавришев C.B., Молчановский В.В., Агасаров Л.Г. Принципы и методы лечения больных с вертеброневрологической патологией. Учебное пособие. Ростов-на-Дону: Феникс, 2001. 608 с.

[27] Khodarev CB, Gavrishev CB, Molchanovsky VV, Agasarov LG. Principles and methods of treatment of patients with vertebroneurological pathology. Training manual. Rostov-on-Don: Phoenix; 2001. 608 p. (In Russ).

[28] Епифанов В.А., Епифанов А.В. Остеохондроз позвоночника (диагностика, лечение, профилактика). Москва: МЕДпресс-информ, 2004. С. 85–86.

[29] Epifanov VA, Epifanov AV. Osteochondrosis of the spine (diagnosis, treatment, prevention). Moscow: MEDpress-inform; 2004. Р. 85–86.

[30] Yıldırım Ç., Bütün B., Çubuk M., Akyokuş A. Akut lomber disk hernilerinde intermitant traksiyon etkinliğinin klinik ve ileri görüntüleme yöntemleri ile değerlendirilmesi // Ege Fiz Tıp ve Reh Derg. 2001. Vol. 7, N 1-2. Р. 7–14.

[31] Yıldırım Ç, Butun B, Chubuk M, Akyokush A. Evaluation of intermittent traction efficiency with clinical and advanced imaging methods in acute lumbar disc hernias. Ege Fiz Tıp ve Reh Derg. 2001;7(1-2):7–14.

[32] Левин О.С. Диагностика и лечение вертеброгенной пояснично-крестцовой радикулопатии // Нейро News. 2010. Т. 8. N 27. С. 5963.

[33] Levin OS. Diagnostics and treatment of vertebrogenic lumbosacral radiculopathy. Neyro News. 2010;8(27):5963. (In Russ).

RIGHTS & PERMISSIONS

Eco-Vector