Outcomes and adverse events from physiotherapy functional restoration for lumbar disc herniation with associated radiculopathy
Andrew J. HahneJon J. FordRana S. HinmanNicholas F. TaylorLuke D. SurkittAdam G. WaltersJoan McMeeken
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Purpose. To report the outcomes and adverse events of people diagnosed with lumbar disc herniation with associated radiculopathy (LDHR) who were treated with a physiotherapy functional restoration programme.Method. Data on functional outcome (Oswestry score), work status, global rating of change, and adverse events were extracted from the files of all people with LDHR treated by three physiotherapists using functional restoration principles from 2001 to 2009.Results. Ninety-five participants were included. The Oswestry score reduced by a mean of 15.9 (95%% CI, 11.8–20.1) points between baseline and discharge following a mean (SD) of 8.7 (9.4) months of treatment. The proportion of participants working full-time increased from 37%% to 67%% between baseline and discharge (p < 0.001). Eighty per cent of participants reported overall improvement between baseline and discharge on the global rating of change scale (p < 0.001). Minor adverse events were reported by eight (8%%) participants, while one (1%%) participant developed adhesive capsulitis.Conclusion. People with LDHR who undertook a physiotherapy functional restoration programme achieved significant improvements in Oswestry disability scores, work status, and global rating of change, with few adverse events reported. A randomised controlled trial is warranted to determine the efficacy of functional restoration for people with this condition.Keywords:
Oswestry Disability Index
odi is a program to calculate the Oswestry Disability Index using Stata. The ODI questionnaire is a 10 item questionnaire which indicates the extent to which a person's functional level is restricted by disability This algorithm supports ODI versions 1.0, 2.0, and 2.1a.
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Objectives : The aim of this study is to determine in the young people whether the physical activity level affects the low back pain or not. Method: The cross-sectional study included with 260 students (131 females and 129 males). Low back pain (LBP) was determined with the validated Oswestry Disability Index (ODI). The Oswestry Disability Index (ODI) consist of ten items and are completed in reference to the patient’s functional status ‘today’. Physical activity level was evaluated by the short form of the International Physical Activity Questionnaire (IPAQ) that is a scale to be recorded at different levels of physical activity in the last week. Results : There was found a negative weak correlation between the ODI and total score of IPAQ (r = - 0,142; p = 0,01). Male’s total physical activity level was higher than women, while Oswestry score was significantly lower than women (p 0,05). Conclusion : According to the study results, it was understood that increasing the level of physical activity in young people is effective in preventing low back pain. We consider that the awareness of young people must be raised with regard to the increasing their physical activity levels. We hope to conduct a study that will examine the relationship between physical activity and low back pain in all age groups in consideration of socioeconomic characteristics and other parameters that may affect low back pain.
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Oswestry Disability Index
Back Pain
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Oswestry Disability Index
Back Pain
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Abstract Background Intervertebral disc degeneration (IVD) is a main underlying cause for low back pain (LBP). Oswestry Disability Index (ODI) is a valuable tool used to measure patient’s low back functional outcome. Our aim is to evaluate the relation between clinical assessment of LBP and health related quality of life with the use of ODI and magnetic resonance image (MRI) findings in patients with degenerative prolapsed IVD disease. Result There was a significant correlation between Pfirrmann grades and ODI ( p < 0.0001) and with type of disc morphology mostly protrusion ( p < 0.0001) but insignificant correlation with visual analogue scale (VAS) ( p = 0.198) and most of the clinical parameters ( p > 0.05). There was a significant correlation between ODI and VAS ( p = 0.003). Higher Pfirrmann grades were found at lower lumbosacral levels L4-5 and L5-S1. Conclusion Higher Pfirrmann grades correlated with the increased ODI. No association was found between MRI grading in lumbosacral spine with pain intensity and most of the clinical parameters among persons with discogenic LBP. Chronic LBP is widely accepted to be a multifactorial disorder that could not be contained within a single lumbar compartment. Clinician should not depend on MRI findings only in the diagnosis. History from the patient and clinical examination is particularly important to reach the final diagnosis. ODI might be convenient in achieving patient’s confidence and decreasing unnecessary investigations.
Oswestry Disability Index
Lumbosacral joint
Back Pain
Degenerative Disc Disease
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Oswestry Disability Index
Back Pain
Straight leg raise
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腰椎椎間板ヘルニア摘出術実施後，多くの症例は良好な経過をたどる．しかし早期に明らかな再発所見なく腰痛が出現，または遺残症状が悪化する症例もたびたび経験する．このような症例がどのようなADLを困難とするのか特徴を明らかにするため，Oswestry Disability Index（ODI）から検討した．対象は2007年5月～08年8月にヘルニア摘出術を実施した122例中，退院2週後の再来時にVisual Analogue Scaleで症状増悪が認められた10例であった．Control群は再来時に良好であった30例とした．検討項目はODIおよびsub-scoreとした．悪化群はsub-scoreの「座ること」について困難度で高値を示す例が多かった．また，再来時に「座ること」「物を持ち上げること」で困難度が高かった例では，“腰痛の悪化”，“早期の職場復帰”が関与していることが考えられた．症例に応じた適切な生活指導と運動療法により退院後の症状悪化を予防できる可能性が示唆された．
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Abstract Background Low back pain (LBP) is a widespread problem and the leading cause of disability worldwide. While the cause of LBP is multifactorial, several studies suggested that inflammatory mediators in damaged subchondral plates of degenerating discs may lead to chemical sensitization and mechanical stimulation, eventually causing pain. The goal of this study was to explore associations between such changes and LBP‐related disability using dynamic contrast‐enhanced MRI. Methods Thirty‐two patients diagnosed with nonspecific LBP and 24 healthy control subjects were studied with dynamic contrast‐enhanced (DCEMRI) MRI and T1r (spin–lattice relaxation in the rotating frame) acquisitions. DCEMRI enhancement in disc endplate regions and average T1ρ measurements in the nucleus pulposus were extracted. The LBP patients were grouped based on their Oswestry Disability Index (ODI) scores and associations between MRI measurements and ODI scores were analyzed. Results Significant associations were found between ODI scores and DCEMRI enhancement in the cartilaginous endplate regions of the most degenerated discs. ODI scores also correlated with T1ρ measurements in the nucleus pulposus of degenerating discs. Conclusions DCEMRI enhancement in the cartilaginous endplate regions and lower T1ρ measurements in the nucleus pulposus (NP) were associated with greater disability that is related to low back pain as reported on the ODI. This complements earlier reports suggesting a link between LBP and endplate degeneration. Further studies are needed to validate these findings. Significance Our findings indicated that dynamic contrast‐enhanced MRI signal enhancement in the cartilaginous endplate regions were associated with greater disability related to low back pain. This signal enhancement might be an indication of inflammatory changes in disc endplate regions. Therefore, advanced quantitative imaging techniques like the ones presented in this study might be needed to complement conventional radiological evaluations to identify the subset of patients who could potentially benefit from novel therapies directed towards treating the disc endplate regions.
Oswestry Disability Index
Intervertebral Disc
Modic changes
Back Pain
Degeneration (medical)
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