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Thoracic mobilisation and periscapular soft tissue manipulations in the management of chronic prolapsed intervertebral disc (PIVD) -- an innovative manual therapy approach [with consumer summary]
Kiran R, Mohanty P, Pattnaik M
The Australasian Medical Journal 2017 Oct;10(10):838-847
clinical trial
3/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: The most common cause of CLBP is discogenic lower back pain. Researches haveshown that connective tissue remodelling occurs in CLBP and thoracic spinal mobility and thoracolumbar mobility have higher correlations with LBP. AIMS: To see the effect of upper back fascia and periscapular muscles stretching and thoracic mobilisation to reduce symptoms in subjects with CLBP due to lumbar disk herniation. METHODS: A total of 40 subjects with CLBP due to prolapsed intervertebral disc (PIVD) were recruited and randomly distributed in two groups. Group 1 was given stretching of upper back fascia and periscapular muscles and thoracic mobilization along with conventional exercises (Cyriax listing correction-I followed by repeated McKenzie back extension exercise and core muscle strengthening). Group 2 received only conventional exercises. OUTCOME MEASURES: Visual analog scale, Oswestry Disability Index and Modified Schober's Test. Measurements were taken before and after three weeks of treatment, for five days/week. RESULTS: Overall results of the study, both group 1 and group 2 showed improvement in pain, function and lumbar range of motion (ROM) after three weeks of intervention. However, group 1 improved significantly to a greater extent in pain, ROM and function than the group 2. CONCLUSION: Stretching of periscapular muscles and fascia of the upper back and mobilisation of upper thoracic spine is found to be effective for the management of chronic low back pain due to PIVD.

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