LOMBER DİSK HERNİASYONU OLAN HASTALARDA SPİNAL MOBİLİZASYON UYGULAMALARININ RADYOLOJİK BULGULAR VE FONKSİYONEL DÜZEY ÜZERİNE ETKİSİ

Abstract

TAŞKAYA B. The Effect of Spinal Mobilization Practices on Radiological Findings and Functional Level in Patients with Lumbar Disc Herniation, Hacettepe University Graduate School Health Sciences Programme of Neurology Physiotherapy Doctor of Philosophy Thesis, Ankara, 2024.The aim of this study was to determine the effect of spinal mobilization applications on radiological findings such as herniation distance, disc height and facet joint distance, functional level, pain, quality of life, psychological factors, spinal postüre, flexibility and range of motion in patients with Lumbar Disc Herniation (LDH). Thirty-two patients (26 males, 6 females) diagnosed with LDH were included in the study and randomly divided into two groups. The control group (n=16, age 38.31±9.21 years) received 10 sessions of stabilization exercises for 5 weeks, 2 sessions per week. The intervention group (n=16, age 39.81±9.45 years) received lumbar spinal mobilization applications including Anterior-Posterior Lumbar Spinal Mobilization, Lumbar Spinal Rotational Mobilization and Joint Mobilization in Lumbar Flexion Position in addition to stabilization exercises. Demographic data of all patients were recorded and herniation distance, disc height and facet joint distance were evaluated by magnetic resonance imaging before and after treatment. Oswestry Low Back Pain Disability Questionnaire (ODQ), Back Performance Scale (BPS), Visual Analog Scale (VAS), McGill-Melzack Pain Questionnaire, Nottingham Health Profile (NHP), Tampa Kinesiophobia Scale (TKS), Catastrophic Pain Scale (CPS), Hospital Anxiety and Depression Scale (HADS), Lumbar range of motion, Straight Leg Raise (SLR), Sit and Reach Test, Lateral Side-Bending Flexibility Test, Static and Dynamic Endurance were evaluated before, after and 3 months after treatment. In intragroup analyses, herniation distance decreased (p<0.05), facet joint distances increased (p<0.05), ODQ and BPS values decreased (p<0.05), VAS, McGill-Melzack Pain Questionnaire, CPS and NHP values decreased (p<0.05), lumbar range of motion, SLR, Sit and Reach Test, Static and Dynamic Endurance values increased (p<0.05) in both intervention group and control group after treatment. In the intervention group, there was an increase in disc height (p<0.05) and a decrease in the HADS and TKS values (p<0.05), while no change was detected in the control group (p>0.05). In this study, it was determined that mobilization applications had positive effects on regression of herniation distance, increase in disc height and facet joint distance, functional status, pain, quality of life, psychological factors, range of motion, flexibility, static and dynamic endurance in patients with LDH. As a result, it was concluded that spinal mobilization applied in addition to the stabilization exercises used intensively in the clinic in the treatment of LDH has a greater effect on radiological findings and functional level and it would be useful to apply it additionally in the clinic.