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Title: | Proprioceptive use and sit-to-stand-to-sit after lumbar microdiscectomy: The effect of surgical approach and early physiotherapy | Authors: | JANSSENS, Lotte Brumagne, Simon Claeys, Kurt Pijnenburg, Madelon GOOSSENS, Nina Rummens, Sofie Depreitere, Bart |
Issue Date: | 2016 | Publisher: | ELSEVIER SCI LTD | Source: | CLINICAL BIOMECHANICS, 32, p. 40-48 | Abstract: | Background: Individuals with non-specific low back pain show decreased reliance on lumbosacral proprioceptive signals and slower sit-to-stand-to-sit performance. However, little is known in patients after lumbar microdiscectomy. Methods: Patients were randomly assigned into transmuscular (n = 12) or paramedian lumbar surgery (n = 13). After surgery, the same patients were randomly assigned into individualized active physiotherapy starting 2 weeks after surgery (n = 12) or usual care (n = 13). Primary outcomes were center of pressure displacement during ankle and back muscles vibration (to evaluate proprioceptive use), and the duration of five sit-to-stand-to-sit movements, evaluated at 2 (baseline), 8 and 24 weeks after surgery. Findings: Two weeks after surgery, all patients showed smaller responses to back compared to ankle muscles vibration (P < 0.05). Patients that underwent a transmuscular surgical procedure and patients that received physiotherapy switched to larger responses to back muscles vibration at 24 weeks, compared to 2 weeks after surgery (P < 0.005), although not seen in the paramedian group and usual care group (P > 0.05). Already 8 weeks after surgery, the physiotherapy group needed significantly less time to perform five sit-to-stand-to-sit movements compared to the usual care group (P < 0.05). Interpretation: Shortly after lumbar microdiscectomy, patients favor reliance on ankle proprioceptive signals over lumbosacral proprioceptive reliance to maintain posture, which resembles the behavior of patients with non-specific low back pain. However, early active physiotherapy after lumbar microdiscectomy facilitated higher reliance on lumbosacral proprioceptive signals and early improvement of sit-to-stand-to-sit performance. Transmuscular lumbar surgery favoured recovery of lumbosacral proprioception 6 months after surgery. (C) 2016 Elsevier Ltd. All rights reserved. | Notes: | [Janssens, Lotte; Brumagne, Simon; Claeys, Kurt; Pijnenburg, Madelon; Goossens, Nina] Katholieke Univ Leuven, Dept Rehabil Sci, Tervuursevest 101,Box 1501, B-3001 3001, Belgium. [Janssens, Lotte] Hasselt Univ, Biomed Res Inst, Diepenbeek, Belgium. [Claeys, Kurt] Katholieke Univ Leuven, Dept Rehabil Sci, Campus Brugge, Brugge, Belgium. [Rummens, Sofie] Univ Hosp Leuven, Dept Phys Med & Rehabil, Leuven, Belgium. [Depreitere, Bart] Univ Hosp Leuven, Dept Neumsurg, Leuven, Belgium. [Pijnenburg, Madelon] Fontys Univ Appl Sci, Dept Allied Hlth Profess, Eindhoven, Netherlands. | Keywords: | Low back pain; Proprioception; Postural control; Microdiscectomy; Physiotherapy; Sit to stand;low back pain; proprioception; postural control; microdiscectomy; physiotherapy; sit to stand | Document URI: | http://hdl.handle.net/1942/21616 | ISSN: | 0268-0033 | e-ISSN: | 1879-1271 | DOI: | 10.1016/j.clinbiomech.2015.12.011 | ISI #: | 000372689400007 | Rights: | © 2016 Elsevier Ltd. All rights reserved. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2017 |
Appears in Collections: | Research publications |
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