The effect of early isometric exercises on clinical and
neurophysiological parameters in patients with sciatica: An interventional
randomized single-blinded study
Affiliations: [a] Department of Pathophysiology of Locomotor Organs,
Karol Marcinkowski Medical University, Poznań, Poland | [b] Department and Clinic for Physiotherapy Rheumatology
and Rehabilitation, Karol Marcinkowski Medical University, Poznań,
Poland
Note: [] Address for correspondence: Juliusz Huber, Department of
Pathophysiology of Locomotor Organs, Wiktor Dega Clinical Orthopaedic and
Rehabilitation Hospital, Karol Marcinkowski University of Medicine, 28 Czerwca
1956r. No 135/147, 61-545, Poznań, Poland. Fax: +48618310230; E-mail:
zpnr@wp.pl
Abstract: Objective: To determine the effects of early introduction of
isometric exercises on pain intensity and trunk and lower extremity muscles
strength in patients with sciatica. Methods: Fifty two patients treated for disc herniation with
sciatica were included in this randomized controlled single-blinded study. They
were examined twice, before and after twenty days of rehabilitation, with
neuroimaging, visual analog scale (VAS), straight leg rising test (SLR), range
of spine movement in a saggital plane, muscle strength, electromyography (EMG),
electroneurography (ENG) and intensity of current vs stimulus duration tests
(IC-SD). Twenty-six patients, selected randomly, were ordered to reduce the
physical activity and frequent loading of the spine (conventional [C] group)
while 26 patients underwent a program of supervised isometric exercises
(intervention [I] group). A control group of healthy subjects performed once
the same examination. Results: Following treatment the muscle strength and flexibility of
the spine showed significant (P< 0.05) improvement in I group with a
significantly lower pain level and number of positive SLR tests. The same tests
performed in C group indicated no parallel improvement. EMG Parameters
increased in almost all muscles, but only in the I group were they associated
with simultaneous improvement in ENG examinations of peroneal nerves. Conclusion: Early introduction of isometric exercises, 14 days after
the incidence, is a relevant choice in cases of patients with sciatica caused
by the disc herniation.
Keywords: Sciatica, isometric exercises, strengthening, early rehabilitation, clinical and neurophysiological evaluation
