1.Status of Return to Play in Growing Athletes with Lumbar Spondylolysis
The Japanese Journal of Rehabilitation Medicine 2020;():20018-
Objective:In athletes who are still in the growing period, lumbar spondylolysis is mainly treated with brace therapy to enable bone fusion. During the brace period, sports activities are often discontinued. The purpose of this study was to investigate how the combination of brace therapy and early physiotherapy affects the duration of return to play in athletes with lumbar spondylolysis.Methods:Thirty-seven athletes in the growing period with unilateral spondylolysis were included in the study. They were classified into two groups:17 patients who rested during the brace period (brace group) and 20 patients who combined the brace with early physical therapy (combination group). The examined items were duration of the brace period and duration from the end of the brace therapy to return to play (return period). Both these items were compared between the brace group and the combination group. In addition, the union rate of both groups was also calculated.Results:The return period was significantly shorter in the combination group than in the brace group. However, there were no statistically significant differences between the groups with respect to other data.Conclusion:Since there was no significant difference in the duration of the brace period and the union rate between both groups, we believe that early physical therapy intervention does not adversely affect bone union in athletes with spondylolysis who are in the growing period. Therefore, it is considered that the combined use of brace therapy and early physical therapy can maintain flexibility and muscular strength during the brace period and can enable a smooth transit to playing after the bone union is complete.
2.Status of Return to Play in Growing Athletes with Lumbar Spondylolysis
The Japanese Journal of Rehabilitation Medicine 2021;58(1):80-85
Objective:In athletes who are still in the growing period, lumbar spondylolysis is mainly treated with brace therapy to enable bone fusion. During the brace period, sports activities are often discontinued. The purpose of this study was to investigate how the combination of brace therapy and early physiotherapy affects the duration of return to play in athletes with lumbar spondylolysis.Methods:Thirty-seven athletes in the growing period with unilateral spondylolysis were included in the study. They were classified into two groups:17 patients who rested during the brace period(brace group)and 20 patients who combined the brace with early physical therapy (combination group). The examined items were duration of the brace period and duration from the end of the brace therapy to return to play (return period). Both these items were compared between the brace group and the combination group. In addition, the union rate of both groups was also calculated.Results:The return period was significantly shorter in the combination group than in the brace group. However, there were no statistically significant differences between the groups with respect to other data.Conclusion:Since there was no significant difference in the duration of the brace period and the union rate between both groups, we believe that early physical therapy intervention does not adversely affect bone union in athletes with spondylolysis who are in the growing period. Therefore, it is considered that the combined use of brace therapy and early physical therapy can maintain flexibility and muscular strength during the brace period and can enable a smooth transit to playing after the bone union is complete.
3.Examination of a Regression Model to Quantify the Severities of Low Back Pain and Lower Limb Symptoms in Patients with Lumbar Spinal Stenosis
Hayato ISHITANI ; Toshiyo TAMURA ; Shigehiko KANAYA
The Japanese Journal of Rehabilitation Medicine 2021;58(6):680-691
Objective:The Japanese Orthopaedic Association Low Back Pain Evaluation Questionnaire (JOABPEQ) consists of 25 questions, which allows for the multifaceted evaluation of patients with low back pain. In this study, we aimed to investigate whether the JOABPEQ could be used to construct a regression model to quantify low back pain, lower limb symptoms, and hip range of motion (ROM) in patients with lumbar spinal stenosis.Methods:We evaluated 115 patients with lumbar spinal stenosis scheduled to undergo surgery at our hospital. We measured the degrees of low back pain, lower leg pain, and lower leg numbness using the visual analog scale before the surgery. In addition, we measured the ROM of the hip joint during flexion, external rotation, and internal rotation. All responses of the JOABPEQ and physical function data were subjected to a partial least-squares (PLS) regression analysis.Results:Low back pain, lower limb pain, lower limb numbness, and hip ROM during flexion could each be used for significant regression models with JOABPEQ items. However, the hip ROMs during external and internal rotation could not be used for regression models with the JOABPEQ.Conclusion:On the basis of the results of the PLS regression analysis in this study, the degree of pain symptoms in patients with lumbar spinal stenosis may be quantified with the JOABPEQ items. Furthermore, the flexion angle of the hip ROM was quantified using the JOABPEQ items. The results of this study may indicate an effective means for establishing treatment plans for physical therapy.