OBJECTIVETo observe the efficacy and mechanism of orthopedic footwear in treating lumbar intervertebral disc herniation with spinal manipulation.

METHODSFrom September 2009 to September 2010, 44 patients with the lumbar intervertebral disc herniation with posture change were selected in the study. There were 28 males (aged from 24 to 58 years) and 16 females (aged from 21 to 60 years). Firstly, the average EMG (AEMG) and spectrum area (SPA) of bilateral lumbar erector spinae of the patients were tested by surface electromyogram (sEMG), and then absolute value of the difference between AEMG and SPA (larAEMG and larSPA) were compared. After that, they were randomly divided into two groups (experiment group and control group), each group had 22 cases. The patients of experiment group received the spinal manipulation treatment assisted with orthopedic footwear and the other group received the spinal manipulation treatment only. Orthopedic footwear was put on by leg with lower iliac crest line, sole thickness of which depended on the degree of pelvic tilt. According to mitigation degree of symptom and sign, sole thickness was modified till removal of orthopedic footwear. Manipulative therapeutic method which was manipulative by doctors set spinal process to normal anatomical position. Manipulative treatment was 2 - 3 times every week. The clinical healing time were observed in the two groups.

RESULTSThe larSPA was 0.12 +/- 0.73, 0.65 +/- 0.61 and the larAEMG was 3.43 +/- 25.56, 21.74 +/- 20.34 in standing 1 minute of two positions of patients with orthopedic footwear and without orthopedic footwear, respectively; the larSPA was 0.15 +/- 0.36, 0.57 +/- 0.24 and the larAEMG was 4.65 +/- 12.87, 25.18 +/- 16.58 in walking 1 minute of two positions of patients with orthopedic footwear and without orthopedic footwear. There were significant difference between the two groups (P < 0.01). The time of healing well in experiment group and control group were respectively (20.36 +/- 4.92) d and (28.14 +/- 7.13) d, experiment group was shorter than that of control group (P < 0.01).

CONCLUSIONOrthopedic footwear can obviously improve the unsymmetrical shrink of bilateral lumbar erector spinae and balance lumbar muscle. Therefore,orthopedic footwear can create favourable conditions for the spinal manipulation in treatment of lumbar intervertebral disc herniation, which can shorten the healing well.