Effect of Decompression With and Without ELDOA in Lumber Disc Protrusion Patients
Condition: Lumbar Disc Herniation
MeSH terms: Intervertebral Disc Displacement; Hernia
Study type: Interventional

Summary: 
      The study will be conducted to determine the effects of spinal decompression with and without
      ELDOA in patients of lumbar disc protrusion. A total of twenty patient with lumber disc
      protrusion will be taken after fulfilling the inclusion criteria. the patient will be divided
      in experimental group i.e. ELDOA along with decompression and control group. Both session got
      pre and post session along with general low back exs.home plan along with precautions was
      guided to every patient of control and experimental group.NPRS ,ODI is assess in first and
      fourth session. The data will be analyzed through IBM SPSS version 21.
    

Detailed description: 
      Low back pain due to lumber disc protrusion is common health problem in all population, which
      affects the normal activities of daily living by decreasing the functional status due to low
      back pain that rad to leg. Literature supports that decompression have significant effect in
      improving the functional status of patient with low back pain with radiation but reoccurrence
      of problem of this problem is common with this problem. So my study is aiming to find the
      effectiveness of ELDOA along with decompression to minimize the re occurrence of low back and
      functional status. ELDOA will help to tone up the fascia and strengthen the spinal muscles
      The intervertebral disc consists of an inner nucleus pulposus (NP) and an outer annulus
      fibroses (AF). The central NP area which facilitate water retention, creating hydrostatic
      pressure to resist axial compression of the spine. The NP is primarily composed of type II
      collagen, which accounts for 20% of its overall dry weight. In contrast, the AF functions to
      maintain the NP within the center of the disc with low amount of PG; 70% of its dry weight is
      comprised of primarily concentric type I collagen fibers . In LDH, narrowing of the space
      available for the thecal sac can be due to protrusion of disc through an intact AF, extrusion
      of the NP through the AF though still maintaining continuity with the disc space, or complete
      loss of continuity with the disc space and sequestration of a free fragment.

      Motorized table with mechanical space in between two parts of table. Pelvic and thoracic belt
      is tie at lumber and thoracic level to fasten the patient. Static, intermittent and cycling
      distractive force applied to lumber area for minute. Distraction(angle of pull) and
      relaxation force is monitored by therapist. Specific disc that cause pain and other symptoms
      are targeted .curves on computer help to reduce muscle spasm. Antigravity force applied on
      lumber area in the space and pull backward protrude disc. Biofeedback computer module in
      which number of session depends upon medical condition age .targeted level of spine is
      selected. neuro oxy spinal decompression non-surgical and cost effective Treatment that
      stimulate natural healing of injured and degenerative vertebra. Works on decompressing and
      lengthening the spine with chronic pains. These movement produce negative pressure in the
      disc as a result vacuum created as a result bulge, protrude part repositioned and align.
      Nourishment of injured area is restore by oxygen and nutrients. Pressure on nerve relives
      patient feel symptoms free. Special senses in machine that detect limitation and tension of
      patient results of spinal decompression is better than traditional traction. Other name of
      decompression is intervertebral differential dynamic therapy, mechanical spinal distraction
      therapy. Negative pressure is created between vertebras so that protruded part pull inward
      and nerve become free from pressure. Table has two parts which is separated with space where
      distractive force apply on spine. Two belts thoracic and lumber to fasten the patient.
      Pulling force is minimal last for a minute depend upon patient symptoms can be adjusted to
      static, intermittent and cycling control by therapist to induce relaxation. During treatment
      antigravity force applied at spine automatically by machine system and helps to move
      protruded part back to position as a result nerve get pressure free. Treatment is painless,
      gentle and intermittent.

      Guy voyer is the founder of Elongation longitudinaux avec decoaption osteoarticulaire or
      LOADS longitudinal osteo articular decoaptation stretching .This exercise specifically work
      on every spinal level. Fascial stretch along with tension at spinal level. Strength of the
      back muscles and stretching of paraspinal work to improve the tone. Concept is based that
      micro movement affects macro movement as a result function betters. Spine contains 24
      segments c0/c1/c3 and end to L5/S1.Fascia attach to vertebral bodies anteriorly. Posteriorly
      osseous framework ,muscles attach with bones ,bony framework include zygapophyseal joints
      that guide movements , ligament structure restrict the movement.Disc that is sponge act as
      shock absorption. Neurological and circulatory system work to continue functioning. They
      effect body locally and generally. Local effects in reducing degeneration by mobilizing the
      zygapophyseal joints exchange of fluid with absorption, improve arterial and venous
      circulation that help to remove waste and improve circulation, improve tone ROM ,posture and
      alignment.

      General effects include postural correction by supporting systems ,limbs ,muscles. Improve
      respiratory mechanism that restore the flow of CSF,effect psychosomatic component make
      balance between mind and body,neurohormonal facilitation by improving autonomic function
      improvement and proper functioning,propioreception improvement by self-correcting poor
      posture, fascia work in coordinated chain manner and help to decrease the energy consumption.
    

Intervention name(s): Elongation Longitudinaux Avec Decoaption Osteo Articulaire; Decompression
Intervention type(s): Other; Other
Intervention description(s): Pre physiotherapy treatment
Gym (treadmill ,cycling,vibrator) according to ability and condition of patient Shortwave diathermy SWD for atleast 10 mins Decompression treatment i.e. Neuro-oxy motorized lumbar spinal decompression therapy for 25 minutes.
Post physiotherapy treatment
Conventional Tens and infrared heat for 10 minutes at low back region. TENS is modality to reduce pain and tension,by stimulating large diameter afferent fiber .IR give superficial heat for circulation and relaxation of muscles.
No exercises or walk were guided for home (till 24 hrs) Low back exs guided i.e knee to chest, pelvic rolling, bridging, SLR, pirformis exs is guided for home plan along with precautions.
No exertion ,drive carefully Avoid stairs climbing ,twisting ,bending ,weight lifting; Pre physiotherapy treatment
Gym (treadmill ,cycling, vibrator) according to ability and condition of patient Shortwave diathermy SWD for at least 10 minutes. ELDOA positions are guided and performed by patients before decompression Low back exercises guided i.e. knee to chest, pelvic rolling, bridging, SLR, piriformis exercises is guided for home plan along with precautions.
Decoarctation of (C0/C1/C2),(C4/C5),(C5,C6),(C6/C7),(T4/T5),(T6/T7),(T8,/T9),(L4/L5),(L5/S1) Neuro-oxy motorized lumbar spinal decompression therapy for 25 minutes. Post physiotherapy treatment Tens and infrared heat for 10 minutes at low back region. TENS is modality to reduce pain and tension, by stimulating large diameter afferent fiber .IR give superficial heat for circulation and relaxation of muscles.
ELDOA exercises(positions)are guided for home plan after session (after 24 hrs) No exertion ,drive carefully Avoid stairs climbing, twisting bending, weight lifting
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Control group will be treated by decompression session while experimental group will be treated with ELDOA along with decompression.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: ELDOA; Disc herniation; Decompression; LBP