Comparison of Cyriax Manipulation and Decompression in LDP
Condition: Lumbar Disc Herniation
MeSH terms: Intervertebral Disc Displacement; Hernia
Study type: Interventional

Summary: 
      In this study, compare the effects of Cyriax manipulation and Decompression in patient with
      lumber disc prolapseThis research will provide an important addition to the evidence based
      treatment intervention in physical therapy in the field of manipulation as there is no such
      research work have been done on comparative study of cyriax manipulation and decompression in
      lumber disc protrusion.
    

Detailed description: 
      According to an estimate, 70 to 80% of the adult population will experience a clinically
      relevant episode of LBP at some time in their lives. Within the vast differential of LBP, the
      most common source is intervertebral degeneration leading to degenerative disc disease and
      LDH. The efficacy of manipulative physical therapy, physical therapy intervention and therapy
      by general practitioner (GP) for persistent general LBP and neck pain was investigated on 256
      patients how didn't received any of the above therapy in last two years were contained in
      this study. Physical therapy included workout exercises, massage, and physical therapy
      (related to hot pack, different pain modalities like therapeutic ultrasound, shortwave
      diathermy, and electrotherapy). Manual therapy includes manual reduction by manipulation and
      mobilization of the back. Interventions received by GP is medicine related (different types
      of pain killer and muscles relaxant), guidance about the posture, home plan exercises and
      different healthy activities and proper rest. Placebo intervention included adjustable
      shortwave diathermy session for (10 minutes), and adjusted therapeutic ultrasound session for
      (10 minutes). Recovery rate in the leading complaint was increased with the group receiving
      manual therapy intervention (4.5) as compare to physical therapy (3.8), after a detailed one
      year of continuous therapy. There is a great progression seen in physical work by manual
      therapy. Moreover, manipulation is get going improved gradually, as compare to physiotherapy
      following in period of 12 months.

      The first meta-analysis estimated the efficacy of SMT for LBP due to LDH with other therapies
      come to the result that SMT was equally effective when compare to other traditional
      therapies. However a past systematic review was come to the conclusion that SMT was secure
      and effective in relation to its costs for managing SLDD like LDH, that conclusion was quoted
      to promote by a very few publications.

      One of the present research studies after one year of continuation showed decrease in pain
      and increase in recreational activities to a long period of time, an additional research work
      in 2016 described, a remarkable progression in sciatica after 30 days, in patients with
      lumber discs extrusion and sequestration, as a result of HVLA thrust.

      In spite of the factor that there is only average numbers of documentation in the written
      work which promoted the utilization of SMT to manage LDH, it is extensively applied by
      therapist.

      the comparison of cyriax manipulation and decompresion is an important adding to the
      researches in evidence based practices. there is no such work done before on comparison of
      both intervention.
    

Intervention name(s): cyriax manipulation lumber; lumber decompression
Intervention type(s): Other; Other
Intervention description(s): In group A patients were treated with conservative therapy (hot pack, Kaltenborn soft tissue techniques and home plan) and Cyriax manipulation.
Exercises (Guided low back exercises, 3-5times/day). Ankle pumping (5-10 repetition with 15-20 second hold), Quads Isometric (5-10 repetition with 15-20 second hold), Hams & Calf stretching (5-10 repetition with 15-20 second hold), Bridging (5-10 repetition with 15-20 second hold), Prone Back extension (10 repetition) Precaution Prevent yourself from sitting low on ground, Sitting with support will be directed and be careful during driving and ascending stairs.
Cyriax Manipulation: 2-3 repetitions/session, 2 session/week Lumbar spinal manipulation Rotation Techniques Lumbar spinal manipulation Extension Techniques Lumbar spinal manipulation Antideviation Techniques total of 4 session were given. 2 session/week.; Group B: In group B patients were treated with conservative therapy (hot pack, Kaltenborn soft tissue techniques and home plan) and Decompression Session.
Conservative therapy: Same as Group A
Lumbar spine decompression:
30 Minutes Session (generalized time for every one) . On the account of MRI description level is recommended and acknowledged by MRI the level of disc protrusion, decompression is operated. Patient is lying on table facing upward. For locking of the patient's body it was secured by pelvis and thoracic straps. One part of the decompression table is immobile other is movable. Bottom extreme part of the table is mobile.
Estimation of weight of patient is first thing to do. We calculated it by division of whole weight by 5 and that 5th segment of weight was utilized as an interventional pound for decompression. .
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Herniation; Cyriax manipulation; decompression; bulge; protruded; extruded