Effects of ELDOA in Lumber Radiculopathy
Condition: Lumbar Radiculopathy
MeSH terms: Radiculopathy
Study type: Interventional

Summary: 
      ELDOA is the most beneficial intervention treating for lumbar pathologies such as
      radiculopathy. This study was a randomized control trial in which data was collected from
      Riphah Rehabilitation and Research Centre and Pakistan Railway Hospital-IIMCT. Purposive
      sampling technique was used for data collection. Research data was recorded by using
      prescribed validated questionnaire, NPRS and ODI. After taking consent from patients,
      patients were divided randomly in two groups through lottery method. Group A was treated with
      ELDOA and mobilization, group B was treated with only mobilization. It was observed that both
      groups showed improvement but ELDOA group showed more significant results.
    

Detailed description: 
      ELDOA is the most beneficial intervention treating for lumbar pathologies such as
      radiculopathy. ELDOA is defined as (Etirements Longitudinaux avec Decoaptation
      Osteo-Articulaire), it's a collective series of programmed group of exercises which are
      created to show remarkable improvements and to focus on healthy posture and a renowned French
      osteopath Guy Voyer, D.O also emphasized on development of spinal health. ELDOA are specially
      designed programmed exercises it regain the place of membranous fascia, soft structures such
      as muscles , cord like structures such as ligaments and tendons of a gliding surfaces like
      joints and vertebral body in their primary positions to the specified joints or spinal
      segmental areas.Musicians should be importantly acknowledge that: the shear forces arises due
      to repetition of movements because of activities of daily living , practicing and
      performances which lies down soft structure such as tissues, resulting in default posture and
      faulty alignment which after prolong time headed towards painful symptoms and dysfunction of
      normal structures. As in between the joints ELDOA forms adequate space in joints and a marked
      improvement is observed with in mechanics of gliding services such as joints, flow of blood
      also increases , with this pressure on intervertebral segmental discs also decreases
      ,inter-segmental hydration is regained, hyper tonicity in muscles occur, alertness, adrenal
      gland hormonal and equilibrium of metabolism occurs, also the tensions created by the
      myofascial like structures get to normal state, decrease in pain perception, progression
      toward ideal posture, different stages of sleep is markedly improved, and the sensation of
      being healthy is also gained. How does it occur? In physiotherapy common practice ELDOA
      assumed postures produces proper spacing in joints physically, it also allows aqua fluid to
      re-enter , moreover it provides early healing and cushioning to the structures, it also
      prepares the neuronal circuits to get adopt by nervous system and readjust the newly assumed
      positioning of the gliding joints. With time it also improves and also eliminates painful
      symptoms along with physical abnormalities.The advantages of regular clinical ELDOA practices
      are proved to be very effective and has significant effect on improving living standards ,
      one perception of living, and how ones feels , it also show improvement in joint functioning
      and mobility and increases the performance through working on its source. Despite of one's
      mobility and strength, flexibility, the protocols affecting the progression factors and least
      almost zero impact of EDOLA exercises makes it possible to be followed by everyone and are
      fully effective for health. ELDOA is being used 2.8% worldwide. Its prevalence is increasing
      rapidly because of its positive immediate effects.ELDOA is a combination of static exercises
      of strengthening and stretching that includes myofascial compartment and it helps to
      decompress the affected joints along with it also functionalizes the facial compartment. From
      the advantages it includes limitation beyond shaping the intrinsic muscles of spinal column
      and providing more strength and stability along with it decreases the risk of accidental
      injury functionalizing spinal segmental disc from effect of decompression forces, it also
      shape's the stretched muscles that are suspensory soft structures such as muscles and organ
      tissues that are connective in nature. Moreover EDOLA showed not only marked improvement but
      also enhanced adaptive postural health and also maintain posture of IS health. The spinal
      canal is arranged as house of exiting nerves that nourish our organs and the structures such
      as connective tissues that deeply suspends into the organs and increases their functioning
      and they are intact with the spinal column.ELDOA has significant effect on fluids and tissues
      it creates normalization, cellular level decompression and traction. When abnormal
      dysfunction occur proprioception, nerves, membranous structures such as fascia, ligaments and
      soft structures like muscle, organs are normalize by implantation of EDOLA and through this
      undergoing functioning of various systems such as of endocrine, hormonal changes and even
      activities of nervous system can also be notified. ELDOA also has significant effect globally
      body various systems and also locally allocating them back into harmony range and it also
      utilizes micro movements which further uproot macro functioning. In common practice it is
      observed that implementation of EDLOA has significant effect on normal digestion and
      absorption action, reproductive and geriatric function, improved sleep, decrease palpitations
      in heart along with decreases issues related to backache , moreover for an ordinary client
      having health related back issues it is not unusual for him to undergo the process of ELDOA.

      The main criteria of this descriptive study is to analyze the effectiveness of interventional
      treatments such as ELDOA and graded mobilization techniques in comparison, Both interventions
      are utilize to treat radiculopathy issues of lumbar segment which arises because of disc
      issues such as herniation, emphasis is on the development of beneficial treatment and
      efficient enough to proceed toward no surgical procedures method for affected persons in
      physiotherapy sciences to treat them with problems of radiculopathy of lumbar segmental area
      may arise due to disc health issues like herniation and to create such effective method which
      ensures more better instantly and long lasting results of ELDOA in treating the patients with
      radiculopathy of lumbar segmental area which arises due to disc herniation. a baseball player
      say that ELDOA's on the other hand allow for natural spinal and joint decompression which
      also allows for larger range of motion (the more open the spine the more a hitter is able to
      rotate and create hip separation which allows for increased power production), freedom of
      movement, and ultimately more athleticism.The object is to create a position that targets a
      specific intervertebral level, by creating a decoarctation between a fixed point means the
      inferior vertebra, and a mobile point the superior vertebra , which the object maintains
      through his/her own myofascial tension of a particular articular chain and result in the
      targeted intervertebral decoarctation. The technique of ELDOA define as step wise is
      as:1)Create a position that targets a specific intervertebral level,2)Creating a
      decoarctation between a fixed point (the inferior vertebra) and a mobile point (the superior
      vertebra).3)Maintains through his or her own myofascial tension of a particular articular
      chain and results in the targeted intervertebral decoarctation.4)The clinician monitors the
      position to provide objective feedback and coaches and encourages the patient.5)The clinician
      uses verbal, visual, and touch cues and works to use these cues Simultaneously. 6)Stack
      tensions and engage the whole body 7)Work in a holistic or multilevel way .8)Not to hold the
      breath or to strain with breathing but as far as possible to encourage a relaxed, "natural"
      diaphragmatic breathing.9)Once the patient is in the position, the clinician needs to palpate
      at the target articular level and cue the patient with "fine tuning" until he/she feels the
      decoaptation movement at the target level. 10)Patients to travel around inside their body and
      learn to fine tune themselves.11)The therapist has to work on progressions before the final
      position can be obtained by the patient.In daily routine PT cannot practice ELDOA to treat
      their patients that's why very few researches are seen on ELDOA in Pakistan. Evidence shows
      that ELDOA has significant results on musculoskeletal disorders; it can help in treating
      patients. This study will explains that ELDOA is very much effective in treating lumbar
      radiculopathy and it can improve their quality of life.
    

Intervention name(s): ELDOA; CONVENTIONAL PHYSIOTHERAPY
Intervention type(s): Other; Other
Intervention description(s): For Spinal Segment L4-L5 and L5-S1 proper ELDOA position was instructed to the experiment group patients.ELDOA stands for Elongation Longitudinaux Avec Decoaption Osteo Articulaire, or LOADS (Longitudinal Osteo-articular De-coaptation Stretching). ... They can be described as fascial stretch that localizes tension at the level of a specific spinal segmental.; Transcutaneous Electrical Nerve Stimulation (TENS):
120Z dual channel TENS unit made in Japan was used in the research. Electrodes of TENS were placed on lumbar region and TENS was given for 15 minutes on Constant mode. Intensity was adjusted according to patient's comfort.
Hot pack was applied on the lumbar region for 10 - 15 minutes.Lumbar Mobilization (CPA) was given on spinous process of L1- L5 vertebrae and L5-S1. For every session given 3 sets of 10 repetitions of each lumbar vertebra was performed.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: ELDOA; mobilization; lumber radiculopathy; NPRS; ODI