Multidisciplinary Conservative Treatment Outcomes of in-Patient Physiotherapy Set-Up Among Patients with Lumbar Disc Herniation in Dhaka City, Bangladesh: A Retrospective, Cross-Sectional Study

Abstract

Background

The study aimed to determine the outcome of Multidisciplinary physiotherapist-led conservative treatment of lumbar disc herniation at an in-patient set-up of a specialized spine center in Dhaka, Bangladesh.

Methods

This was a retrospective cross-sectional study of 228 cases completing treatment and follow-up sessions. The outcome was evaluated as pain at rest and five different functional positions, neurological recovery, and Magnetic resonance imaging (MRI) changes during discharge and follow-up.

Results

80.3% had a complete recovery with a typical motor and sensory status, no limitations in straight leg raise (SLR), no cauda equina symptom (CES), and no or <3 pain during more than 30 minutes of daily living activities. Statistically significant changes were noted at all outcome measures at the follow-up (day 90), compared to baseline (day 1) P<0.01. In the posthoc tests, pain, SLR, and CES had the most significant improvement at discharge (day 12) compared to the baseline (P < 0.01) and at follow-up compared to discharge (P < 0.01). No major adverse events noted.

Conclusion

Physiotherapist-led in-patient treatment results in significant resting and functional pain outcomes in 12 days. Also, the improvements in neurological recovery and normalizing disc position are statistically significant in 90 days.

Keywords:

• lumbar disc herniation
• multidisciplinary
• conservative treatment
• physiotherapy

Data Sharing Statement

Data is available as LDH dataset.xls in Mendeley Data, V1, www.doi.org/10.17632/ym5h3prdmp.1.

Institutional Review Board

Ethical approval was obtained before data collection from the Institutional review board of the Institute of Physiotherapy, Rehabilitation and Research (BPA-IPRR/IRB/06/16/20394) on June 16, 2022.

Informed Consent Statement

The study was a retrospective study on treated patients. During the intervention, participants provided consent in written form through informed consent of assessment, treatment, and using unanimous data for conducting research later.

Acknowledgment

The authors acknowledge Md. Arif Hossain for coordinating the data collection process and the volunteers of “Amran’s School of Thoughts” for their contribution to data auditing and analysis.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declared no conflicts of interest in this work.

Additional information

Funding

The study was a self-funded study by the authors.