Abstract

Lumbar pain is very common problem in elderly patients in the western world and mostly the reason for inability to work. Influence of orthopedic devices on these patients is very controversial in orthopedics and physical therapy as effect on the posture was not mentioned yet and even a negative effect on the muscle strength of abdominal and lumbar muscle was respected. The aim of this study was to assess the effect of lumbar orthoses on the pain, muscular dysbalance and posture as well as on strength in comparison to natural history without specific treatment and with physical therapy. The prospective randomized study was done with 70 patients with pain over a period of 6 weeks.

4 groups were tested:

A. No therapy,

B. Only lumbar orthoses,

C. Only physical therapy,

D. Physical therapy plus orthoses.

The examination consisted in questionnaire about back pain (Bessel analog scale) amount of medicaments taken, general state of health, isometric maximal muscle testing and posture survey with computer surface measurements (Optrimetrie). In the first two weeks the groups with lumbar orthosis showed significant as pain reduction and reduced pain killing drugs and kept this for the post study period of 6 weeks. Muscle strength progressed in the groups proved by orthoses. The posture did not change very much in the study period whereas the reduction of lumbar lordosis was the highest in the group with lumbar orthoses and physical therapy.

Conclusion: Stabilisation orthoses enable early reduction of pain and mobility as well as the improvement of muscle strength. The old theory about muscle weakness due to lumbar orthoses has to be abolished. Lumbar orthoses are low-cost and effective treatment for lumbar back pain and can definitively added to physical therapy to improve in short time period muscle strength and posture and brings patients back to live.

Keywords: Low backpain; Spinal disorders; Muscle strength; Lumbar belt; Physiotherapy