The Effect of Exercise And Healthy Nutrition Program On Physical and Functional Level in Patients With Lumbal Disc Herniation: A Case Study

Yıl 2020, Cilt: 7 Sayı: 2, 123 - 135, 28.08.2020

Birgül Morkoç , Sevil Bilgin , Esra Dülger Ruhi Soylu İnci Türkoğlu , Ebru Melekoğlu

https://doi.org/10.21020/husbfd.546385

Öz

Objectives: This study was carried out to investigate the effect of lumbal stabilization exercises and healthy nutrition programme on the physical and functional levels of people with low back pain associated with lumbar disc herniation.
Materials and Methods: Two subjects with lumbar disc herniation were included in the study. One patient received lumbar stabilization exercises (Case 1) and the other patient (Case 2) received lumbar stabilization exercises and a healthy diet program under control of dietitian. Exercises were performed under the supervision of a physiotherapist for 8 weeks, 3 days a week. Pain, Transversus Abdominus and Multifidus muscle thickness, trunk and lower limb muscle strength, anthropometric measurement, physical activity, energy and nutrient intake measurements were measured before and 8 weeks after the treatment.
Results: After 8 weeks of treatment, it was observed that pain decreased in both cases, there was no significant change in muscle thickness, trunk and lower limb muscle strength increased, body weights and fat mass decreased. In case 2, it was seen that the level of physical activity increased significantly and energy and nutrient intake approached normal.
Conclusion: This is the first study to investigate the effect of exercise and healthy nutrition program on the physical and functional level of people with lumbar disc herniation. We think that directing people with low back pain to healthy nutrition programs with exercise will have a positive effect on physical and functional level. 

Anahtar Kelimeler

Low back pain, exercise, nutrition

Lumbal Disk Hernisinde Egzersiz ve Sağlıklı Beslenme Programının Fiziksel ve Fonksiyonel Düzey Üzerine Etkisi: Vaka Çalışması

Öz

Amaç: Bu çalışma lumbal stabilizasyon egzersizleri ve sağlıklı beslenme programının lumbal disk hernisine bağlı bel ağrısı olan kişilerin fiziksel ve fonksiyonel düzeyleri üzerine etkisini incelemek amacıyla yapılmıştır.
Gereç ve Yöntem: Çalışmaya lumbal disk hernisi tanısı konulan iki birey dahil edildi. Bir hastaya lumbal stabilizasyon egzersizleri (Olgu 1), diğer hastaya stabilizasyon egzersizlerine ek olarak diyetisyen kontrolünde sağlıklı beslenme programı (Olgu 2) verildi. Egzersizler 8 hafta, haftada 3 gün fizyoterapist gözetiminde yaptırıldı. Tedavi öncesi ve 8. haftada ağrı, Transversus Abdominus ve Multifidus kas kalınlığı, gövde ve alt ekstremite kas kuvveti, antropometrik ölçüm, fiziksel aktivite, enerji ve besin öğeleri ölçümleri yapıldı.
Bulgular: 8 haftalık tedavi sonrasında her iki olguda da ağrıların azaldığı, kas kalınlığında belirgin değişiklik olmadığı, gövde ve alt ekstremite kas kuvvetinin arttığı, vücut ağırlıklarının ve yağ kütlesinin azaldığı görüldü. Olgu 2’de ise fiziksel aktivite düzeyinin belirgin arttığı, enerji ve besin alımının normale yaklaştığı görüldü.
Sonuç: Bu çalışma egzersiz ve sağlıklı beslenme programının lumbal disk hernisinde bireylerin fiziksel ve fonksiyonel düzey üzerine etkisini inceleyen ilk çalışmadır. Bel ağrılı kişilerin egzersiz ile birlikte sağlıklı beslenme programlarına yönlendirilmesinin fiziksel ve fonksiyonel düzey üzerine olumlu etki sağlayacağını düşünmekteyiz. 

Anahtar Kelimeler

Bel ağrısı, egzersiz, beslenme

Kaynakça

• Cowan SM, Crossley KM, Bennell KL. (2009). Altered hip and trunk muscle function in individuals with patellofemoral pain. British journal of sports medicine, 43(8):584-8.
• Gibson RS. (2005). Principles of nutritional assessment: Oxford university press, USA.
• Hodges PW, Richardson CA. (1996). Inefficient muscular stabilization of the lumbar spine associated with low back pain: a motor control evaluation of transversus abdominis. Spine, 21(22):2640-50.
• Hodges P, Holm AK, Hansson T, Holm S. (2006). Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury. Spine, 31(25):2926-33.
• Inani SB, Selkar SP. (2013). Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain: a randomized clinical trial. Journal of back and musculoskeletal rehabilitation, 26(1):37-43.
• Jaramillo J, Worrell TW, Ingersoll CD. (1994). Hip isometric strength following knee surgery. Journal of Orthopaedic & Sports Physical Therapy, 20(3):160-5.
• Khan, A. N., Jacobsen, H. E., Khan, J., Filippi, C. G., Levine, M., Lehman, R. A., ... & Chahine, N. O. (2017). Inflammatory biomarkers of low back pain and disc degeneration: a review. Annals of the New York Academy of Sciences, 1410(1), 68-84.
• Kim, S. K., Jung, I., & Kim, J. H. (2008). Exercise reduces C-reactive protein and improves physical function in automotive workers with low back pain. Journal of occupational rehabilitation, 18(2), 218-222.
• Kisacik, P., et al., (2016). Investigating the effects of a multidimensional exercise program on symptoms and antiinflammatory status in female patients with ankylosing spondylitis. Complementary therapies in clinical practice, 22: p. 38-43.
• Martínez-Rodríguez, A., Leyva-Vela, B., Martinez-Garcia, A., & Nadal-Nicolas, Y. (2018). Effects of lacto-vegetarian diet and stabilization core exercises on body composition and pain in women with fibromyalgia: randomized controlled trial. Nutricion hospitalaria, 392-399.
• McCormack HM, David JdL, Sheather S. (1988). Clinical applications of visual analogue scales: a critical review. Psychological medicine, 18(4):1007-19.
• Merdol T. 2003. Standart Yemek Tarifeleri (3. bs.). Ankara: Hatipoğlu Yayınevi.
• Moreland J, Finch E, Stratford P, Balsor B, Gill C. (1997). Interrater reliability of six tests of trunk muscle function and endurance. Journal of Orthopaedic & Sports Physical Therapy, 26(4):200-8.
• Neale E, Batterham M, Tapsell LC. (2016). Consumption of a healthy dietary pattern results in significant reductions in C-reactive protein levels in adults: a meta-analysis. Nutrition research, 36(5):391-401.
• Rakıcıoğlu N, Tek Acar N, Ayaz A, Pekcan G. 2009. Yemek ve besin fotoğraf kataloğu-ölçü ve miktarlar. Ankara: Ata Ofset Matbaacılık.