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LETTER TO EDITOR
Year : 2014  |  Volume : 24  |  Issue : 4  |  Page : 262-263
 

Effect of exercise program on lumbosacral strain in patients on continuous ambulatory peritoneal dialysis


1 Department of Physiotherapy, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
2 Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India

Date of Web Publication10-Jul-2013

Correspondence Address:
V S Kumar
Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-4065.133787

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How to cite this article:
Krishna S R, Madhavi K, Kishore C K, Kumar V S. Effect of exercise program on lumbosacral strain in patients on continuous ambulatory peritoneal dialysis. Indian J Nephrol 2014;24:262-3

How to cite this URL:
Krishna S R, Madhavi K, Kishore C K, Kumar V S. Effect of exercise program on lumbosacral strain in patients on continuous ambulatory peritoneal dialysis. Indian J Nephrol [serial online] 2014 [cited 2021 Dec 6];24:262-3. Available from: https://www.indianjnephrol.org/text.asp?2014/24/4/262/133787


Sir,

In patients on continuous ambulatory peritoneal dialysis (CAPD), a weight of 2 l (2 kg) dialysate in the peritoneal cavity causes low back strain and pain. The lumbosacral strain is assessed by measurement of lumbosacral angle (LSA) radiologically by Ferguson's technique (normal humans around 30°), [1] range of motion (ROM) of lumbar spine is by Schober's test [2] and lumbosacral discomfort through Visual Analogue Scale (VAS) scoring.

We studied 11 patients (male: female = 8:3), five were diabetic, none had disc prolapse, fracture and infections of lumbosacral spine. The assessment of these parameters were carried out on three occasions in all patients, firstly [Figure 1] when the peritoneal cavity was empty (without fluid), secondly when the peritoneal [Figure 2] cavity was filled with fluid (after infusion of CAPD bag) and thirdly 3 weeks after initiating the exercises as prescribed below. The prescribed exercises were, (a) pelvic tilt in lying, (b) abdominal curl up, (c) single knee to chest flexion with flexion and extension of knee, (d) straight leg raising with ankle dorsiflexion and (e) standing pelvic tilt. [3] The measurements of LSA, ROM and VAS score were tabulated in [Table 1].
Figure 1: Lumbosacral angle before continuous ambulatory peritoneal
dialysis bag infusion


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Figure 2: Lumbosacral angle after continuous ambulatory peritoneal
dialysis bag infusion


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We observed by repeated measure analysis of variance statistical technique there was a statistically significant reduction in LSA and ROM of the lumbar spine and VAS score after the exercise program in comparison with the value before the initiation of exercise program.
Table 1: The statistically significant improvement of LSA, ROM of lumbar spine and VAS score after initiation of the
exercise program


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In conclusion, we suggest that an effective exercise program applied under physiotherapy specialists' guidance improves musculoskeletal strength of lumbosacral region to mitigate lumbosacral strain.


  Acknowledgment Top


We thank to Dr. Vishnu Vardhan Ph.D. (Statistics) for his help in statistical data analysis of our study.

 
  References Top

1.Goodman CE, Husserl EF. Etiology prevention and treatment of back pain in patients undergoing continuous ambulatory peritoneal dialysis. Perit Dial Int 1981;1:119-22.  Back to cited text no. 1
    
2.Hellems HK Jr, Keats TE. Measurement of the normal lumbosacral angle. Am J Roentgenol Radium Ther Nucl Med 1971;113:642-5.  Back to cited text no. 2
    
3.Magee DJ. Orthopedic Physical Assessment. 5 th ed. St. Louis, Missouri: Saunders; 2008. p. 515-616.  Back to cited text no. 3
    


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Indian Journal of Nephrology
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