Specialized Manual Therapy Techniques which Can Improve Neuromotor Outcome in Patients with Foot-Drop Syndrome

Abstract

Introduction: Functional rehabilitation of foot-drop syndrome due to lumbar disc herniation it is a problem that concerns many researchers. Study objective was to investigate if specialized manual therapy techniques and functional electrical stimulation alone and combined can influence the overall neuromotor outcome. Methods: 90 subjects were randomized to 3 groups, 30 subjects allocated to control group (CG) which received physical therapy, 30 subjects in functional electrical stimulation group (FES) and 30 subjects in combined FES with manual therapy techniques (FES-MT). All groups received a number of 20 sessions. We evaluated nerve conduction study, dynamometry, goniometry, functional ankle disability index (FADI), Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS). Results: For Compound muscle action potential we have found significant modifications when comparing FES-MT vs CG (p<0.011). For dynamometry we registered as follows: FES-MT vs CG (0.0001), FES-MT vs FES (p<0.003). ODI and FADI scores were more significant in FES-MT and FES compare with CG. Conclusions: Manual therapy techniques utilized for increasing the excitability of neuromuscular spindle can increase the overall functionality of the tibialis muscle in case of foot drop syndrome. The combination between FES and MT showed better functional results than physical therapeutic exercises and FES alone.