Effect of Pneumatic Compression on Diaphragmatic Excursion in Hemodialysis Patients With Low Back Dysfunction

Effect of Pneumatic Compression on Diaphragmatic Excursion in Hemodialysis Patients With Low Back Dysfunction

This study will be conducted to investigate any significant effect of pneumatic compression on diaphragmatic excursion in patients with low back dysfunction .

The prevalence of the musculoskeletal manifestations is high (76.4%) in the hemodialysis population .Pain is the most frequently reported symptom (44.9%). Seven studies (28%) reported back pain With a prevalence ranging from 14.29%-52%. In hemodialysis patients, Low back pain (LBP) can be attributed to sedentary lifestyle ،low physical performance, muscular weakness ،psychological factors, altered metabolic activity of the bones and joints, and rare causes such as tumor, spinal infection, and osteoporotic fractures.

Diaphragm is an important component of spine lumbar stability. In presence of low back pain ،there may be some alterations in this muscle like other muscles that are responsible for lumbar stabilization. Respiratory muscle training (RMT) has been proven to reduce pain intensity and improve respiratory muscle strength, physical function, balance, and consequently، the overall quality of life in several population groups.

Pneumatic compression device had a significant improvement in pulmonary functions and inspiratory muscle training. And pneumatic compression can be considered as an effective component for pulmonary rehabilitation in chronic obstructive pulmonary lung disease. patients. Up to investigated knowledge, No previous studies conducted to explore the effect of pneumatic compression versus Inspiratory muscle training on diaphragmatic function in patients with low back dysfunction .

Inclusion Criteria:

• Patients have been on regular hemodialysis (three sessions a week) at least 6 months before the start of the study
• Patients 'Age between 40 and 60 years old
• Patients have not participated in any physical activity program at least 6 months before the start of the study
• Patients have chronic back pain > 3months
• Patients has non specific low back pain
• Body mass index (BMI) from 25 to 34.9 kg/m2.
• Patients are clinically and medically stable

Exclusion Criteria:

• Instability of patient's medical condition
• Patients with chest infection
• Inability to comprehend and follow instructions as in dementia or speech problems such as dysphasia,
• uncontrolled diabetes mellitus,
• Persistent systolic Blood Pressure (BP) greater than 200 mmHg, persistent diastolic BP greater than 120 mmHg
• Chronic lung disease which result in significant oxygen desaturation on exercise or pulmonary congestion
• Patients with lupus nephritis.
• Patients with Spondylodiscitis , Compression fracture, Spinal stenosis