Dr. Med., Associate Professor P.G. Shnyakin¹
PhD A.V. Botov¹
PhD, Associate Professor A.Y. Osipov¹
Dr. Hab., Associate Professor R.S. Nagovitsyn^2
1Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky, Krasnoyarsk
²Glazov State Pedagogical Institute named after V.G. Korolenko, Glazov

Key words: intervertebral hernia, physiotherapy, physical therapy.

Introduction. Excessive stress on the spine and paravertebral muscles in professional sports increases the likelihood of intervertebral hernia in athletes [1].
The aim of the study was to evaluate the effect of electro-neuromyostimulation and rehabilitation physical training on the fat degeneration of the multipart back muscle in athletes with a removed herniated disc (L4‑L5-S1).
Methodology and organization of the study. The participants are men (n=23) with experience of sports practice from 4 to 12 years. The average age of athletes is 29.74±6.43 years. All athletes successfully underwent surgical intervention – transpedicular fixation of the L5‑S1 segment with interbody corporodesis and decompression of the dural sac and nerve roots L5, S1.The follow-up period was 12 months. Five days after the operation, the athletes were randomly divided into two approximately equal groups. Group 1 (n=11) started daily rehabilitation with physical therapy (20-30 minutes). Group 2 (n=12) used electroneuromyostimulation of the paravertebral muscle area daily (two sessions of 30 minutes, pulse frequency-50 Hz), for two months. In the future, all the athletes studied used physical therapy for four months (at least 60 minutes a day). The presence of pain syndrome in athletes was assessed using the visual analog pain scale (VAS). To assess the degree of adipose degeneration of the multipart back muscle, the results of MRI and MSCT (1, 3, 6, 9 and 12 months after the operation). The Hounsfield scale was used for the calculation.
The results of the study and their discussion. The VAS data show a decrease in the dynamics of pain syndrome in all the studied athletes, starting from the moment of discharge (5.91±0.76 days after surgery) and until the end of the observation period. However, the magnitude of the pain syndrome in group 1 athletes was significantly higher (p<0.01) during the entire observation period. On average, the intensity of the pain syndrome in group 1 athletes exceeds the VAS indicators of group 2 by 1.73±0.46 points. MRI analysis and MSCT of athletes revealed an increase in adipose degeneration of the divided back muscle at the levels of L4‑L5‑S1 in athletes of both groups. However, the intensity of fat degeneration at L4‑L5‑S1 levels in Group 1 athletes was significantly higher (p<0.01) during the entire observation period.
Conclusion. The obtained data indicate the feasibility of using electroneuromyostimulation in athletes with a removed herniated disc (L4‑L5-S1) in the early postoperative period.

Literature

1. Botov A. Search for effective treatment techniques for professional athletes with lower back pain / A. Botov, P. Shnyakin, A. Osipov et al. // Journal of Physical Education and Sport. – 2018. – №18 (1). – P.17-22. DOI:10.7752/jpes.2018.01002.

Information for contacting the author: gto18@mail.ru