© 2017 Hormoz Maragoul
Background and Purpose: Spondylolisthesis is a condition that describes the anterior translation of the cephalad vertebral segment of the skeletal spine relative to the caudal segment. This condition comes about by forces of gravity acting through the lordotic curve of the lumbar spine. Repetitive extension movements and weakened stabilizing muscles of the trunk like the abdominals and the gluteals may also play a role in contributing to spondylolisthesis. There is an increase in incidence rate of spondylolisthesis in adolescents who participate in sports involving repetitive extension motions. The purpose of this study is to examine the effectiveness of physical therapy management aimed at stability and strengthening for an adolescent with spondylolisthesis. Case Description: The patient was a 14-year-old female who was referred to an outpatient orthopedic physical therapy clinic diagnosed with spondylolisthesis at the level of L5 with imaging. Upon evaluation, the patient demonstrated hyperflexibility, joint hypomobility, weakness and instability. Treatments included gluteals and abdominal strengthening and stabilization. The Oswestry Disability Index (ODI) was used to quantify impairment and to measure improvement over the episode of care. Outcomes: During the initial evaluation, the patient reported a Numeric Pain Rating Scale (NPRS) of 6/10 at worse, an ODI score of 62% and a Manual Muscle Testing (MMT) grade of 2/5, 3/5 and 3/5 for transverse abdominus, hip extension and hip abduction, respectively. At the four-week point the patient reported a NPRS of 4/10 at worse, an ODI score of 20% and a MMT of 2+/5 for transverse abdominus with no change for hip extension and hip abduction. Results improved further during discharge with a reported 2/10 on the NPRS, a 7% on the ODI and MMT improvements to 3/5, 4/5 and 4/5 for transverse abdominus, hip extension and hip abduction, respectively. Discussion: Abdominal stabilization and gluteal strengthening seem to have a positive effect in reducing both pain and ODI score of a fourteen-year-old dancer with low back pain caused by spondylolisthesis.
Maragoul, Hormoz, "The Effect Of A Stability And Strengthening Program On The Oswestry Disability Index In A 14-Year-Old Patient With Spondylolisthesis: A Case Report" (2017). Case Report Papers. 80.