Wearable Inertial Sensors-based Efficacy Evaluation of Comprehensive Traditional Chinese Medicine Therapy for Lumbar Disc Herniation Due to Qi-stagnation and Blood-stasis

Abstract

Background Conservative traditional Chinese medicine (TCM) treatment has clinically proven to have a clear curative effect on lumbar disc herniation (LDH) , and its mechanism of action and biomechanical effects are the hot spots in current research. Objective To perform a wearable inertial sensors-based gait analysis in LDH patients with qi-stagnation and blood-stasis before and after treatment, and to verify the advantages of comprehensive TCM therapy by biomechanical methods. Methods This study selected 40 inpatients with an admission diagnosis of LDH treated with comprehensive TCM therapy from Tuina Department, the Affiliated Hospital of Changchun University of Chinese Medicine from June 2020 to December 2021. The patients' age, gender, the lower limb with pain, baseline body mass index, hospitalization time and pre- and post-treatment scale scores for low back pain were collected. Gait parameters were collected by wearable inertial sensors at pre- and post-treatment. Results Among the 40 patients, 18 were males and 12 were females. Eighteen patients had pain in the left lower limb, 8 had pain in the right lower limb, and the other 14 had pain in both lower limbs. Patients had a mean age of (52.3±15.2) years, a mean body mass index of (25.2±4.2) kg/m2, and a mean length of hospitalization of (17.5±6.2) days. The treatment was effective or marketed effective in 35 cases, ineffective in 5 cases, achieving an overall response rate of 87.5%. The Visual Analogue Scale score and Oswestry Disability Index decreased, and the Japanese Orthopaedic Association Score increased after treatment compared with the baseline levels (P<0.05) . After treatment, the patient's cadence, speed, stride length, gait cycle, swing phase percentage, shank and foot shock impact increased, and the stance phase percentage decreased (P<0.05) . The range of motion of hip abduction and adduction, hip rotation, knee varus and valgus, knee rotation and ankle rotation decreased (P<0.05) . Increased pelvic obliquity index, pelvic tilt index, hip abduction and adduction degrees, hip flexion and extension degrees, hip rotation index, knee rotation index, ankle inversion and eversion degrees, ankle flexion and extension index, and ankle rotation index were also found after treatment (P<0.05) . No toxic or adverse events occurred during the treatment. Five cases had repeated symptoms or were rehospitalized during the follow-up. Conclusion Comprehensive TCM therapy can obviously relieve the pain, improve functional disorders and increase the gait dynamic stability in patients with LDH due to qi-stagnation and blood-stasis, which is a safe and effective conservative treatment option.

Keywords

• intervertebral disc displacement|intervertebral disk displacement|gait analysis|traditional chinese medicine therapy|manipulation, spinal|acupuncture moxibustion therapy|treatment outcome