Reabilitação precoce de atletas utilizando hidroterapia após o tratamento cirúrgico de hérnia discal lombar: relato preliminar de 3 casos Early rehabilitation of athletes using hydrotherapy after surgical treatment of lumbar disc herniation: preliminary report of three cases

Os autores avaliaram três atletas do sexo masculino, submetidos a tratamento cirúrgico de hérnia discal lombar, com o objetivo de avaliar os resultados, após serem submetidos a um protocolo de reabilitação com base em hidroterapia. Este método permitiu a reabilitação precoce dos atletas, iniciando-se na primeira semana após a cirurgia. Os atletas foram avaliados em 5 ocasiões: pré-operatório e nos 4 meses seguintes. Houve melhora completa da dor em dois atletas. O terceiro caso apresentou no 4º mês 1,3% da intensidade máxima. As atividades de vida diária no período pré-operatório em média apresentaram-se com 21,6% da freqüência máxima, chegando a 99,3% no 4º mês. A freqüência de prática esportiva teve em média 10% da intensidade no pré-operatório, no 4º mês os atletas já praticavam a atividade esportiva com uma freqüência de 84,6% do normal. O nível de atividade esportiva foi relatado em média como 10% daquele estabelecido pelos atletas antes do início dos sintomas, atingindo 88,3% no 4º mês. Concluímos que os atletas apresentaram melhora evolutiva em todos os parâmetros analisados, especialmente em relação a dor. Portanto, a hidroterapia mostrou-se um método eficaz e bem tolerado na reabilitação precoce da cirurgia de hérnia discal em atletas.<br>Three male athletes submitted to surgical treatment of lumbar disc herniation were assessed aiming to evaluate the results of a rehabilitation protocol based on aquatic therapy. This method allowed early rehabilitation of the athletes, within a week after surgery. The athletes were evaluated in 5 occasions: pre-operatively and in the 4 following months. Complete improvement of pain was observed in two athletes. The third case had 1.3% of the maximum intensity in the 4th month. The daily life activities during the pre-operative period presented 21.6% of the maximum frequency on average, reaching 99.3% in the 4th month. The frequency of practicing sports was on average 10% the pre-operative intensity; in the 4th month the athletes already played sports with a frequency 84.6% of the normal. The level of sporting activities was reported as 10% on average of the one established by the athletes before the symptoms had started, reaching 88.3% in the 4th month. We conclude that the athletes had an evolutionary improvement in all the analyzed parameters, especially as regards pain. Thus, hydrotherapy was an effective and well tolerated method in the early rehabilitation of athletes after disc herniation surgery

A review of current treatment for lumbar disc herniation in children and adolescents

Lumbar disc herniation (LDH) is a common disorder among adults with degenerated lumbar intervertebral discs. However, its occurrence in childhood and adolescence is much less frequent mostly because children and adolescents tend to have a healthier lumbar spine as compared with adults. This difference indicates that children and adolescents are far from being just little adults. Over the years, there have constantly been published studies concerning this entity where the findings suggested that pediatric LDH is, in many ways, different from that in adults. To date, the prevalence, the etiological and the diagnostic features of pediatric LDH have been fully described in the literature whereas the characteristics regarding to the treatment is yet to be reviewed in details. The aim of the present review is to provide a collective opinion on the treatment of pediatric LDH as well as its outcome. It reviewed the relevant information available in the literature and compared the results among and within various treatments. It was found that pediatric patients responded less favorably to conservative treatment as compared with adults. In addition, the outcome of surgery remained to be satisfactory for at least 10 years after the initial operation, even though it appeared to deteriorate slightly. To the best of our knowledge, this is the first literature review focusing on the treatment of pediatric LDH