COMPARISON OF THE EFFECTIVENESS OF MCKENZIE EXTENSION EXERCISES VERSUS SWISS BALL EXERCISES ON PAIN, LUMBAR ROM AND FUNCTIONAL DISABILITY AMONG SUBJECTS WITH PIVD.

ABSTRACT Introduction: A Prolapsed Intervertebral Disc (PIVD), often called a lumbar disc herniation (LDH), is a common reason for lower back pain and sciatica, affecting many adults around the world. It happens when the soft inner part of a spinal disc pushes out through a weakened outer layer, pressing on nearby nerves. This pressure can lead to pain, stiffness in the lower back, and difficulty doing everyday activities . Aim: To know and compare the effectiveness of McKenzie extension exercises and Swiss ball exercises on pain, Lumbar Range of Motion and Functional disability among subjects with PIVD. Method:Thirty subjects were included in the study selected on the basis of inclusion, exclusion criteria and the subjects were assigned into two groups i.e., Group A and Group B after obtaining informed consent from the subjects. McKenzie extension exercises were given to GROUP A and Swiss ball exercises were given to GROUP B. TENS and stretchings were given to bilateral hamstring muscles and calf muscles to both the groups in common. Cryotherapy and kneading were given to the patients with paraspinal muscle spasm. Both the groups were treated for 4 sessions in a week for 3 weeks. Numerical pain rating scale was used to assess the pain, modified Schober’s index was used to assess the lumbar ROM and Oswestry disability index was used to assess the functional disability. Results: The descriptive statistics indicate that both Group A and Group B had similar participant characteristics, with mean ages of 41 and 41.27 years respectively, and an identical average PIVD duration of 2.27 months. Within-group analysis showed that both groups experienced significant improvements post-intervention. In Group A, pain (NPRS) scores reduced from 7.47 to 3.87, disability (ODI) scores from 20.87 to 13.60, and lumbar ROM (Modified Schober’s Index) increased from 1.20 cm to 3.07 cm, all with highly significant p values (<0.0001). Similarly, Group B showed reductions in pain (7.53 to 5.13), disability (20.87 to 13.60), and increased ROM (1.33 cm to 3.60 cm), with p value < 0.0001. Between-group comparisons revealed that Group A had significantly greater reductions in pain (p = 0.048) and functional disability (p = 0.001), while Group B showed significantly greater improvement in lumbar ROM (p = 0.037). Conclusion: The present study concludes that both McKenzie extension exercises and Swiss ball exercises are effective in reducing pain and functional disability, as well as improving lumbar range of motion (ROM). However, when compared, McKenzie extension exercises are more effective in reducing pain and functional disability, while Swiss ball exercises are more beneficial for increasing lumbar ROM. Key words: PIVD, McKenzie extension exercises, Swiss ball exercises, Numerical Pain Rating Scale, Modified Schober’s Index, Oswestry Disability Index