Abstract

Relevance. This study addresses the issue of rehabilitation for military personnel with lumbar disc herniation, which poses a critical challenge due to high levels of physical exertion and combat stress.

Aim. To investigate the effectiveness of manual therapy as a means of correcting the psychoemotional state and improving the quality of life of such patients within a long rehabilitation cycle.

Materials and methods. The study involved 30 military personnel (23 men and 7 women), randomised into two groups: basic (manual therapy + exercise (MT)) and control (exercise only + sham mobilisation (EX)). The assessment was performed using a number of tools: the McGill-Melzack Pain Questionnaire (pain), the HADS (anxiety/depression), the Tampa Scale of Kinesiophobia (kinesiophobia), the PCS (pain catastrophisation), and the Nottingham Health Profile (quality of life). Patients’ condition was assessed in three stages: before treatment (T1), after a 5-week course (T2), and after three months of follow-up (T3).

Results. At baseline, the groups were homogeneous, although the MT group had higher levels of pain and catastrophisation. After the course (T2), both cohorts showed significant progress: in the MT group, pain intensity halved and quality of life improved by 64.1% (compared to 36.8% in EX). Only the MT group had a statistically significant reduction in anxiety and depression (49.2%) with a high effect size (0.432). Furthermore, in this group, the effect size for reducing pain catastrophisation (0.571) was twice that of the EX group (0.256). However, at the T3 stage, different trajectories were found: in the MT group, partial regression of results occurred, while the EX group showed a prolongation of the effect with a stable improvement in quality of life by 54.8%. Therefore, manual therapy is effective for rapid psychoemotional stabilisation, and physical exercises are effective for maintaining a long-lasting analgesic result.

Conclusions. Manual therapy is an effective tool in the comprehensive rehabilitation of service personnel, as it not only helps to reduce the intensity of pain but also successfully overcomes psychological barriers, such as fear of movement and depressive states. To achieve the most sustainable functional well-being, it is recommended to integrate manual techniques into long-term physical training programmes.