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A New Perspective on Lumbar Disc Herniation Management Using Prone Knee Extension
Majid Shahbazi1, Tayyebeh Sadat Fatemi2
1Department of Physiotherapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran, mums.ac.ir.
Case Reports in Medicine
|January 12, 2026
Summary
This case report introduces the prone knee extension (PKE) exercise as a novel physiotherapy approach for lumbar disc herniation (LDH). The PKE exercise, combined with other therapies, effectively reduced pain and improved function in a patient with LDH.
Area of Science:
- Orthopedics
- Physical Therapy
- Rehabilitation Medicine
Background:
- Lumbar disc herniation (LDH) is a common cause of low back pain and radiculopathy, significantly impacting function and quality of life.
- Nonsurgical interventions are crucial for managing LDH symptoms and improving spinal stability.
- A novel physiotherapy approach is explored for its potential in managing LDH.
Purpose of the Study:
- To investigate the effectiveness of the prone knee extension (PKE) exercise as part of a comprehensive physiotherapy regimen for lumbar disc herniation (LDH).
- To assess the impact of PKE exercise on pain, mobility, and functional impairments in a patient with LDH.
Main Methods:
- A 34-year-old male with an acute exacerbation of LDH (L4-L5 disc protrusion) received a 5-week physiotherapy treatment plan.
- The regimen included prone knee extension (PKE) exercise, infrared heat, dry needling, diaphragmatic breathing, and core stability exercises.
- A home exercise program was also provided alongside 10 in-clinic physiotherapy sessions.
Main Results:
- Significant improvements were observed, including marked pain reduction and resolution of radiating lower limb symptoms.
- Lumbar range of motion increased, and patient-reported outcomes showed reduced disability (Oswestry Disability Index) and enhanced overall function (Global Rating of Change Scale).
- Improved sleep quality was also reported by the patient.
Conclusions:
- Integrating the prone knee extension (PKE) exercise into physiotherapy may be an effective nonsurgical intervention for managing lumbar disc herniation (LDH).
- This approach shows potential for pain relief, improved health status, and enhanced functional capacity in LDH patients.
- Further research is warranted to validate these preliminary findings and explore the broader applicability of PKE exercise in LDH management.
