Focused Spinal Stenosis Rehabilitation Program for Lumbar Spinal Stenosis
| Status: | Withdrawn |
|---|---|
| Conditions: | Orthopedic |
| Therapuetic Areas: | Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 40 - Any |
| Updated: | 2/7/2018 |
| Start Date: | May 1, 2017 |
| End Date: | February 1, 2018 |
Focused Spinal Stenosis Rehabilitation Program vs. Generic Williams Flexion Protocol
Lumbar spinal stenosis with neurogenic claudication is a common condition in the elderly
population and is characterized by bilateral buttock, thigh, or calf discomfort and/or pain,
as well as by weakness precipitated by walking and prolonged standing. Self-management
options include physical therapy, which includes exercise as a core component for improving
the flexibility and mobility of the spine and hips. A Williams flexion protocol has
historically been used to treat low-back pain following degenerative changes to the posterior
elements of the lumbar spine. However, few studies have been done to validate the efficacy of
this protocol. A more focused treatment protocol may be more efficacious. Patients in this
study will be randomized to receive either the generic physical therapy protocol (15
sessions) or the focused rehabilitation program (5 sessions). The sessions will take place
over the course of 6 months. Outcomes will be assessed using validated questionnaires and
physical function tests.
population and is characterized by bilateral buttock, thigh, or calf discomfort and/or pain,
as well as by weakness precipitated by walking and prolonged standing. Self-management
options include physical therapy, which includes exercise as a core component for improving
the flexibility and mobility of the spine and hips. A Williams flexion protocol has
historically been used to treat low-back pain following degenerative changes to the posterior
elements of the lumbar spine. However, few studies have been done to validate the efficacy of
this protocol. A more focused treatment protocol may be more efficacious. Patients in this
study will be randomized to receive either the generic physical therapy protocol (15
sessions) or the focused rehabilitation program (5 sessions). The sessions will take place
over the course of 6 months. Outcomes will be assessed using validated questionnaires and
physical function tests.
Inclusion Criteria:
- Lumbar spinal stenosis with neurogenic claudication
- Symptoms present for at least 3 months
- Moderate to severe acquired or congenital LSS based on radiological evaluation
- Lumbar MRI obtained within the past 12 months prior to initial physical therapy visit
- 40 years of age or older
- Body mass index less than or equal to 35
- Can tolerate a 6-min treadmill test
- Willing to comply with home exercises as prescribed
Exclusion Criteria:
- Acute disc herniation
- Grade 3 or greater spondylolisthesis
- Rheumatoid or autoimmune conditions (e.g., ankylosing spondylitis)
- Active spinal compression fractures
- Knee surgery in the previous 6 months (e.g., total knee arthroplasty)
- Previous spinal fusion
- Absence of pedal pulses
- Inflammation/infectious process
- Myelopathy
- Psychiatric disorder preventing informed consent or participation in assigned physical
therapy sessions
- Patients with pending litigation or workers compensation
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Hospital for Special Surgery Founded in 1863, Hospital for Special Surgery is the nation
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