Supervised physical therapy versus unsupervised exercise for patients with lumbar spinal stenosis : 1-year follow-up of a randomized controlled trial
OBJECTIVE: To compare the 1-year outcomes of patients with lumbar spinal stenosis treated with supervised physical therapy or unsupervised exercise.
DESIGN: A single-center randomized controlled trial with concealed allocation, blinded assessor and intention-to-treat analysis.
SETTING: Spine care center.
SUBJECTS: A total of 86 patients presenting with symptoms of neurogenic claudication caused by lumbar spinal stenosis.
INTERVENTIONS: The physical therapy group received supervised physical therapy sessions twice a week for 6 weeks and home exercise program. The home exercise group received 6-week home exercise program only.
MAIN MEASURES: The primary outcome was symptom severity on the Zurich claudication questionnaire at 1 year. Secondary outcomes included physical function, pain, health-related quality of life and the surgery rate after 1 year.
RESULTS: At 1 year, more patients in the physical therapy group than in the home exercise group achieved minimum clinically important differences in Zurich claudication questionnaire symptom severity (60.5% vs 32.6%; adjusted odds ratio [AOR] 4.3, [95% CI [1.5-12.3], P = 0.01); Zurich claudication questionnaire physical function (55.8% vs 32.6%; AOR 3.0 [1.1-8.1], P = 0.03); SF-36 bodily pain (48.8% vs 25.6%; AOR 2.8 [1.1-7.3], P = 0.03), and SF-36 general health (20.9% vs 7.0%; AOR 6.1 [1.1-33.0], P = 0.04). The surgery rate at 1 year was lower in the physical therapy than in the home exercise group (7.0% vs 23.3%; AOR 0.2 [0.04-0.9] P = 0.04).
CONCLUSIONS: Supervised physical therapy produced greater improvements in symptom severity and physical function than unsupervised exercise and was associated with lower likelihood of receiving surgery within 1 year.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
|---|---|
| Enthalten in: |
Clinical rehabilitation - 35(2021), 7 vom: 19. Juli, Seite 964-975 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Minetama, Masakazu [VerfasserIn] |
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| Links: |
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| Themen: |
Exercise |
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| Anmerkungen: |
Date Completed 21.07.2021 Date Revised 23.04.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/0269215520986688 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM319870669 |
|---|
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| 041 | |a eng | ||
| 100 | 1 | |a Minetama, Masakazu |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Supervised physical therapy versus unsupervised exercise for patients with lumbar spinal stenosis |b 1-year follow-up of a randomized controlled trial |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 21.07.2021 | ||
| 500 | |a Date Revised 23.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To compare the 1-year outcomes of patients with lumbar spinal stenosis treated with supervised physical therapy or unsupervised exercise | ||
| 520 | |a DESIGN: A single-center randomized controlled trial with concealed allocation, blinded assessor and intention-to-treat analysis | ||
| 520 | |a SETTING: Spine care center | ||
| 520 | |a SUBJECTS: A total of 86 patients presenting with symptoms of neurogenic claudication caused by lumbar spinal stenosis | ||
| 520 | |a INTERVENTIONS: The physical therapy group received supervised physical therapy sessions twice a week for 6 weeks and home exercise program. The home exercise group received 6-week home exercise program only | ||
| 520 | |a MAIN MEASURES: The primary outcome was symptom severity on the Zurich claudication questionnaire at 1 year. Secondary outcomes included physical function, pain, health-related quality of life and the surgery rate after 1 year | ||
| 520 | |a RESULTS: At 1 year, more patients in the physical therapy group than in the home exercise group achieved minimum clinically important differences in Zurich claudication questionnaire symptom severity (60.5% vs 32.6%; adjusted odds ratio [AOR] 4.3, [95% CI [1.5-12.3], P = 0.01); Zurich claudication questionnaire physical function (55.8% vs 32.6%; AOR 3.0 [1.1-8.1], P = 0.03); SF-36 bodily pain (48.8% vs 25.6%; AOR 2.8 [1.1-7.3], P = 0.03), and SF-36 general health (20.9% vs 7.0%; AOR 6.1 [1.1-33.0], P = 0.04). The surgery rate at 1 year was lower in the physical therapy than in the home exercise group (7.0% vs 23.3%; AOR 0.2 [0.04-0.9] P = 0.04) | ||
| 520 | |a CONCLUSIONS: Supervised physical therapy produced greater improvements in symptom severity and physical function than unsupervised exercise and was associated with lower likelihood of receiving surgery within 1 year | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Exercise | |
| 650 | 4 | |a Physical Therapy | |
| 650 | 4 | |a intermittent claudication | |
| 650 | 4 | |a lumbar spinal stenosis | |
| 650 | 4 | |a surgery rate | |
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| 700 | 1 | |a Teraguchi, Masatoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Kagotani, Ryohei |e verfasserin |4 aut | |
| 700 | 1 | |a Mera, Yoshimasa |e verfasserin |4 aut | |
| 700 | 1 | |a Sumiya, Tadashi |e verfasserin |4 aut | |
| 700 | 1 | |a Nakagawa, Masafumi |e verfasserin |4 aut | |
| 700 | 1 | |a Yamamoto, Yoshio |e verfasserin |4 aut | |
| 700 | 1 | |a Matsuo, Sachika |e verfasserin |4 aut | |
| 700 | 1 | |a Sakon, Nana |e verfasserin |4 aut | |
| 700 | 1 | |a Nakatani, Tomohiro |e verfasserin |4 aut | |
| 700 | 1 | |a Kitano, Tomoko |e verfasserin |4 aut | |
| 700 | 1 | |a Nakagawa, Yukihiro |e verfasserin |4 aut | |
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