A qualitative study of older people’s experience of living with neurogenic claudication to inform the development of a physiotherapy intervention

Abstract

We have obtained important findings about older people's experiences of living with NC and preferences for physiotherapy treatment and outcomes. These will be incorporated into an evidence-based intervention and evaluated in a randomized controlled trial. Implications for rehabilitation Older people living with NC want to get back to meaningful activities and learn how to live with the threat of pain. Allied health professionals (AHPs) should be sensitive to the complex and ambiguous ways in which older people live with ageing and age-related decline. AHPs are in a position to support patients' successful transition to the use of walking aids thereby reducing stigmatizing effects and increasing activity. AHPs should consider a mixture of one-to-one and group classes to enable rehabilitation for older NC patients.

Health-related preferences of older patients with multimorbidity: an evidence map

“…Thirty-two studies (22 %) investigated a variety of treatment preferences concerning (1) medication (13/32),37 41–43 47 49 53 54 105–108 perhaps for a specific blood pressure-lowering drug due to its characteristics (eg, effects and dose schedule),106 (2) dialysis as a treatment option in end-stage renal disease (6/32),48 109–113 (3) surgery (4/32),114–117 such as a decision in favour of implantable cardioverter-defibrillators or joint replacement, (4) chemotherapy (5/32),35 57 118–120 for which studies may have examined preferences in adjuvant cancer treatments and (5) non-pharmacological/conservative interventions (3/32),121–123 such as studies exploring preferences for activity interventions 121…”

Minimally Invasive Decompression and Physiotherapy for Lumbar Spinal Stenosis in Geriatric Patients

“…Limited data exist to guide the development of a physiotherapy regimen for geriatric patients with LSS, and the data that does exist is largely derived from non-surgical populations. Furthermore, no standard of care exists for the delivery of physiotherapy for LSS [ 23 ], and when regimens are evaluated, the actual amount of therapy delivered is frequently not standardized or adequately described [ 24 - 25 ]. Likewise, the modalities applied in the community are heterogeneous [ 26 ].…”

“…Likewise, the modalities applied in the community are heterogeneous [ 26 ]. The phases of rehabilitation in our regimen were designed to represent an incremental progression of ambulatory ability because ambulation is a primary concern of older patients with neurogenic claudication [ 23 ]. Strengthening and aerobic conditioning are central components of each phase, which have been shown to be effective for reducing pain and disability in patients with LSS [ 27 ].…”

AAPT Diagnostic Criteria for Chronic Low Back Pain

“…1,29 Many patients complain about a decrease in their social interactions. 1,55 Comorbid symptoms of depression appear to adversely impact postoperative symptom severity and disability in patients with lumbar stenosis undergoing surgical decompression. 60 The physical limitations associated with NC often lead to feelings of sadness, social isolation, and depression.…”

“…60 The physical limitations associated with NC often lead to feelings of sadness, social isolation, and depression. 1,29,55 The unpredictability of symptom severity and inability to perform activities of daily living can lead to anxiety, embarrassment, and lack of independence. 1…”