Comparison of two types of exercises in the treatment of lumbar spinal stenosis

Abstract

Objective:To evaluate the efficacy of core stability exercise versus conventional exercise in the treatment of lumbar spinal stenosis.Methods:Between January 2014 and May 2017, patients with lumbar spinal stenosis were recruited and divided into group of core stability exercise or conventional exercise randomly. All the patients were treated using middle frequency electrotherapy, in addition to that, the patients in group of core stability exercise were treated using core stability exercise. The patients in group of conventional exercise were treated using conventional exercise. The outcome was evaluated using Japanese Orthopedic Association (JOA) score, self-reported walking capacity and lumbar lordosis angle at baseline and after treatment.Results:In the current study, sixty-two patients with lumbar spinal stenosis met the inclusion and exclusion criteria, in which 33 patients were included in group of core stability exercise and 29 in group of conventional exercise. After treatment, both Japanese Orthopedic Association scores (p<0.05) and self-reported walking capacity (p<0.05) increased significantly in each group when compared with baseline. The self-reported walking capacity and JOA scores in the group of core stability exercise were significantly higher than those in the conventional exercise group (p<0.05). However, both the intragroup and intergroup comparison of lumbar lordosis presented with no significance (p>0.05).Conclusion:Core stability exercise presents with better efficacy than conventional exercise in the treatment of lumbar spinal stenosis.

Exercise treatments for lumbar spinal stenosis: A systematic review and intervention component analysis of randomised controlled trials

“…Participant characteristics, interventions and comparators, follow-up time points, risk of bias, and intervention reporting quality of the included trials are presented in Table 2. Ten trials [25][26][27][28][29][30][31][32][33][34][35] had two treatment arms, and the remainder had three arms. [36][37][38] The included trials involved a total of 1440 participants with a mean age of 65 years (standard deviation 9), of whom 985 were allocated to a supervised or structured home exercise intervention.…”

“…Over half of the exercise interventions (15/23) were 'multi-modal' in nature, combined with manual therapy, passive modalities, medical treatments, education, or psychologically informed approaches. Studies published in the last 5 years [29][30][31][32][33][34][35]37 were less likely to include passive modalities and more likely to include a psychologically informed approach.…”

“…From the 13 trials, eight exercise interventions from seven trials 29 , 30 , 32 , 33 , 35 – 38 reported in favour of exercise for one or more short-term or medium-to-long-term outcome and were coded as ‘successful’.…”

“…Fifteen interventions from 10 of the trials 25 – 28 , 30 – 34 , 36 , 37 did not report in favour of exercise for our predefined short-term or medium- to long-term outcomes and were therefore coded as ‘unsuccessful’. Of these, one trial 31 that combined exercise with medical treatment reported findings in favour of the control intervention of medical treatment without exercise.…”

Nonsurgical therapy for lumbar spinal stenosis caused by ligamentum flavum hypertrophy: A review

“…Kim et al [33] found that after 4 weeks of lumbar dorsiflexion training in 15 patients with LSS, the mean scores on the Oswestry Disability Index (ODI), Spinal Stenosis Scale, and Roland-Morris Disability Questionnaire decreased by >25%, indicating that the patients' pain and lower limb function were obviously improved. Mu et al [34] found that Japanese Orthopaedic Association scores and walking distance were improved in patients with LSS after core strength training such as plank, side plank, and bridge. Pauwels et al [35] instructed 12 patients with LSS to perform bicycling, and 7 of them showed a mean decrease of 63.5% in the numerical rating scale after 3 months, suggesting marked relief of neurogenic pain.…”