Effect of a Multimodal Movement Intervention in Patients With Neurogenic Claudication Based on Lumbar Spinal Stenosis and/or Degenerative Spondylolisthesis-A Pilot Study

Kim-Charline Broscheid; Tom Behrendt; Dennis Hamacher; Svantje Böker; Tabea Gagelmann; Christian Schmidt; Christina Caspari; Katharina Meiler; Andre Napiontek; Jörg Franke; Lutz Schega

doi:10.3389/fmed.2020.540070

Effect of a Multimodal Movement Intervention in Patients With Neurogenic Claudication Based on Lumbar Spinal Stenosis and/or Degenerative Spondylolisthesis-A Pilot Study

Front Med (Lausanne). 2020 Dec 8:7:540070. doi: 10.3389/fmed.2020.540070. eCollection 2020.

Affiliations

¹ Department Human Science, Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany.
² Department of Orthopaedic Surgery, Klinikum Magdeburg, Magdeburg, Germany.
³ Association for Health, Exercise and Sport, Magdeburg, Germany.

Abstract

Chronic low-back pain is a major individual, social, and economic burden. The impairment ranges from deterioration of gait, limited mobility, to psychosocial distress. Due to this complexity, the demand for multimodal treatments is huge. Our purpose is to compare the effects of a multimodal movement intervention (MI) (coordinative-cognitive exercises and dancing program) with standard physical therapy (PT) on gait, physical function, and quality of life in patients with lumbar spinal stenosis (LSS). The study design is based on a 6-week intervention with a two (group: MI/PT) by two (measurement time points: pre-/post-test) parallel group design with random assignment. Twenty-four subjects (18 female/6 male, 70.8 ± 10.6 years old) diagnosed with LSS were included and randomly allocated to the MI or PT group. The primary outcomes are minimum toe clearance (MTC) and double step length (DSL) variability and the Timed "Up & Go" test (TUG). Secondary outcomes are the Brief Pain Inventory, the short Fall Efficacy Scale-International (sFES-I), and the Oswestry Disability Index. Nine subjects for each group could be analyzed. The MTC variability revealed a significant between-group difference in the posttest (p = 0.008) showing a lower MTC variability for the MI compared to the PT group. The MI group displayed an improved TUG (p = 0.031) and a reduced sFES-I (p = 0.044). The decreased MTC variability and fear of falling as well as the improved functional mobility may contribute to a reduced risk of falling. For the subsequent study, further kinematic and cognitive parameters should be analyzed, and the number of participants has to be increased. Clinical Trial Registration: German Clinical Trial Register (ID: DRKS00021026/URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021026).

Keywords: chronic low-back pain; degenerative spondylolisthesis; functional mobility; gait variability; lumbar spinal stenosis; risk of falling; spinal cord claudication; the timed “up & go” test.