EFFECTIVENESS OF EXERCISE PROGRAMS FOR SYMPTOMATIC LUMBAR SPINAL STENOSIS: A SYSTEMATIC REVIEW

IF 0.2 Q4 SPORT SCIENCES Kinesiologia Slovenica Pub Date : 2022-11-20 DOI:10.52165/kinsi.28.3.201-212
Katja Plaskan, Miha Vodičar, M. Pajek
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Abstract

Patients with lumbar spinal stenosis (LSS) have significant disability and functional limitations of walking. They commonly report problems with balance, sensory loss, and weakness of the muscles of the lower extremities. The prevalence and economic burden associated with LSS are expected to increase dramatically because of the aging population. Recently, physical exercise and walking programs have been presented as possible interventions to improve daily life in patients with lumbar spinal stenosis (LSS). To date, there is a lack of clear descriptions of non-surgical treatment protocols and how combinig these interventions affect daily life of the patients and help to prolong the time to surgery. The aim of this systematic review is to provide a comprehensive and updated summary to the reader addresing exercise programs which can help reduce symptoms of lumbar spinal stenosis. Two electronic databases were searched for randomized controlled studies of physical exercise or walking programs and other non-surgical treatment that examined effects on physical abilities/performance in daily life. Four articles were included. All included studies used physical exercise as an intervention, with one study also including medical care (tablet-based with the option of epidural steroid injections). Two studies included manual therapy and two studies offered individually supervised exercise sessions. As a control group, two included a home-based intervention and one was comparing three different conservative treatments included manual therapy/individualized exercise. A significant intervention effect was observed in all studies compared with the control groups, except in study, where the primary outcomes were between-group differences. The present systematic review on non-operative treatment included patients diagnosed for lumbar spinal stenosis with neurogenic claudication concluded that there is moderate-quality evidence and limiting the ability to make conclusions about their effectiveness. Further trials are needed.
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运动方案对症状性腰椎管狭窄的有效性:一项系统综述
腰椎管狭窄(LSS)患者有明显的残疾和行走功能限制。他们通常会出现平衡、感觉丧失和下肢肌肉无力等问题。由于人口老龄化,与LSS相关的患病率和经济负担预计将急剧增加。最近,体育锻炼和步行计划被认为是改善腰椎管狭窄(LSS)患者日常生活的可能干预措施。迄今为止,缺乏对非手术治疗方案的明确描述,以及这些干预措施如何影响患者的日常生活并帮助延长手术时间。本系统综述的目的是为读者提供一个全面和最新的总结,以解决有助于减轻腰椎管狭窄症状的锻炼计划。研究人员在两个电子数据库中搜索了关于体育锻炼或步行计划以及其他非手术治疗对日常生活中身体能力/表现的影响的随机对照研究。共纳入四篇文章。所有纳入的研究都使用体育锻炼作为干预措施,其中一项研究还包括医疗护理(以片剂为基础,可选择硬膜外类固醇注射)。两项研究包括手工疗法,两项研究提供个人监督的锻炼课程。作为对照组,两组包括家庭干预,一组比较三种不同的保守治疗,包括手工治疗/个性化锻炼。与对照组相比,所有研究均观察到显著的干预效果,但主要结果存在组间差异的研究除外。目前对非手术治疗的系统评价包括诊断为腰椎管狭窄伴神经源性跛行的患者,结论是有中等质量的证据,并且限制了对其有效性作出结论的能力。需要进一步的试验。
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Kinesiologia Slovenica
Kinesiologia Slovenica SPORT SCIENCES-
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