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

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.