Home-based cycling program tailored to older people with lumbar spinal stenosis: Barriers and facilitators - 07/05/18
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Highlights |
• | A home-based cycling program with ergometric bicycles tailored to older patients’ preferences in lumbar spinal stenosis is feasible. |
• | The present study allowed us to optimize and consolidate the content of the home-based cycling program and the measures to enhance adherence. |
• | The present intervention will now be assessed in a large randomized trial of 296 patients with lumbar spinal stenosis. |
Abstract |
Background |
Lumbar-flexion-based endurance training, namely cycling, could be effective in reducing pain and improving function and health-related quality of life in older people with chronic low back pain.
Objectives |
To assess barriers and facilitators to home-based cycling in older patients with lumbar spinal stenosis (LSS).
Methods |
We conducted a retrospective mixed-method study. Patients≥50 years old followed up for LSS from November 2015 to June 2016 in a French tertiary care center were screened. The intervention consisted of a single supervised session followed by home-based sessions of cycling, with dose (number of sessions and duration, distance and power per session) self-determined by patient preference. The primary outcome was assessed by a qualitative approach using semi-structured interviews at baseline and 3 months and was the identification of barriers and facilitators to the intervention. Secondary outcomes were assessed by a quantitative approach and were adherence monitored by a USB stick connected to the bicycle, burden of treatment assessed by the Exercise Therapy Burden Questionnaire (ETBQ) and clinical efficacy assessed by change in lumbar pain, radicular pain, disability, spine-specific activity limitation and maximum walking distance at 3 months.
Results |
Overall, 15 patients were included and data for 12 were analyzed at 3 months. At baseline, the mean age was 70.9 years (95% CI: 64.9–76.8) and 9/15 patients (60.0%) were women. Barriers to cycling were fear of pain and fatigue, a too large bicycle, burden of hospital follow-up and lack of time and motivation. Facilitators were clinical improvement, surveillance and ease-of-use of the bicycle. Adherence remained stable overtime. The burden of treatment was low [mean ETBQ score: 21.0 (95% confidence interval: 11.5–30.5)]. At 3 months, 7/12 patients (58.3%) self-reported clinical improvement, with reduced radicular pain and disability [mean absolute differences: −27.5 (−43.3 to −11.7), P<0.01 and −17.5 (−32.1 to −2.9), P=0.01, respectively].
Conclusions |
For people with LSS, home-based cycling is a feasible intervention.
Le texte complet de cet article est disponible en PDF.Keywords : Burden of illness, Spinal stenosis, Radicular claudication, Cycling, Rehabilitation, Clinical trial
Plan
| ☆ | ClinicalTrials.gov identifier: NCT03325309. First posted: October 30, 2017. Last update posted: October 30, 2017. |
Vol 61 - N° 3
P. 144-150 - mai 2018 Retour au numéro
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