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.
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.
To assess barriers and facilitators to home-based cycling in older patients with lumbar spinal stenosis (LSS).
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.
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].
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
|☆|| ClinicalTrials.gov identifier: NCT03325309. First posted: October 30, 2017. Last update posted: October 30, 2017.