BACKGROUND In this aging population,lumbar spinal stenosis(LSS)reduces walking distance and impairs functionality.The definitive treatment is still controversial.AIM To assess the efficacy of physical therapy and surg...BACKGROUND In this aging population,lumbar spinal stenosis(LSS)reduces walking distance and impairs functionality.The definitive treatment is still controversial.AIM To assess the efficacy of physical therapy and surgery in improving function and reducing pain levels in patients with LSS,both in the short and long term.METHODS This prospective study screened patients aged 50-80 years with LSS and divided them into two groups based on certain criteria:Surgical and conservative.The conservative group received a supervised physical therapy and exercise program for 45 minutes,five days a week,for one month.The surgery group underwent micro endoscopic decompression surgery based on their LSS levels.Assessments,conducted before treatment and at one-month and one-year intervals,included the participants'walking distance,pain level using the visual analog scale,func tionality using the Istanbul low back pain disability index(ILBDI)and Swiss Spinal Stenosis Questionnaire(SSS)Scale,and activities of daily living level using the Nottingham Extended Activities of Daily Living.RESULTS The study comprised 40 participants,equally divided into surgical and conservative treatment groups,with no significant demographic differences.After one year,both groups exhibited similar changes in walking distance and pain levels.However,the conservative group demonstrated significantly greater improvements in sub-parameters of functional activity and symptom severity of the SSS.After one year,the surgical group showed greater functionality,as assessed by ILBDI,and superior improvement in activities of daily living compared to the conservative group.CONCLUSION Both treatments showed comparable efficacy in core outcomes(pain,walking distance).However,complementary advantages were observed:Conservative management demonstrated superior improvement in SSS functional subscales,while surgery yielded greater gains in daily living activities and low-back-pain-related disability.展开更多
The aim of the study was to investigate the functional performance in children with spina bifida, using the Pediatric Evaluation of Disability Inventory （PEDI） to look into capacity of twen- ty-eight children with s...The aim of the study was to investigate the functional performance in children with spina bifida, using the Pediatric Evaluation of Disability Inventory （PEDI） to look into capacity of twen- ty-eight children with spina bifida with lesions at different levels in different dimensions of self- care, mobility and social function. Mean age of the patients was 3.5 ± 2.3 （1-10） years. In the muscle test carried out, 13 patients （44.8%） had no movements including pelvic elevation in lower extremity muscles and they were at level 5. Sixteen patients （54%） were non-ambulatory according to the Hoofer ambulation classification. Raw and scale scores in the self-care, mobil- ity and social function domains both in the functional skill scale and in the caregiver scale were found to be lower compared to the data of the normal population. A statistically significant correlation was observed in the self-care values of the Functional Skills Scales and the Caregiver Assistance Scale measurements, which was positive for age and negative for Functional Ambu- lation Scale and muscle test （P 〈 0.05）. A positive relation was found between the Functional Skills Scales-mobility area and age while a negative relation was observed between Functional Ambulation Scale and muscle test （P 〈 0.005）. A negative relation was also found between Care- giver Assistance Scale-mobility and Functional Ambulation Scale and muscle test （P 〈 0.005）. In our study, the functional performance of the children was found to be low. Low-level lesions, encouraging muscular strength and independence in mobility are all very important factors for functional independence.展开更多
文摘BACKGROUND In this aging population,lumbar spinal stenosis(LSS)reduces walking distance and impairs functionality.The definitive treatment is still controversial.AIM To assess the efficacy of physical therapy and surgery in improving function and reducing pain levels in patients with LSS,both in the short and long term.METHODS This prospective study screened patients aged 50-80 years with LSS and divided them into two groups based on certain criteria:Surgical and conservative.The conservative group received a supervised physical therapy and exercise program for 45 minutes,five days a week,for one month.The surgery group underwent micro endoscopic decompression surgery based on their LSS levels.Assessments,conducted before treatment and at one-month and one-year intervals,included the participants'walking distance,pain level using the visual analog scale,func tionality using the Istanbul low back pain disability index(ILBDI)and Swiss Spinal Stenosis Questionnaire(SSS)Scale,and activities of daily living level using the Nottingham Extended Activities of Daily Living.RESULTS The study comprised 40 participants,equally divided into surgical and conservative treatment groups,with no significant demographic differences.After one year,both groups exhibited similar changes in walking distance and pain levels.However,the conservative group demonstrated significantly greater improvements in sub-parameters of functional activity and symptom severity of the SSS.After one year,the surgical group showed greater functionality,as assessed by ILBDI,and superior improvement in activities of daily living compared to the conservative group.CONCLUSION Both treatments showed comparable efficacy in core outcomes(pain,walking distance).However,complementary advantages were observed:Conservative management demonstrated superior improvement in SSS functional subscales,while surgery yielded greater gains in daily living activities and low-back-pain-related disability.
文摘The aim of the study was to investigate the functional performance in children with spina bifida, using the Pediatric Evaluation of Disability Inventory （PEDI） to look into capacity of twen- ty-eight children with spina bifida with lesions at different levels in different dimensions of self- care, mobility and social function. Mean age of the patients was 3.5 ± 2.3 （1-10） years. In the muscle test carried out, 13 patients （44.8%） had no movements including pelvic elevation in lower extremity muscles and they were at level 5. Sixteen patients （54%） were non-ambulatory according to the Hoofer ambulation classification. Raw and scale scores in the self-care, mobil- ity and social function domains both in the functional skill scale and in the caregiver scale were found to be lower compared to the data of the normal population. A statistically significant correlation was observed in the self-care values of the Functional Skills Scales and the Caregiver Assistance Scale measurements, which was positive for age and negative for Functional Ambu- lation Scale and muscle test （P 〈 0.05）. A positive relation was found between the Functional Skills Scales-mobility area and age while a negative relation was observed between Functional Ambulation Scale and muscle test （P 〈 0.005）. A negative relation was also found between Care- giver Assistance Scale-mobility and Functional Ambulation Scale and muscle test （P 〈 0.005）. In our study, the functional performance of the children was found to be low. Low-level lesions, encouraging muscular strength and independence in mobility are all very important factors for functional independence.
