According to American Academy of Orthopedic Surgeons, Lumbar Spinal Stenosis (LSS) is defined as the narrowing of body channel occupied by spinal nerves or the spinal cord.
The incidence of LSS in the United States has been estimated at 8 percent to 11 percent of the population. As the “baby boomers” age, an estimated 2.4 million Americans will be affected by LSS by 2021. With the first wave of baby boomers just qualifying for Medicare, this condition will undoubtedly have an impact on government healthcare spending. The adjusted rate of lumbar stenosis surgery per 100,000 Medicare beneficiaries was 137.4 in 2002 and 135.5 in 2007; these numbers are expected to double in the coming years due to the increased numbers of older adults.
The current accepted treatment for LSS begins with nonsteroidal anti-inflammatory drugs and narcotics, physical therapy, and pain management modalities such as epidural steroid injections. Over the long term, 15 percent of patients will improve with nonsurgical modalities, and 70 percent will continue to experience neurogenic claudication. Therefore, most patients with LSS will, in time, require surgical intervention for a more definitive treatment.
Because of the increased pain in all types of movement, an increase in obesity is directly related to spinal stenosis. A 2015 research study conducted by the Department of Physical Education and Recreation Studies at Mount Royal University in Canada to develop a health intervention that increases physical activity and decreases fat mass in people with LSS. The method of this study was to reach weekly fitness goals, monitored through a pedometer, while consulting a dietitian and exercise specialist throughout the 12-week study.
The conclusion of this pilot study show positive results as 70% of patients increased weight loss, 50% increased walking capacity, and 60% increased overall quality of life over 12-weeks intervention.
What does this mean for recreation therapists working in physical medicine and rehabilitation? This research could be translated into an intervention (or even follow up research study) for patients with spinal stenosis in our facilities. If a pedometer program is not feasible in your budget, a patient could use the smart phone/ iPad app “Map My Walk” to record daily steps. Since this study showed a 60% increase in quality of life and focuses on increased physical fitness, it is definitely within the RT scope of practice.
For more information about this study, check out this link: http://www.ncbi.nlm.nih.gov/pubmed/25452012
What are your thoughts about this 2015 pilot study? Have you seen a recent increase in patients with spinal stenosis diagnosis/post-operation? Could this research study be continued at your setting to increase weight loss, walking endurance, and overall quality of life for patients with LSS?