Efficacy of exercise and ultrasound in patients with lumbar spinal stenosis: a prospective randomized controlled trial.
OBJECTIVE
To assess the effectiveness of therapeutic exercises alone and in combination with a single physical agent - ultrasound - in patients with lumbar spinal stenosis.


METHODS
Randomized, prospective, controlled trial.


METHODS
Department of Physical Medicine and Rehabilitation, University Hospital.


METHODS
Forty-five patients presenting with symptoms of neurological claudication and magnetic resonance image-proven lumbar spinal stenosis were assigned to one of three groups: ultrasound plus exercise group (group 1, n =15), sham ultrasound plus exercise group (group 2, n= 15) and no exercise - no treatment group (control group, n = 15).


METHODS
Stretching and strengthening exercises for lumbar, abdominal, leg muscles as well as low-intensity cycling exercises were given as therapeutic exercises. Ultrasound was applied with 1 mHz, 1.5 W/cm(2) intensity, in continuous mode on the back muscle for 10 minutes in group 1 while ultrasound on/off mode was applied in group 2.


METHODS
Before and after a three-week period, all subjects were evaluated by pain, disability, functional capacity and consumption of analgesic.


RESULTS
Thirty-two of the participants were women and 13 were men, with an average age of 53.2 +/- 12.68 years (range 25-82 years). After a three-week treatment period, leg pain decreased in group 1 (-1.47 +/- 3.02) and group 2 (-2.47 +/- 3.75) compared with the control group (P<0.05). Disability score decreased in group 1 (-3.94 +/- 7.20) and group 2 (-7.80 +/- 10.26) compared with control group (P<0.05). We did not find any statistically significant difference between groups 1 and 2 (P>0.05). The amount of analgesic consumption is significantly less in the group with ultrasound application compared to that in the control group (P<0.05).


CONCLUSIONS
The results of our study suggest that therapeutic exercises are effective for pain and disability in patients with lumbar spinal stenosis and that addition of ultrasound to exercise therapy lowers the analgesic intake substantially.
Bio-Fiz Rehabilitation Center, Ankara, Turkey.
Ahmet
A
Goren
Necmettin
N
Yildiz
Oya
O
Topuz
Gulin
G
Findikoglu
Fusun
F
Ardic
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000517:prevention & control; D008161:Lumbosacral Region / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013130:Spinal Stenosis / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy; D014464:Ultrasonic Therapy
D000700:Analgesics