title: Improving treadmill performance in patients with lumbar stenosis: evaluation of a custom angle load reduction device.
abstract: OBJECTIVE
  The aim of this study was to evaluate a custom angle load reduction rolling walker to determine the relationship between flexion and load reduction on walking performance in patients with lumbar spinal stenosis.The hypothesis was that walking performance in patients with lumbar spinal stenosis would be significantly improved using the Oliver Static Measuring Apparatus device compared with unaided treadmill walking.
  
  
  METHODS
  Fifteen patients with symptomatic neurogenic intermittent claudication caused by lumbar spinal stenosis were recruited at a Veterans Affairs Medical Center. This study used a cross-sectional design with two random-order treadmill conditions: (1) spinal flexion and unloading and (2) level walking. Primary outcome measures included initiation time of first symptoms, total walking time, spinal flexion angle, and unloading force. Secondary measures included baseline pain, fatigue, and disability severity.
  
  
  RESULTS
  The participants' initiation time of symptoms and total walking time were significantly greater with the use of the Oliver Static Measuring Apparatus compared with the unaided walking trial. The participants with increased baseline pain, fatigue, and disability severity had decreased walking performance for the unaided condition but not for the Oliver Static Measuring Apparatus condition.
  
  
  CONCLUSIONS
  The results show that spinal flexion is important for pain reduction in lumbar spinal stenosis. The Oliver Static Measuring Apparatus device used in this study was shown to be effective and immediate in significantly increasing total walking time and prolonging the onset of neurogenic intermittent claudication symptoms while ambulating.
authors.affiliation: Jackson Memorial Medical Center, Miami, FL, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Weiner
authors.forename: Doug
authors.initials: D
authors.lastname: Johnson-Greene
authors.forename: Ronald
authors.initials: R
authors.lastname: Tolchin
authors.forename: Lauren
authors.initials: L
authors.lastname: Abratt
authors.forename: Brian
authors.initials: B
authors.lastname: Frank
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004867:Equipment Design; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D013130:Spinal Stenosis / Q000175:diagnosis / Q000534:rehabilitation*; D013647:Task Performance and Analysis; D014853:Walkers; D016138:Walking / Q000502:physiology*; D016474:Weight-Bearing