title: The spinal stenosis pedometer and nutrition lifestyle intervention (SSPANLI): development and pilot.
abstract: BACKGROUND
  Owing to mobility limitations, people with lumbar spinal stenosis (LSS) are at risk for diseases of inactivity, including obesity. Therefore, weight management in LSS is critical. Body mass index is the strongest predictor of function in LSS, suggesting that weight loss may promote physical activity and provide a unique treatment option. We propose a lifestyle modification approach of physical activity and nutrition education, delivered through an e-health platform.
  
  
  OBJECTIVE
  The purpose of this study was to develop and pilot an e-health intervention aimed at increasing physical activity and decreasing fat mass in people with LSS.
  
  
  METHODS
  The study design was based on intervention development and pilot.
  
  
  METHODS
  Ten overweight or obese individuals with LSS were confirmed clinically and on imaging.
  
  
  METHODS
  Self-reported measures were food record, Short-Form 36 (SF-36), pain scales, Swiss Spinal Stenosis Symptom and Physical Function Scales, Oswestry Disability Index (ODI), Pain Catastrophizing Questionnaire, Tampa Scale for Kinesiophobia, Center for Epidemiologic Studies(Depression) Scale, Behavioral Regular in Exercise Questionnaire, and Regulation for Eating Behavior Scale and physiologic measures were dual-energy X-ray absorptiometry (DXA), blood draw, 7-day accelerometry, self-paced walking test, and balance test.
  
  
  METHODS
  The e-health platform was developed.
  
  
  METHODS
  during Week 1, participants received a pedometer and a personalized consultation with a dietitian and an exercise physiologist. For 12 weeks, participants logged on to the e-health Web site to access personal step goals, nutrition education videos, and a discussion board. Follow-up occurred at Week 13.
  
  
  RESULTS
  Nine participants had a mean age of 67.5±6.7 years (60% women). Significant improvements were observed for fat mass (DXA), trunk fat mass, symptom severity (Swiss Symptom Scale), energy intake, maximum continuous activity (accelerometry), and mental health (SF-36) (p<.05). Nonsignificant improvements were observed for waist circumference, pain, ODI, and obesity biomarkers. Seventy percent lost weight, 50% increased walking capacity, and 60% increased quality of life. The mean increase in steps was 15%.
  
  
  CONCLUSIONS
  The spinal stenosis pedometer and nutrition lifestyle intervention was shown to be feasible, attractive to participants, and effective in this small sample. This intervention provides people with LSS the opportunity to participate in their own health management, potentially improving access to care. Efficacy is currently being assessed in a randomized trial.
authors.affiliation: Department of Physical Education and Recreation Studies, Mount Royal University, 4825 Mt Royal Gate SW, Calgary, Alberta, Canada T3E 6K6. Electronic address: clane@mtroyal.ca.
authors.forename: Christy C
authors.initials: CC
authors.lastname: Tomkins-Lane
authors.affiliation: Department of Physical Education and Recreation Studies, Mount Royal University, 4825 Mt Royal Gate SW, Calgary, Alberta, Canada T3E 6K6.
authors.forename: Lynne M Z
authors.initials: LM
authors.lastname: Lafave
authors.affiliation: Department of Physical Education and Recreation Studies, Mount Royal University, 4825 Mt Royal Gate SW, Calgary, Alberta, Canada T3E 6K6.
authors.forename: Jill A
authors.initials: JA
authors.lastname: Parnell
authors.affiliation: Department of Nursing, Mount Royal University, 4825 Mt Royal Gate SW, Calgary, Alberta, Canada T3E 6K6.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Rempel
authors.affiliation: Southport Atrium-Cubicle #1510, Alberta Health Services, 10301 Southport Ln SW, Calgary, Alberta, Canada T2W 1S7.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Moriartey
authors.affiliation: Office of Research Services, Mount Royal University, 4825 Mt Royal Gate SW, Calgary, Alberta, Canada T3E 6K6.
authors.forename: Yvette
authors.initials: Y
authors.lastname: Andreas
authors.affiliation: Department of Kinesiology, Brock University, WC25, 500 Glenridge Ave., St Catharines, Ontario, Canada L2S 3A1.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Wilson
authors.affiliation: Department of Computer Science and Information Systems, Mount Royal University, 4825 Mt Royal Gate SW, Calgary, Alberta, Canada T3E 6K6.
authors.forename: Charles
authors.initials: C
authors.lastname: Hepler
authors.affiliation: Department of Physical Education and Recreation Studies, Mount Royal University, 4825 Mt Royal Gate SW, Calgary, Alberta, Canada T3E 6K6.
authors.forename: Heather A
authors.initials: HA
authors.lastname: Ray
authors.affiliation: Department of Surgery, University of Calgary, Foothills Medical Centre, Rm 0492, McCaig Tower, 3134 Hospital Dr NW, Calgary, Alberta, Canada T2N 5A1.
authors.forename: Richard
authors.initials: R
authors.lastname: Hu
mesh_terms: D056044:Actigraphy / Q000295:instrumentation* / Q000379:methods; D000368:Aged; D031204:Caloric Restriction / Q000379:methods; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000628:therapy*; D050177:Overweight / Q000150:complications / Q000628:therapy*; D010865:Pilot Projects; D013130:Spinal Stenosis / Q000150:complications* / Q000534:rehabilitation; D016138:Walking / Q000502:physiology; D061217:Weight Reduction Programs / Q000379:methods*
keywords: Lumbar spinal stenosis; Nutrition; Obesity; Physical activity; Weight loss; e-Health