title: Clinical outcomes for neurogenic claudication using a multimodal program for lumbar spinal stenosis: a retrospective study.
abstract: OBJECTIVE
  The purpose of this preliminary study was to assess the effectiveness of a 6-week, nonsurgical, multimodal program that addresses the multifaceted aspects of neurogenic claudication.
  
  
  METHODS
  In this retrospective study, 2 researchers independently extracted data from the medical records from January 2010 to April 2013 of consecutive eligible patients who had completed the 6-week Boot Camp Program. The program consisted of manual therapy twice per week (eg, soft tissue and neural mobilization, chiropractic spinal manipulation, lumbar flexion-distraction, and muscle stretching), structured home-based exercises, and instruction of self-management strategies. A paired t test was used to compare differences in outcomes from baseline to 6-week follow-up. Outcomes included self-reported pain, disability, walking ability, and treatment satisfaction.
  
  
  RESULTS
  A total of 49 patients were enrolled, with a mean age of 70 years. The mean difference in the Oswestry Disability Index was 15.2 (95% confidence interval [CI], 11.39-18.92), and that for the functional and symptoms scales of the Swiss Spinal Stenosis Questionnaire was 0.41 (95% CI, 0.26-0.56) and 0.74 (95% CI, 0.55-0.93), respectively. Numeric pain scores for both leg and back showed statistically significant improvements. Improvements in all outcomes were clinically important.
  
  
  CONCLUSIONS
  This study showed preliminary evidence for improved outcomes in patients with neurogenic claudication participating in a 6-week nonsurgical multimodal Boot Camp Program.
authors.affiliation: Assistant Professor, Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; Associate Scientist, Department of Medicine, Mount Sinai Hospital, Toronto, Canada; Assistant Professor, Department of Surgery, University of Toronto, Toronto, Canada. Electronic address: cammendolia@mtsinai.on.ca.
authors.forename: Carlo
authors.initials: C
authors.lastname: Ammendolia
authors.affiliation: Clinical Resident, Department of Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, Canada.
authors.forename: Ngai
authors.initials: N
authors.lastname: Chow
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology* / Q000628:therapy*; D008297:Male; D009422:Nervous System Diseases / Q000150:complications*; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D013130:Spinal Stenosis / Q000150:complications*; D016896:Treatment Outcome
keywords: Chiropractic; Claudication; Lumbar Vertebrae; Manual Therapy; Osteoarthritis; Rehabilitation; Spinal Stenosis; Spine