Home-based cycling program tailored to older people with lumbar spinal stenosis: Barriers and facilitators / Charlotte Pauwels in Annals of physical and rehabilitation medicine, Vol. 61, n°3 (Mai 2018)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 61, n°3 (Mai 2018) . - p. 144-150 Titre : Home-based cycling program tailored to older people with lumbar spinal stenosis: Barriers and facilitators Type de document : texte imprimé Auteurs : Charlotte Pauwels ; Alexandra Roren ; Adrien Gautier ; Jonathan Linières ; François Rannou ; Serge Poiraudeau ; Christelle Nguyen Année de publication : 2018 Article en page(s) : p. 144-150 Note générale : Doi : 10.1016/j.rehab.2018.02.005 Langues : Anglais (eng) Mots-clés : Burden of illness  Spinal stenosis  Radicular claudication  Cycling  Rehabilitation  Clinical trial Résumé : Background Lumbar-flexion-based endurance training, namely cycling, could be effective in reducing pain and improving function and health-related quality of life in older people with chronic low back pain. Objectives To assess barriers and facilitators to home-based cycling in older patients with lumbar spinal stenosis (LSS). Methods We conducted a retrospective mixed-method study. Patients≥50 years old followed up for LSS from November 2015 to June 2016 in a French tertiary care center were screened. The intervention consisted of a single supervised session followed by home-based sessions of cycling, with dose (number of sessions and duration, distance and power per session) self-determined by patient preference. The primary outcome was assessed by a qualitative approach using semi-structured interviews at baseline and 3 months and was the identification of barriers and facilitators to the intervention. Secondary outcomes were assessed by a quantitative approach and were adherence monitored by a USB stick connected to the bicycle, burden of treatment assessed by the Exercise Therapy Burden Questionnaire (ETBQ) and clinical efficacy assessed by change in lumbar pain, radicular pain, disability, spine-specific activity limitation and maximum walking distance at 3 months. Results Overall, 15 patients were included and data for 12 were analyzed at 3 months. At baseline, the mean age was 70.9 years (95% CI: 64.9–76.8) and 9/15 patients (60.0%) were women. Barriers to cycling were fear of pain and fatigue, a too large bicycle, burden of hospital follow-up and lack of time and motivation. Facilitators were clinical improvement, surveillance and ease-of-use of the bicycle. Adherence remained stable overtime. The burden of treatment was low [mean ETBQ score: 21.0 (95% confidence interval: 11.5–30.5)]. At 3 months, 7/12 patients (58.3%) self-reported clinical improvement, with reduced radicular pain and disability [mean absolute differences: −27.5 (−43.3 to −11.7), P<0.01 and −17.5 (−32.1 to −2.9), P=0.01, respectively]. Conclusions For people with LSS, home-based cycling is a feasible intervention. Permalink : ./index.php?lvl=notice_display&id=80461 [article] Home-based cycling program tailored to older people with lumbar spinal stenosis: Barriers and facilitators [texte imprimé] / Charlotte Pauwels ; Alexandra Roren ; Adrien Gautier ; Jonathan Linières ; François Rannou ; Serge Poiraudeau ; Christelle Nguyen . - 2018 . - p. 144-150. Doi : 10.1016/j.rehab.2018.02.005 Langues : Anglais (eng) in Annals of physical and rehabilitation medicine > Vol. 61, n°3 (Mai 2018) . - p. 144-150 Mots-clés : Burden of illness  Spinal stenosis  Radicular claudication  Cycling  Rehabilitation  Clinical trial Résumé : Background Lumbar-flexion-based endurance training, namely cycling, could be effective in reducing pain and improving function and health-related quality of life in older people with chronic low back pain. Objectives To assess barriers and facilitators to home-based cycling in older patients with lumbar spinal stenosis (LSS). Methods We conducted a retrospective mixed-method study. Patients≥50 years old followed up for LSS from November 2015 to June 2016 in a French tertiary care center were screened. The intervention consisted of a single supervised session followed by home-based sessions of cycling, with dose (number of sessions and duration, distance and power per session) self-determined by patient preference. The primary outcome was assessed by a qualitative approach using semi-structured interviews at baseline and 3 months and was the identification of barriers and facilitators to the intervention. Secondary outcomes were assessed by a quantitative approach and were adherence monitored by a USB stick connected to the bicycle, burden of treatment assessed by the Exercise Therapy Burden Questionnaire (ETBQ) and clinical efficacy assessed by change in lumbar pain, radicular pain, disability, spine-specific activity limitation and maximum walking distance at 3 months. Results Overall, 15 patients were included and data for 12 were analyzed at 3 months. At baseline, the mean age was 70.9 years (95% CI: 64.9–76.8) and 9/15 patients (60.0%) were women. Barriers to cycling were fear of pain and fatigue, a too large bicycle, burden of hospital follow-up and lack of time and motivation. Facilitators were clinical improvement, surveillance and ease-of-use of the bicycle. Adherence remained stable overtime. The burden of treatment was low [mean ETBQ score: 21.0 (95% confidence interval: 11.5–30.5)]. At 3 months, 7/12 patients (58.3%) self-reported clinical improvement, with reduced radicular pain and disability [mean absolute differences: −27.5 (−43.3 to −11.7), P<0.01 and −17.5 (−32.1 to −2.9), P=0.01, respectively]. Conclusions For people with LSS, home-based cycling is a feasible intervention. Permalink : ./index.php?lvl=notice_display&id=80461

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