[article]
| 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 : |
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in Annals of physical and rehabilitation medicine > Vol. 61, n°3 (Mai 2018) . - p. 144-150
[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 |
|  |
Home-based cycling program tailored to older people with lumbar spinal stenosis: Barriers and facilitators in Annals of physical and rehabilitation medicine, Vol. 61, n°3 (Mai 2018)
