Article

OBJECTIVE: To assess the effectiveness of therapeutic exercises alone and in
combination with a single physical agent - ultrasound - in patients with lumbar
spinal stenosis. DESIGN: Randomized, prospective, controlled trial. SETTING:
Department of Physical Medicine and Rehabilitation, University Hospital.
SUBJECTS: Forty-five patients presenting with symptoms of neurological
claudication and magnetic resonance image-proven lumbar spinal stenosis were
assigned to one of three groups: ultrasound plus exercise group (group 1, n =15),
sham ultrasound plus exercise group (group 2, n= 15) and no exercise - no
treatment group (control group, n = 15). INTERVENTIONS: Stretching and
strengthening exercises for lumbar, abdominal, leg muscles as well as
low-intensity cycling exercises were given as therapeutic exercises. Ultrasound
was applied with 1 mHz, 1.5 W/cm(2) intensity, in continuous mode on the back
muscle for 10 minutes in group 1 while ultrasound on/off mode was applied in
group 2. MAIN OUTCOME MEASURES: Before and after a three-week period, all
subjects were evaluated by pain, disability, functional capacity and consumption
of analgesic. RESULTS: Thirty-two of the participants were women and 13 were men,
with an average age of 53.2 +/- 12.68 years (range 25-82 years). After a
three-week treatment period, leg pain decreased in group 1 (-1.47 +/- 3.02) and
group 2 (-2.47 +/- 3.75) compared with the control group (P<0.05). Disability
score decreased in group 1 (-3.94 +/- 7.20) and group 2 (-7.80 +/- 10.26)
compared with control group (P<0.05). We did not find any statistically
significant difference between groups 1 and 2 (P>0.05). The amount of analgesic
consumption is significantly less in the group with ultrasound application
compared to that in the control group (P<0.05). CONCLUSION: The results of our
study suggest that therapeutic exercises are effective for pain and disability in
patients with lumbar spinal stenosis and that addition of ultrasound to exercise
therapy lowers the analgesic intake substantially.

Langue : ANGLAIS