I’ve been reviewing some literature concerning surgical vs. conservative management of common pathologies such as spinal stenosis and came across a recent RCT by Delitto et al. It’s a solid study backing up the effectiveness of Physiotherapy in treating lumbar spinal stenosis! Past studies reported on the surgical method in detail but failed to elaborate on standardized conservative interventions.
Delitto et al report which interventions were done: instruction in lumbar flexion exercises, including posterior pelvic tilts and supine knee-to-chest and quadruped flexion exercises; general conditioning exercises, including stationary cycling or treadmill walking; lower extremity strengthening exercises deemed appropriate for the patient after examination (for example, standing squats, seated knee extension, or supine straight-leg raises); lower extremity flexibility exercises deemed appropriate for the patient on the basis of individual examination (for example, hamstring or hip flexor stretching); and patient education to avoid postures involving hyperextension of the lumbar spine.
The results of the study show that both at the 52w and 104w follow up both patient groups show significant and similar improvement in functioning rated on the SF-36.
This is great news for our profession – not to mention the economic benefits for our healthcare systems!
To the study (no open access): http://annals.org/mobile/article.aspx?articleid=2214174