Affiliations: [a] Department of Rehabilitation, International University of Health and Welfare Mita Hospital, Tokyo, Japan | [b] Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi, Japan | [c] Department of Rehabilitation, International University of Health and Welfare Hospital, Tochigi, Japan | [d] Department of Rehabilitation, International University of Health and Welfare Narita Hospital, Chiba, Japan | [e] Toyota Tsusho All Life Corporation, Tokyo, Japan
Correspondence:
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Corresponding author: Tatsuya Igawa, Department of Physical Therapy, School of Health Science, International University of Health and Welfare 2600-1, Kitakanemaru, Ohtawara, Tochigi, 323-8501, Japan. E-mail: [email protected].
Note: [1] Tatsuya Igawa and Ryunosuke Urata contributed equally to this work.
Abstract: BACKGROUND: The benefits of combining supervised exercise in the non-surgical treatment of lumbar spinal stenosis (LSS) is unclear. OBJECTIVE: To compare the effectiveness of non-surgical treatments with and without supervised exercise for pain intensity, symptom severity, functional impairment/disability, walking distance, and quality of life (QOL) in LSS patients. METHODS: Randomized controlled trials (RCTs) evaluating combinations of supervised exercises were searched using four electronic databases up to August 13, 2020. Meta-analysis was conducted for immediate and long-term results. RESULTS: Three studies were identified, including 244 participants. Immediate-term results showed that leg pain intensity (mean distance [MD]: -0.94, 95% confidence intervals [95% CI]: -1.60 to -0.29, p< 0.01) and symptom severity (MD: -0.29, 95% CI: -0.50 to -0.08, p< 0.01) were lower in the study group than in the control group, and walking distance (MD: 415.83, 95% CI: 298.15–533.50, p< 0.001) and QOL were higher in the study group. Long-term results showed that functional disability/impairment (MD: 0.27, 95% CI: -0.49 to -0.04, p< 0.05) was lower in the study group than in the control group, and walking distance and QOL were higher in the study group. CONCLUSION: The number of studies on this topic was small and limited. Combinations of non-surgical treatment and supervised exercise may not provide significant benefits.
Keywords: Spinal stenosis, exercise therapy, systematic review as topic, meta-analysis as topic
