Lumbar Degenerative Spinal Stenosis
Conditions
Brief summary
Spinal stenosis is a common orthopedic spine condition that limits individuals ability to walk and stand because of nerve compression. Surgical treatment can alleviate leg pain and improve function such as increasing physical activity. This study will use Fitbit technology to monitor patient's post-operative physical activity. It will evaluate the efficacy of a Fitbit incentive based walking program on improving post-operative physical activity and rehabilitation.
Interventions
BEHAVIORALBlinded Fitbit
Fitbit is worn for 3 months post-operatively with no activity feedback or step goals
BEHAVIORALFitbit
Fitbit is worn for 3 months post-operatively with feedback and step goals
Sponsors
The London Spine Centre
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Caregiver)
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 60 years of age and older * diagnosed with neurogenic claudication or radiculopathy secondary to central or lateral recess stenosis between L3-L5 confirmed by CT or MRI * consent for surgical treatment
Exclusion criteria
* traumatic stenosis from a pathologic fracture * inflammatory spine disease * peripheral arterial disease * hip or knee arthritis or pulmonary or circulatory diseases for which exercise is contraindicated * severe or progressive neurologic deficit effecting ambulatory ability * cancer * no access to a computer or mobile device * inability to complete the questionnaires or provide follow-up (i.e. lack of permanent address, substance abuse, interfering psychiatric illness).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Self-Paced Walking Test | Change in 3 months post-op from baseline | Variability of the self-paced walking test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Self-paced walking test | Change in 3 months post-op from baseline | Self-paced walk test (SPWT) is a validated measure of walking capacity in lumbar degenerative spinal stenosis. The individual walks comfortably at his/her own pace until he/she must rest due to symptoms of back or leg pain. The total time and distance walked is recorded, time/distance to onset of symptoms, and nature and location of symptoms (pain numbness/tingling, weakness or fatigue), average walking speed, and reason for termination (symptoms of LSS, fatigue, shortness of breath, pain, other comorbidities). Patients are not permitted to use an assistive device. The test is either self-terminated (complete stop of 3 seconds or more) due to symptoms or at 30 minutes whichever occurs first. Participants are asked to indicate when they first experience symptoms. |
| Steps walked/day | Change in 3 months post-op from baseline | Comparison of Fitbit activity data of steps taken between groups |
| Leg Pain | Change in 3 months post-op from baseline | Numeric Rating Score for Leg Pain. The (NRS) for leg pain numeric rating scale ranges from 0 to 10, with lower scores indicating less severe symptoms |
| Patient Recruitment | Number consented by 17 months | Participants will be included if they are 60 years of age and older, diagnosed with neurogenic claudication or radiculopathy secondary to central or lateral recess stenosis between L3-L5 confirmed by CT or MRI, and consent for surgical treatment. Include patients with Grade 1 spondylolithesis. Patients will be excluded if the stenosis was not degenerative (i.e. traumatic stenosis from a pathologic fracture), they had inflammatory spine disease, they had peripheral arterial disease, or pulmonary or circulatory diseases for which exercise is contraindicated, osteoarthritis in the lower extremities, severe or progressive neurologic deficit requiring urgent surgery, cancer, previous lumbar surgery, they have no access to a computer or mobile device, an inability to complete the questionnaires or provide follow-up (i.e. lack of permanent address, substance abuse, interfering psychiatric illness). |
| General Health | Change in 3 months post-op from baseline | General health assessed by SF12. The SF12 is a generic, multidimensional self-report health questionnaire and is validated when applied to the spine patient. Questions are categorized into scales for general health, physical functioning, social functioning, role limitation-physical, role limitation-emotional, mental health, energy/fatigue, pain, comparative health. These are summarized into the SF12-physical component summary score (PCS) and mental component summary score (MCS). Scores range from 0 to 100. Higher scores imply better functioning. |
| Functional Ability | Change in 3 months post-op from baseline | Functional ability assessed by Oswestry Disability Index. Oswestry Disability Index (ODI) is a validated questionnaire in lumbar degenerative spinal stenosis patients that assesses back pain-related disability. A higher score denotes worsening disability. |
| Back Pain | Change in 3 months post-op from baseline | Numeric Rating Score for Back Pain. The (NRS) for back pain numeric rating scale ranges from 0 to 10, with lower scores indicating less severe symptoms |
Countries
Canada
Outcome results
None listed