ORIGINAL PAPER
Correlation of functional claudication distance with canal diameter in patients with lumbar canal stenosis: a preliminary report
More details
Hide details
1
Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, India
2
Department of Physiotherapy, University Institute of Applied Health Sciences, Chandigarh University, Mohali, India
Submission date: 2020-09-17
Acceptance date: 2020-10-16
Publication date: 2021-12-06
Physiother Quart. 2021;29(4):60-64
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Neurogenic claudication is the classic clinical presentation of patients with lumbar canal stenosis. Several studies have addressed the assessment of such patients, but the impact of such change in canal diameter on the distance of walking is still to be identified. The study aimed to assess the functional claudication distance in relation to the canal diameter change in patients with lumbar canal stenosis.
Methods:
Overall, 50 patients presenting with lumbar canal stenosis with the canal diameter of 8–12 mm at the level of L4 and below were recruited for this study. Individuals with trauma or associated fracture, laminectomy, or congenital stenosis were excluded. The demographic characteristics and anthropometrics of each patient were established. Canal diameter was documented with the help of magnetic resonance imaging. For functional claudication distance measurement, the participants were asked to walk on a treadmill up to the distance at which they preferred to stop owing to pain.
Results:
The mean ± standard deviation (95% CI) of canal diameter and functional claudication distance were found to be 10.33 ± 1.26 mm (10.00–10.69) and 141.29 ± 44.20 m (130–153.44), respectively. The Pearson correlation coefficient determined a moderate to good positive correlation (r = 0.73) between lumbar canal diameter and functional claudication distance.
Conclusions:
The study concluded that an increase in the anteroposterior canal diameter might increase functional claudication distance or vice versa. The results may be helpful in estimating the distance of walking in patients with lumbar canal stenosis.
REFERENCES (24)
1.
Azimi P, Mohammadi HR, Benzel EC, Shahzadi S, Azhari S. Lumbar spinal canal stenosis classification criteria: a new tool. Asian Spine J. 2015;9(3):399–406; doi: 10.4184/asj.2015.9.3.399.
2.
Fritz JM, Delitto A, Welch WC, Erhard RE. Lumbar spinal stenosis: a review of current concepts in evaluation, management, and outcome measurements. Arch Phys Med Rehabil. 1998;79(6):700–708; doi: 10.1016/S0003-9993(98)90048-X.
3.
Anasuya DG, Jayashree A, Moorthy NLN, Madan S. Anatomical study of lumbar spinal canal diameter on MRI to assess spinal canal stenosis. Int J Anat Res. 2015;3(3):1441–1444; doi: 10.16965/ijar.2015.261.
4.
De C, Ray MK, Chatterjee B, Duttaroy S, Ghosh PK, De C. Correlation between clinical and imaging finding of symptomatic degenerative lumbar spine disease. Saudi J Sports Med. 2018;18(2):79–84; doi: 10.4103/sjsm.sjsm_24_17.
5.
Ju J-H, Ha H-G, Jung C-K, Kim H-W, Lee C-Y, Kim J-H. Patterns of epidural venous varicosity in lumbar stenosis. Korean J Spine. 2012;9(3):244–249; doi: 10.14245/kjs.2012.9.3.244.
6.
Kim K, Shin K-M, Hunt CL, Wang Z, Bauer BA, Kwon O, et al. Nonsurgical integrative inpatient treatments for symptomatic lumbar spinal stenosis: a multi-arm randomized controlled pilot trial. J Pain Res. 2019;12:1103–1113; doi: 10.2147/JPR.S173178.
7.
Mbada CE, Makinde MO, Odole AC, Dada OO, Ayanniyi O, Salami AJ, et al. Comparative effects of clinic- and virtual reality-based McKenzie extension therapy in chronic non-specific low-back pain. Hum Mov. 2019;20(3):66–79; doi: 10.5114/hm.2019.83998.
8.
Comer CM, Redmond AC, Bird HA, Conaghan PG. Assessment and management of neurogenic claudication associated with lumbar spinal stenosis in a UK primary care musculoskeletal service: a survey of current practice among physiotherapists. BMC Musculoskelet Disord. 2009;10:121; doi: 10.1186/1471-2474-10-121.
9.
Otani K, Kikuchi S, Yabuki S, Igarashi T, Nikaido T, Watanabe K, et al. Lumbar spinal stenosis has a negative impact on quality of life compared with other comorbidities: an epidemiological cross-sectional study of 1862 community-dwelling individuals. Sci World J. 2013;2013:590652; doi: 10.1155/2013/590652.
10.
Kamińska J, Pawlak M. The use of analgesics among Poznań marathon runners. Hum Mov. 2019;20(3):23–28; doi: 10.5114/hm.2019.83993.
11.
Steurer J, Nydegger A, Held U, Brunner F, Hodler J, Porchet F, et al. LumbSten: the lumbar spinal stenosis outcome study. BMC Musculoskelet Disord. 2010;11:254; doi: 10.1186/1471-2474-11-254.
12.
Rajagopal TS, Marshall RW. Understanding and treating spinal stenosis. J Bone Joint Surg (Br). 2010;1–7.
13.
Ahmad T, Goel P, Babu CSR. A study of lumbar canal by M.R.I. in clinically symptomatic and asymptomatic subjects. J Anat Soc India. 2011;60(2):184–187; doi: 10.1016/S0003-2778(11)80022-5.
14.
Ammendolia C, Chow N. Clinical outcomes for neurogenic claudication using a multimodal program for lumbar spinal stenosis: a retrospective study. J Manipulative Physiol Ther. 2015;38(3):188–194; doi: 10.1016/j.jmpt.2014.12.006.
15.
Łozińska P, Wójtowicz D, Wdowiak P, Dziuba-Słonina A. Changes in kinematic parameters during walking in adults with low back pain subjected to Vojta therapy. A pilot study. Physiother Quart. 2019;27(2):22–28; doi: 10.5114/pq.2019.84273.
16.
Kruidenier LM, Nicolaï SPA, Willigendael EM, de Bie RA, Prins MH, Teijink JAW. Functional claudication distance: a reliable and valid measurement to assess functional limitation in patients with intermittent claudication. BMC Cardiovasc Disord. 2009;9:9; doi: 10.1186/1471-2261-9-9.
17.
Ammendolia C, Côté P, Southerst D, Schneider M, Budgell B, Bombardier C, et al. Comprehensive nonsurgical treatment versus self-directed care to improve walking ability in lumbar spinal stenosis: a randomized trial. Arch Phys Med Rehabil. 2018;99(12):2408–2419.e2; doi: 10.1016/j.apmr.2018.05.014.
18.
Le Faucheur A, Abraham P, Jaquinandi V, Bouyé P, Saumet JL, Noury-Desvaux B. Measurement of walking distance and speed in patients with peripheral arterial disease: a novel method using a global positioning system. Circulation. 2008;117(7):897–904; doi: 10.1161/CIRCULATIONAHA.107.725994.
19.
Kumar S, Narkeesh A. Effect of integrated exercise protocol in lumbar spinal stenosis as compare with conventional physiotherapy – a randomized control trial. Int J Neurorehabilitation. 2017;4(6):301; doi: 10.4172/2376-0281.1000301.
20.
Moczek K, Gawlik K, Rosołek B. The relationship between physical activity and the prevalence of disabilities caused by back pain in men over 60 years of age. Postep Rehabil. 2018;32(4):29–35; doi: 10.5114/areh.2018.83392.
21.
Lim JU, Lee JH, Kim JS, Hwang YI, Kim T-H, Lim SY, et al. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. Int J Chron Obstruct Pulmon Dis. 2017;12:2465–2475; doi: 10.2147/COPD.S141295.
22.
Kanno H, Ozawa H, Koizumi Y, Morozumi N, Aizawa T, Kusakabe T, et al. Dynamic change of dural sac cross-sectional area in axial loaded magnetic resonance imaging correlates with the severity of clinical symptoms in patients with lumbar spinal canal stenosis. Spine. 2012;37(3):207–213; doi: 10.1097/BRS.0b013e3182134e73.
23.
Mathur R, Swaminathan S, The Core Advisory Group. National ethical guidelines for biomedical & health research involving human participants, 2017: a commentary. Indian J Med Res. 2018;148(3):279–283; doi: 10.4103/0971-5916.245303.
24.
Portney LG, Watkins MP. Correlation. In: Portney LG, Watkins MP, Foundations of clinical research: applications to practice, 3rd ed. Philadelphia: F.A. Davis Company; 2015; 523–537.