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REVIEW PAPER
Physiotherapy versus alternative medicine for pain and quality of life in patients with lumbar spinal stenosis: a systematic review with meta-analysis
1
Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Ambala, India
2
Department of Physiotherapy, University Institute of Allied Health Sciences, Chandigarh University, Mohali, India
3
Department of Physiotherapy, School of Allied Health Science, Galgotias University, Greater Noida, India
4
Department of Orthopedics, Adesh Medical College, Pt. B. D. Sharma University, Rothak, India
5
Yenepoya Physiotherapy College (Deemed to be University), Yenepoya, India
Submission date: 2022-03-12
Acceptance date: 2022-09-27
Publication date: 2024-03-25
Corresponding author
Physiother Quart. 2024;32(1):25-34
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Lumbar spinal stenosis (LSS) is a prevailing condition widely affecting mobility. However, many non-invasive treatments have been proposed for LSS. Physiotherapy is reported as more commonly used with very little evidence reporting the efficacy of alternative medicine. For clinicians, there was a need to find a better mode of treatment. The purpose of this paper is to compare the effectiveness of physiotherapy interventions and alternative medicine for leg pain, back pain, and walking distance in patients with LSS.
Methods:
Data sources: PubMed, Web of Science, and Scopus databases were searched for papers published in the previous 5 years (2016–2020). The systematic review and meta-analysis were conducted from September 2021 to December 2021 at the Musculoskeletal Research Lab of Maharishi Markandeshwaer Institute of Physiotherapy & Rehabilitation. Study selection and outcomes: randomised controlled trials (RCT), randomised clinical trials, randomised cross-over trials, quasi-RCTs, and non-RCTs were included if they evaluated the effects of physiotherapy or alternative medicine on pain and walking distance in patients with LSS. The Numeric Rating Scale (NRS), Visual Analogue Scale (VAS), Self-paced walk test (SPWT), and treadmill walking were used as outcome measures. All the authors independently screened and extracted data from the 8 studies retrieved through the search using a pilot-tested performa. The quality of studies was assessed using the PEDro scale and the Cochrane risk of bias criteria.
Results:
Meta-analysis was performed using a fixed-effects model that showed (1) Physiotherapy was more effective than the control in improving leg pain. The Standardised mean difference (SMD) (95% CI) in the NRS score for leg pain was found to be 1.12 (0.83, 1.40); (2) Physiotherapy was more effective than the control in improving back pain. The SMD (95% CI) in the NRS score for back pain was 0.29 (−0.18, 0.76); (3) Physiotherapy was more effective than the control in improving walking distance. The SMD (95% CI) for walking distance was found to be 144.59 m (133.16 m, 159.02 m).
Conclusions:
The results of the present study indicate that physiotherapy has higher significant results than alternative medicine in patients with lumbar spinal stenosis.
Lumbar spinal stenosis (LSS) is a prevailing condition widely affecting mobility. However, many non-invasive treatments have been proposed for LSS. Physiotherapy is reported as more commonly used with very little evidence reporting the efficacy of alternative medicine. For clinicians, there was a need to find a better mode of treatment. The purpose of this paper is to compare the effectiveness of physiotherapy interventions and alternative medicine for leg pain, back pain, and walking distance in patients with LSS.
Methods:
Data sources: PubMed, Web of Science, and Scopus databases were searched for papers published in the previous 5 years (2016–2020). The systematic review and meta-analysis were conducted from September 2021 to December 2021 at the Musculoskeletal Research Lab of Maharishi Markandeshwaer Institute of Physiotherapy & Rehabilitation. Study selection and outcomes: randomised controlled trials (RCT), randomised clinical trials, randomised cross-over trials, quasi-RCTs, and non-RCTs were included if they evaluated the effects of physiotherapy or alternative medicine on pain and walking distance in patients with LSS. The Numeric Rating Scale (NRS), Visual Analogue Scale (VAS), Self-paced walk test (SPWT), and treadmill walking were used as outcome measures. All the authors independently screened and extracted data from the 8 studies retrieved through the search using a pilot-tested performa. The quality of studies was assessed using the PEDro scale and the Cochrane risk of bias criteria.
Results:
Meta-analysis was performed using a fixed-effects model that showed (1) Physiotherapy was more effective than the control in improving leg pain. The Standardised mean difference (SMD) (95% CI) in the NRS score for leg pain was found to be 1.12 (0.83, 1.40); (2) Physiotherapy was more effective than the control in improving back pain. The SMD (95% CI) in the NRS score for back pain was 0.29 (−0.18, 0.76); (3) Physiotherapy was more effective than the control in improving walking distance. The SMD (95% CI) for walking distance was found to be 144.59 m (133.16 m, 159.02 m).
Conclusions:
The results of the present study indicate that physiotherapy has higher significant results than alternative medicine in patients with lumbar spinal stenosis.
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