Background context-Ambulation limitation is the hallmark of impairment in lumbar spinal stenosis (LSS). Capacity and performance have been defined as two distinct aspects of disability. Previous literature suggests that a person's walking capacity may not be reflected in their daily walking performance.
The SPWT is presented as a feasible and reproducible criterion measure of walking capacity for use with LSS patients. Although a strong relationship was demonstrated between the treadmill protocol and the SPWT, a systematic bias was observed with patients walking significantly further in the SPWT (36% in mean).
These results can guide both clinical research priorities and standards of care for physical therapy treatments of LSS. Based on the results of this study, future research foci should include massage, flexibility and strengthening exercises, stabilization techniques and heat/ice treatments.
Results support construct validity of the Physical Function Scale for the measurement of walking in an lumbar spinal stenosis population. However, it cannot be ascertained from the current study that the construct being measured is, indeed, walking capacity. Further research is warranted to investigate criterion validity evidence for the use of the Physical Function Scale in the measurement of walking capacity in lumbar spinal stenosis, by examining the relationships between self-report and observational measures of walking.
Activity restriction in hospital is commonly prescribed by care providers to decrease the incidence of maternal or fetal morbidity in high-risk pregnancies. The purpose of this pilot descriptive study was to collect preliminary data on dietary intake, capillary blood glucose concentrations, and activity level in high-risk, activity-restricted, pregnant women in the third trimester of pregnancy. Dietary food intake records, capillary blood glucose, and daily pedometer step totals were investigated in 20 activity-restricted women over 7 consecutive days in hospital. Subjects were asked to collect hospital meal tickets, as well as record any additional items not provided by the hospital in a dietary log each day. Capillary blood glucose was collected every morning (fasting) as well as 1 h after breakfast (post-prandial) using a glucometer. Subjects wore a pedometer 24 h/d, and recorded step totals 4 times daily in a pedometer log. In the analysis, average energy and macronutrient intakes met dietary reference intake (DRI) recommendations, as did average intakes of all micronutrients, including maternal supplementation. Without supplementation, vitamin E and iron intakes were lower (p<0.05) than the DRI recommendations. Average fasting (4.6+/-0.5 mmol/L) and post-prandial (7.1+/-1.0 mmol/L) blood glucose concentrations in subjects without gestational diabetes (GDM) did not exceed Canadian Diabetes Association cut-off values for screening of GDM. The mean daily step total of 1579+/-936 was lower than ambulatory third-trimester women (6495+/-2282 steps; p<0.001). Results from this pilot study suggest that with maternal supplementation, these activity-restricted, hospitalized, pregnant women were meeting dietary recommendations, and did not have elevated capillary blood glucose. However, given the severity of activity restriction, these women may be at risk for consequences of extreme inactivity.
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