The association between pain, balance, fall, and disability in patients with lumbar spinal stenosis with vascular claudication

Abstract

Background The effect of lumbar spinal stenosis (LSS) and peripheral vascular disease (PVD), which occurs with similar degenerative conditions, when seen together, has not been studied. The aim of this study is to examine and compare the relationship between pain, balance, disability, fear of falling, and kinesiophobia in LSS patients with intermittent vascular claudication (IVC). Methods Seventy-two patients diagnosed with LSS using magnetic resonance imaging participated in this study. Thirty-five patients with IVC symptoms and showing vascular lesions by lower extremity venous and arterial Doppler ultrasonography imaging were included in the IVC-LSS group. The pain, static balance, dynamic balance, disability, fear of falling, and kinesiophobia were evaluated using the numeric rating scale, single leg stance test, Time Up and Go (TUG), the Oswestry Disability Index (ODI), Fall Efficacy Scale-International (FES-I), and Tampa Scale for Kinesiophobia (TSK), respectively. Results Age and female sex were found to be higher in the IVC-LSS group ( P = 0.024; P = 0.012). The IVC-LSS group had a shorter single leg stance time and TUG test duration, pain intensity, ODI, FES-I, and TSK scores were higher than patients with LSS ( P = 0.001). Pain, fear of falling, and kinesiophobia were moderately correlated with disability in the IVC-LSS group. No relationship was found between pain and dynamic balance. Also, the pain was not related to kinesiophobia. Conclusions The findings indicated that IVC causes loss of balance and an increase in pain, disability, fear of falling, and kinesophobia in patients with LSS.

Relationship Between Physical Performance and Peripheral Arterial Diseases in Different Age Groups of Chinese Community-Dwelling Older Adults

“…This study found a correlation between balance and PAD (OR=1.058, 95% CI=1.007-1.112) in older people. This was consistent with the results of previous studies 37,38) . The TUGT has been endorsed by the US Centers for Disease Control and Prevention as a clinically useful tool for evaluating gait, strength, and balance in determining fall risk in elderly patients 39) .…”

Comparison of ligamentum flavum thickness between central and lateral lesions in a patient with central lumbar spinal canal stenosis

“…Second, several different methods have been shown to be effective in discriminating spinal stenosis to evaluate lumbar spinal stenosis, such as sedimentation sign and morphologic grade system. [23][24][25][26][27][28][29][30] However, we only measured CLFT and LLFT. Thus, our research might have some limitations regarding measurement of morphologic change and epidural pressure.…”

Mechanical Needling With Sterile Water Versus Lidocaine Injection for Lumbar Spinal Stenosis

“…The researchers analyzed the medical data from patients aged 60-92 years who had axial and radicular pain from LSS and were given either mechanical needling with sterile water injection or lidocaine injection. The following symptoms were used to diagnose patients with LSS: (1) having leg or buttock pain while walking; (2) flexing forward to relieve symptoms; (3) feeling relief when using a shopping cart or bicycle; (4) having motor or sensory disturbance while walking; (5) the pulses in the foot are present and symmetric; (6) have lower extremity weakness and decreased walking ability; (7) have low back pain. Patients were then selected to be recruited if there were the following signs: (1) Kemp's sign, (2) induced pain in the articular or transverse apophysis, and (3) sign of facet tension or new lumbar facet sign.…”

“…Facet joint hypertrophy is a condition which the cartilage between the inferior and superior articular processes breaks down and becomes inflamed, causing pain signals to be sent to the innervated medial branch nerve endings. [6][7][8][9][10][11] The L4-L5 region of the lumbar spine is the most prevalent site of LSS. 7,[9][10][11][12][13] Radicular pain in spinal stenosis is caused by inflammation or compression of the spinal nerve root, with disc herniation being the most prevalent cause.…”

“…Spondylolisthesis and degenerative scoliosis cause spine instability, which is unavoidable as the condition worsens. [6][7][8][9][10][11] There is moderate-quality evidence suggesting a multimodal approach that incorporates manual therapy and exercise, with or without education, is a successful treatment for LSS with neurogenic claudication, and that epidural steroids are ineffective. The quality of evidence for all other non-operative therapies was insufficient to make inferences about their efficacy.…”