Article

OBJECTIVE: To examine changes in objectively measured physical activity
(performance) at 1 week following epidural steroid injection for lumbar spinal
stenosis. DESIGN: Prospective cohort. SETTING: University spine program.
PARTICIPANTS: Individuals (N=17) who were undergoing fluoroscopically guided
epidural steroid injection for symptomatic lumbar spinal stenosis (mean age +/-
SD, 70.1+/-6.7; 47% women). INTERVENTION: Fluoroscopically guided epidural
injection. MAIN OUTCOME MEASURE(S): The 2 primary outcomes, measured with
accelerometers, were total activity (performance) measured over 7 days and
maximum continuous activity (capacity). Walking capacity was also assessed with
the Self-Paced Walking Test, and subjects completed the Oswestry Disability
Index, Swiss Spinal Stenosis Questionnaire, Medical Outcomes Study 36-Item
Short-Form Health Survey, visual analog pain scales, and body diagrams. RESULTS:
At 1 week postinjection, 58.8% of the subjects demonstrated increased total
activity and 53% had increased maximum continuous activity, although neither
change was statistically significant. Significant improvements were observed in a
number of the self-report instruments, including the Physical Function Scale of
the Swiss Spinal Stenosis Questionnaire, general health (Medical Outcomes Study
36-Item Short-Form Health Survey), role-limitation emotional (Medical Outcomes
Study 36-Item Short-Form Health Survey), leg pain intensity (visual analog pain
scales), and presence of leg weakness. CONCLUSIONS: While patients perceived
improvements in pain and function following injection, these improvements were
not reflected in significant changes in performance or capacity. Future studies
will continue to find value in subjective measures of pain and quality of life.
However, with modern technology, performance is no longer a subjective variable.
Use of activity monitors to objectively measure performance can result in more
rigorous validation of treatment effects, while simultaneously highlighting the
potential need for additional postinjection rehabilitation aimed at improving
performance.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS