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Title: Outcomes of non-surgical interventions for neurogenic claudication
Author: Comer, Christine
ISNI:       0000 0004 2724 3379
Awarding Body: University of Leeds
Current Institution: University of Leeds
Date of Award: 2011
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Neurogenic claudication is the classic clinical presentation of lumbar spinal stenosis. It is defined by symptoms of leg pain, numbness and heaviness provoked by walking and relieved by sitting down or stooping such as when pushing a shopping trolley. The condition is prevalent in older people and represents the most common reason for spinal surgery in adults over the age of 65. Because surgical results are variable and may deteriorate over time, non-surgical treatments are commonly used. Little research evidence is available, however, regarding the effectiveness of non- surgical treatments. The hypothesis for the work in this thesis was that neurogenic claudication can be effectively treated using non-surgical treatments that modify spinal posture and loading. A literature review informed the specific areas of focus for study. Firstly, a survey was conducted to provide insight into currently used non-surgical treatments for neurogenic claudication. A series of studies then explored the effects of spinal posture and loading, and an evaluation of the commonly used Swiss Spinal Stenosis outcome measure was undertaken. These preliminary studies provided the setting for a final clinical trial of physiotherapy exercise intervention. The results presented in this thesis indicated that mechanisms of neurogenic claudication symptom provocation may be related both to spinal posture and also loading through the spine. Exercises and prescription of walking sticks are common interventions, but a walking stick was found to have no effect on walking posture nor on symptoms or walking tolerance. Equally, a self-directed exercise programme had no universal effect on symptom severity or function. Subgroup analysis suggests that further research to evaluate the effectiveness of specific exercise programmes within different subgroups of patients is required. Alternative treatments such as orthoses and different walking aids which may offer similar benefits to pushing a trolley also warrant further exploration.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available