The Boot Camp treatment program for patients with lumbar spinal stenosis in Danish chiropractic care-a feasibility study.

IF 1.6 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Rikke Krüger Jensen, Lisbeth Hartvigsen, Berit Schiøttz-Christensen, Henrik Wulff Christensen, Jan Hartvigsen
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引用次数: 0

Abstract

Background: Lumbar spinal stenosis (LSS) affects older people, leading to a decline in functional ability, and its prevalence is projected to rise with the aging population. Effective, affordable, and low-risk interventions are needed to maintain the function and quality of life for LSS patients. This study tested the feasibility of implementing a comprehensive conservative treatment program (Boot Camp Program) for LSS in Danish chiropractic clinics to inform a future randomised clinical trial. The objectives were to assess feasibility in terms of recruitment, adherence, data collection procedures, and completeness of outcomes, and to describe patient characteristics and investigate changes in outcomes over time.

Method: Using a prospective, single-arm, pretest-posttest design, this study sought to recruit 50 patients with LSS from six chiropractors in two primary care chiropractic practices. The program consisted of 12 visits and included patient education, manual therapy, and a progressive home exercise program. The impact of the program was assessed by measuring walking distance using a treadmill test at the 6- and 12-week follow-ups visits and self-reported pain and physical function at 6-, 12-, 20-, and 52-week intervals.

Results: In total, 147 patients were screened for eligibility and 38 (26%) were included. The mean age was 69 years (SD 10, range 47-89) and 61% were women. Thirty-four (90%) completed the 6-week program and 32 (84%) provided follow-up data. Almost 80% completed one daily exercise session 5 to 7 days a week. Overall, data collection procedures were feasible, except for paper patient diaries. Follow-up rates at 12, 20, and 52 weeks were 87%, 82%, and 74% respectively. Participants improved their walking distance on average by 45% and 53% at 6 and 12 weeks, respectively. Clinically relevant improvement was observed in secondary outcomes such as leg pain, back pain, and physical function at all follow-ups.

Conclusions: The Boot Camp Program for LSS was feasible to deliver in Danish chiropractic practice and patients improved on relevant outcomes. However, the recruitment procedure was ineffective. Logistics, awareness, incentives, timeframes, and patient motivation may have influenced enrolment and adherence. Recruitment in multiple settings and patient enrolment incentives will be considered.

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丹麦捏脊治疗中腰椎管狭窄患者的训练营治疗方案-可行性研究。
背景:腰椎管狭窄症(LSS)影响老年人,导致功能能力下降,其患病率预计将随着人口老龄化而上升。需要有效、负担得起和低风险的干预措施来维持LSS患者的功能和生活质量。本研究测试了在丹麦脊椎指压诊所实施LSS综合保守治疗方案(新兵训练营方案)的可行性,为未来的随机临床试验提供信息。目的是评估招募、依从性、数据收集程序和结果完整性方面的可行性,描述患者特征并调查结果随时间的变化。方法:采用前瞻性,单臂,前测后测设计,本研究试图从两家初级保健脊医的6名脊医中招募50名LSS患者。该计划包括12次访问,包括患者教育,手工治疗和渐进式家庭锻炼计划。通过在6周和12周的随访中使用跑步机测试测量步行距离,以及在6周、12周、20周和52周的间隔中自我报告疼痛和身体功能来评估该计划的影响。结果:共筛选147例患者,其中38例(26%)纳入。平均年龄为69岁(SD 10,范围47-89),61%为女性。34例(90%)完成了6周的计划,32例(84%)提供了随访数据。几乎80%的人每周锻炼5到7天。总体而言,除纸质患者日记外,数据收集程序是可行的。12周、20周和52周的随访率分别为87%、82%和74%。在第6周和第12周,参与者的步行距离分别平均增加了45%和53%。在所有随访中,次要结果如腿痛、背痛和身体功能均有临床相关改善。结论:在丹麦的捏脊实践中,LSS的训练营计划是可行的,患者的相关结果得到了改善。但是,征聘程序是无效的。后勤、意识、激励、时间框架和患者动机可能影响了入组和依从性。将考虑多种环境下的招募和患者入组激励措施。
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来源期刊
Pilot and Feasibility Studies
Pilot and Feasibility Studies Medicine-Medicine (miscellaneous)
CiteScore
2.70
自引率
5.90%
发文量
241
审稿时长
9 weeks
期刊介绍: Pilot and Feasibility Studies encompasses all aspects of the design, conduct and reporting of pilot and feasibility studies in biomedicine. The journal publishes research articles that are intended to directly influence future clinical trials or large scale observational studies, as well as protocols, commentaries and methodology articles. The journal also ensures that the results of all well-conducted, peer-reviewed, pilot and feasibility studies are published, regardless of outcome or significance of findings. Pilot and feasibility studies are increasingly conducted prior to a full randomized controlled trial. However, these studies often lack clear objectives, many remain unpublished, and there is confusion over the meanings of the words “pilot” and “feasibility”. Pilot and Feasibility Studies provides a forum for discussion around this key aspect of the scientific process, and seeks to ensure that these studies are published, so as to complete the publication thread for clinical research.
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