Do Lower Spine Injections Improve Outcomes for Lower Back Pain Patients

Study Overview
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Brief Summary
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The purpose of this project is to determine the effect of lower back injections on select biomechanical outcomes, walking patterns, lower back flexibility and balance.

Detailed Description
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The purpose of this project is to determine the effect of lumbar injections on select biomechanics parameters; walking pattern, lumbar flexibility and balance. The surveys will help assess the patient's sense of functional ability and feeling of wellness compared with low back pain scores. The long terms goals of this project will be to elucidate the mechanism of action of injections and to improve identification of patients that are likely to benefit from injection therapy

Official Title
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Do Lumbar Spine Injections Improve Short-Term Biomechanical Outcomes in Patients With Chronic Low Back Pain

Conditions
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Low Back Pain

Intervention / Treatment
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* Other: Observation of biomechanical effects post injection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosis of lumbar spine stenosis receiving lumbar epidural injection age 18-90 years BMI <35kg/m2 walking unaided Exclusion Criteria: age <18 or >90 years BMI >35 kg/m2 severely impaired intellectual capacity medications that could impact balance dementia, or other neurodegenerative diseases that would preclude appropriate cognitive or physical ability to perform study protocol

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Observation of biomechanical effects post injection<br>Observation of effects on gait, lumbar spine range of motion and pain symptoms immediately following injection and at two weeks post injection. | Other: Observation of biomechanical effects post injection<br>* Observation of effects on gait, lumbar spine range of motion and pain symptoms immediately following injection and at two weeks post injection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determine the immediate biomechanical effect in patients that receive a lumbar epidural injection | We hypothesize that patients will demonstrate increased gait velocity, increased step length, decreased asymmetry and increased lumbar ROM immediately after injection compared to pre-injection | Immediately following injection | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determine the short-term biomechanical effect in patients that receive a lumbar epidural injection | We hypothesize that patients will demonstrate increased gait velocity, increased step length, decreased asymmetry and increased lumbar ROM 2 weeks after injection compared with pre- and post-injection time points | Two weeks following injection | 
| Determine the relationship between biomechanical status before injection and short-term pain reduction | We hypothesize that those patients with moderate biomechanical limitation before injection (e.g., higher gait velocity, higher step length, lower asymmetry, and greater lumbar ROM) will have greater positive biomechanical response than patients who demonstrate severe biomechanical limitation pre-injection. This response to the injection will be measured by the changes in gait and lumbar spine range of motion and pain symptoms with these activities at 2 weeks after the injection | Two weeks following injection | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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low back pain, lumbar, injection, lumbar pain