Lumbar Proprioception in Patients With Lumbar Spinal Stenosis

Study Overview
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Brief Summary
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The primary aim of this study was to compare spinal proprioception in patients with Lumbal Spinal Stenosis (LSS) (with or without surgery) and healthy controls. A secondary aim was to investigate the effect of pain at target positions where repositioning error (RE) was assessed and TLF flexibility on spinal proprioception deficiency.This cross-sectional and healthy controlled study was conducted in patients with LSS. Participants will be grouped as: Healthy control (Group I), chronic low back pain due to LSS (Group II) and undergoing surgery due to LSS (Group III). Reposition error (RE), pain at target positions of RE and flexibility of the TLF were assesed with iphone tiltmeter app, VAS and goniometric platform, respectively. Target positions of reposition error were: 30º forward bending and 15º backward bending in sitting and standing.

Detailed Description
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This cross-sectional and healthy controlled study was conducted in patients with LSS. Participants will be grouped as: Healthy control (Group I), chronic low back pain due to LSS (Group II) and undergoing surgery due to LSS (Group III). Reposition error (RE), pain at target positions of RE and flexibility of the TLF were assesed with iphone tiltmeter app, VAS and goniometric platform, respectively. Target positions of reposition error were: 30º forward bending and 15º backward bending in sitting and standing. The general study inclusion criteria were as follows: age between 20 and 50 years and not having had lower extremity surgery. In addition to the general inclusion criteria, the inclusion criteria for the control group were as follows: not having a chronic spinal disorders and not having low back pain in the last week. Group II consisted of patients diagnosed with LSS and confirmed by MRI findings. In addition to the general inclusion criteria, the inclusion criteria for the LSS group were as follows: having low back pain for more than 3 months and having low back pain intensity of 4 or more assessed with VAS. There was not any additional inclussion criteria for Group III. The exclusion criteria of current study are; having any previous inner ear inflammation or vestibular disorders, having diabetes and being pregnant.

Official Title
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Effect of Different Injury Mechanism on Lumbar Proprioception in Patients With Lumbar Spinal Stenosis: an Observational Healthy Controlled Study

Conditions
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Spinal Stenosis Lumbar

Intervention / Treatment
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* Other: Reposition error (RE), pain at target positions of RE and flexibility of the TLF were assesed with iphone tiltmeter app, VAS and goniometric platform, respectively.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age between 20 and 50 years not having had lower extremity surgery not having a chronic spinal disorders not having low back pain in the last week having low back pain for more than 3 months having low back pain intensity of 4 or more assessed with VAS Exclusion Criteria: .having any previous inner ear inflammation or vestibular disorders .having diabetes and being pregnant.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group I (Healthy control)<br>Group I consists of patient relatives and patients who applied to the outpatient clinic for another ailment. | Other: Reposition error (RE), pain at target positions of RE and flexibility of the TLF were assesed with iphone tiltmeter app, VAS and goniometric platform, respectively.<br>* Target positions of reposition error were: 30º forward bending and 15º backward bending in sitting and standing.<br>|
| Group II (chronic low back pain due to LSS )<br>Group II consisted of patients diagnosed with LSS and confirmed by MRI findings. | Other: Reposition error (RE), pain at target positions of RE and flexibility of the TLF were assesed with iphone tiltmeter app, VAS and goniometric platform, respectively.<br>* Target positions of reposition error were: 30º forward bending and 15º backward bending in sitting and standing.<br>|
| Group III (undergoing surgery due to LSS )<br>Participants who had surgery for LSS at least 3 months ago were included in Group III. | Other: Reposition error (RE), pain at target positions of RE and flexibility of the TLF were assesed with iphone tiltmeter app, VAS and goniometric platform, respectively.<br>* Target positions of reposition error were: 30º forward bending and 15º backward bending in sitting and standing.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| reposition error | Reposition error was asessed by measuring the difference in angles between the target position and the re-produced position. Target positions were 30º forward bending and 15º backward bending in sitting and standing positions. The target and the reproduced angles were measured with the iPhone tilt-meter application. | september 2020-february 2021 | 
| pain intensity | . Pain intensity was assessed with the 10 cm horizontal Visual Analogue Scale (VAS) at target positions (during sitting and standing in combination with forward and backward bending) | september 2020-february 2021 | 
| flexibility of the TLF | Flexibility of the TLF was evaluated with goniometric platform. The participant was asked to sit on a height-adjustable chair with the hip and knee flexed at 90º and the lumbar region in a neutral position. The goniometric platform was placed on the table in front of the participant. The therapist fixed the posterior superior iliac spines of the participant. And then participants were asked to hold the hands in front of the body (90° shoulder flexion) with a pen clamped between the hands. Participants were warned that the arms should follow the trunk rotation. Participants performed trunk rotation 3 times in the same direction and marked the point on the goniometric platform. The mean of the 3 measurements was calculated. The same protocol was repeated in the opposite direction. | september 2020-february 2021 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Lumbar spinal stenosis, proprioception, reposition error