Does type 2 diabetes affect the efficacy of therapeutic exercises for degenerative lumbar spinal stenosis?
Abstract Design Propensity-matched retrospective study. Objectives To determine whether type 2 diabetes mellitus (T2D) would affect prognosis in patients with degenerative lumbar spinal stenosis (DLSS) who underwent therapeutic exercises. Methods This study included consecutive patients with or with...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-023-06305-0 |
| _version_ | 1797865901005996032 |
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| author | Tengbin Shi Zhi Chen Dingxiang Hu Wenwen Li Zhenyu Wang Wenge Liu |
| author_facet | Tengbin Shi Zhi Chen Dingxiang Hu Wenwen Li Zhenyu Wang Wenge Liu |
| author_sort | Tengbin Shi |
| collection | DOAJ |
| description | Abstract Design Propensity-matched retrospective study. Objectives To determine whether type 2 diabetes mellitus (T2D) would affect prognosis in patients with degenerative lumbar spinal stenosis (DLSS) who underwent therapeutic exercises. Methods This study included consecutive patients with or without T2D who underwent therapeutic exercises for symptomatic DLSS from December 2018 to January 2020. Baseline demographics and clinical and radiological data were collected. The 2 groups of patients were further matched in a 1:1 fashion based on the propensity score, balancing the groups on pre-treatment factors including age, sex, leg and back pain, and low back disability. The primary outcomes included self-reported leg pain intensity (Numerical Rating Scale, NRS) and low back disability (Oswestry Disability Index, ODI) and the secondary outcomes included low back pain intensity and walking capacity (self-paced walking test, SPWT) were compared at baseline, 6 weeks, and 12 weeks. Results Forty-one pairs of patients were selected by propensity matching. After 6-week therapeutic exercises, patients with T2D achieved a lower improvement in leg pain at 6 weeks (NRS leg change, 1.21 ± 0.40 vs. 1.78 ± 0.52, P = 0.021) and 12 weeks (NRS leg change, 1.52 ± 0.92 vs. 2.18 ± 0.96, P = 0.007) above minimal clinically important difference (MCID), with a significant Group × Time interactions (F1,80 = 16.32, p < 0.001, ηp2 = 0.053). However, the two groups showed no difference in the improvement of ODI, although the sample had significant improvements at 6 weeks (ODI change 3.02 [95% CI, 2.08 to 2.77], P < 0.001) and 12 weeks ([ODI change 3.82 [95% CI, 4.03 to 4.90], P < 0.001), 46% of the patients achieved an MCID. Conclusion Six-week therapeutic exercises have an inferior effect on DLSS patients with T2D. Findings from this study will provide an increased understanding of exercise treatment in patients with DLSS. |
| first_indexed | 2024-04-09T23:15:34Z |
| format | Article |
| id | doaj.art-a5c7fd385c964b3894b17fc1edb9c419 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-09T23:15:34Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-a5c7fd385c964b3894b17fc1edb9c4192023-03-22T10:02:33ZengBMCBMC Musculoskeletal Disorders1471-24742023-03-0124111010.1186/s12891-023-06305-0Does type 2 diabetes affect the efficacy of therapeutic exercises for degenerative lumbar spinal stenosis?Tengbin Shi0Zhi Chen1Dingxiang Hu2Wenwen Li3Zhenyu Wang4Wenge Liu5Department of Orthopedics, Fujian Medical University Union HospitalDepartment of Orthopedics, Fujian Medical University Union HospitalSchool of Health, Fujian Medical UniversitySchool of Health, Fujian Medical UniversityDepartment of Orthopedics, Fujian Medical University Union HospitalDepartment of Orthopedics, Fujian Medical University Union HospitalAbstract Design Propensity-matched retrospective study. Objectives To determine whether type 2 diabetes mellitus (T2D) would affect prognosis in patients with degenerative lumbar spinal stenosis (DLSS) who underwent therapeutic exercises. Methods This study included consecutive patients with or without T2D who underwent therapeutic exercises for symptomatic DLSS from December 2018 to January 2020. Baseline demographics and clinical and radiological data were collected. The 2 groups of patients were further matched in a 1:1 fashion based on the propensity score, balancing the groups on pre-treatment factors including age, sex, leg and back pain, and low back disability. The primary outcomes included self-reported leg pain intensity (Numerical Rating Scale, NRS) and low back disability (Oswestry Disability Index, ODI) and the secondary outcomes included low back pain intensity and walking capacity (self-paced walking test, SPWT) were compared at baseline, 6 weeks, and 12 weeks. Results Forty-one pairs of patients were selected by propensity matching. After 6-week therapeutic exercises, patients with T2D achieved a lower improvement in leg pain at 6 weeks (NRS leg change, 1.21 ± 0.40 vs. 1.78 ± 0.52, P = 0.021) and 12 weeks (NRS leg change, 1.52 ± 0.92 vs. 2.18 ± 0.96, P = 0.007) above minimal clinically important difference (MCID), with a significant Group × Time interactions (F1,80 = 16.32, p < 0.001, ηp2 = 0.053). However, the two groups showed no difference in the improvement of ODI, although the sample had significant improvements at 6 weeks (ODI change 3.02 [95% CI, 2.08 to 2.77], P < 0.001) and 12 weeks ([ODI change 3.82 [95% CI, 4.03 to 4.90], P < 0.001), 46% of the patients achieved an MCID. Conclusion Six-week therapeutic exercises have an inferior effect on DLSS patients with T2D. Findings from this study will provide an increased understanding of exercise treatment in patients with DLSS.https://doi.org/10.1186/s12891-023-06305-0Lumbar spinal stenosisType 2 diabetesExercise therapyMultifidus muscleFatty infiltration |
| spellingShingle | Tengbin Shi Zhi Chen Dingxiang Hu Wenwen Li Zhenyu Wang Wenge Liu Does type 2 diabetes affect the efficacy of therapeutic exercises for degenerative lumbar spinal stenosis? BMC Musculoskeletal Disorders Lumbar spinal stenosis Type 2 diabetes Exercise therapy Multifidus muscle Fatty infiltration |
| title | Does type 2 diabetes affect the efficacy of therapeutic exercises for degenerative lumbar spinal stenosis? |
| title_full | Does type 2 diabetes affect the efficacy of therapeutic exercises for degenerative lumbar spinal stenosis? |
| title_fullStr | Does type 2 diabetes affect the efficacy of therapeutic exercises for degenerative lumbar spinal stenosis? |
| title_full_unstemmed | Does type 2 diabetes affect the efficacy of therapeutic exercises for degenerative lumbar spinal stenosis? |
| title_short | Does type 2 diabetes affect the efficacy of therapeutic exercises for degenerative lumbar spinal stenosis? |
| title_sort | does type 2 diabetes affect the efficacy of therapeutic exercises for degenerative lumbar spinal stenosis |
| topic | Lumbar spinal stenosis Type 2 diabetes Exercise therapy Multifidus muscle Fatty infiltration |
| url | https://doi.org/10.1186/s12891-023-06305-0 |
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