Treadmill walking with body weight support is no more effective than cycling when added to an exercise program for lumbar spinal stenosis: a randomised controlled trial.

QUESTION Is 6 weeks of treadmill walking with body weight support more effective than cycling in people with lumbar spinal stenosis when added to an exercise program? DESIGN Randomised controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. PARTICIPANTS Sixty-eight patients aged 58 (SD 8) with symptoms of lumbar spinal stenosis for 12 weeks (SD 49). INTERVENTION Participants performed either treadmill with body weight support or cycling, twice weekly, for 6 weeks. Both groups also received an exercise program consisting of heat, lumbar traction, and flexion exercises. OUTCOME MEASURES The primary outcome was disability measured using the modified Oswestry Disability Index. Secondary outcomes were disability, measured using the Roland-Morris Disability Questionnaire, pain severity, and patient perceived benefit. Measures were collected midway through intervention at 3 weeks and after intervention at 6 weeks. RESULTS There was no difference between the groups in reduction in disability or pain over the 6-week intervention period. The between-group difference in the modified Oswestry Disability Index was 3.2 points (95% CI -3.1 to 7.7) at 6 weeks, and in pain severity was 2 mm on a 100 visual analogue scale (95% CI -5 to 10). Furthermore, the wide confidence intervals associated with estimates of patient benefit are consistent with no difference between the two groups. However, both groups did improve. CONCLUSION Treadmill with body weight support and cycling may be equally effective in the conservative management of people with lumbar spinal stenosis. However, the improvement observed in both groups was probably a combination of the intervention and the natural course of recovery of lumbar spinal stenosis.