A home exercise programme is no more beneficial than advice and education for people with neurogenic claudication: results from a randomised controlled trial
To compare the effectiveness of a physiotherapy programme with a control treatment of advice and education in patients with neurogenic claudication symptoms. Pragmatic randomised controlled clinical trial. Primary care-based musculoskeletal service. Adults aged 50 or over with neurogenic claudicatio...
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| description | To compare the effectiveness of a physiotherapy programme with a control treatment of advice and education in patients with neurogenic claudication symptoms.
Pragmatic randomised controlled clinical trial.
Primary care-based musculoskeletal service.
Adults aged 50 or over with neurogenic claudication symptoms causing limitation of walking.
Condition-specific home exercises combined with advice and education, or advice and education alone.
The primary outcome was the difference in improvement of symptom severity scores on the Swiss Spinal Stenosis Scale at eight weeks. Secondary outcomes included measures of physical function, pain and general well-being at eight weeks and 12 months.
There was no significant difference between groups in the Swiss Spinal Stenosis symptom severity scale at eight weeks (t = 0.47, p = 0.643): mean change (SD) control group -0.18 (0.47), treatment group -0.10 (0.66), difference (95% CI) 0.08 (-0.19, 0.35); baseline-adjusted difference 0.06 (-0.19, 0.31)]. An unplanned subgroup analysis suggested that for patients with the top 25% of baseline symptom severity scores, the physiotherapy exercise programme resulted in an improvement in the primary outcome, and modest but consistently better secondary outcomes at both time-points compared to the control group. The effectiveness in different subgroups requires further direct evaluation.
In the treatment of patients with neurogenic claudication symptoms, a physiotherapist-prescribed home exercise programme is no more effective than advice and education.
The study was approved by Leeds Central Ethics Committee and informed consent was given by all participating patients.
The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, a worldwide licence to the Publishers and its licensees in perpetuity, in all forms, formats and media (whether known now or created in the future), to i) publish, reproduce, distribute, display and store the Contribution, ii) translate the Contribution into other languages, create adaptations, reprints, include within collections and create summaries, extracts and/or, abstracts of the Contribution, iii) create any other derivative work(s) based on the Contribution, iv) to exploit all subsidiary rights in the Contribution, v) the inclusion of electronic links from the Contribution to third party material where-ever it may be located; and, vi) licence any third party to do any or all of the above.
ISRCTN 7828 |
| doi_str_mv | 10.1371/journal.pone.0072878 |
| format | Article |
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Pragmatic randomised controlled clinical trial.
Primary care-based musculoskeletal service.
Adults aged 50 or over with neurogenic claudication symptoms causing limitation of walking.
Condition-specific home exercises combined with advice and education, or advice and education alone.
The primary outcome was the difference in improvement of symptom severity scores on the Swiss Spinal Stenosis Scale at eight weeks. Secondary outcomes included measures of physical function, pain and general well-being at eight weeks and 12 months.
There was no significant difference between groups in the Swiss Spinal Stenosis symptom severity scale at eight weeks (t = 0.47, p = 0.643): mean change (SD) control group -0.18 (0.47), treatment group -0.10 (0.66), difference (95% CI) 0.08 (-0.19, 0.35); baseline-adjusted difference 0.06 (-0.19, 0.31)]. An unplanned subgroup analysis suggested that for patients with the top 25% of baseline symptom severity scores, the physiotherapy exercise programme resulted in an improvement in the primary outcome, and modest but consistently better secondary outcomes at both time-points compared to the control group. The effectiveness in different subgroups requires further direct evaluation.
In the treatment of patients with neurogenic claudication symptoms, a physiotherapist-prescribed home exercise programme is no more effective than advice and education.
The study was approved by Leeds Central Ethics Committee and informed consent was given by all participating patients.
The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, a worldwide licence to the Publishers and its licensees in perpetuity, in all forms, formats and media (whether known now or created in the future), to i) publish, reproduce, distribute, display and store the Contribution, ii) translate the Contribution into other languages, create adaptations, reprints, include within collections and create summaries, extracts and/or, abstracts of the Contribution, iii) create any other derivative work(s) based on the Contribution, iv) to exploit all subsidiary rights in the Contribution, v) the inclusion of electronic links from the Contribution to third party material where-ever it may be located; and, vi) licence any third party to do any or all of the above.
ISRCTN 78288224 - doi10.1186/ISRCTN35836727; UKCRN 4814.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0072878</identifier><identifier>PMID: 24098633</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adaptation ; Adaptations ; Adults ; Aged ; Arthritis ; Back pain ; Biomedical research ; Clinical trials ; Education ; Ethics ; Exercise ; Exercise Therapy - methods ; Exercise Therapy - statistics & numerical data ; Female ; Health care ; Health services ; Humans ; Informed consent ; Intermittent Claudication - therapy ; Male ; Middle Aged ; Pain ; Pain Measurement ; Patient Education as Topic - methods ; Patient Education as Topic - statistics & numerical data ; Patients ; Physical fitness ; Physical therapy ; Physiotherapy ; Posture ; Primary care ; Randomization ; Rehabilitation ; Spinal cord ; Spinal stenosis ; Stenosis ; Subgroups ; Surgery ; Surgical outcomes ; Surveys and Questionnaires ; Teaching hospitals ; Treatment Outcome ; Walking ; Well being</subject><ispartof>PloS one, 2013-09, Vol.8 (9), p.e72878-e72878</ispartof><rights>2013 Comer et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Comer et al 2013 Comer et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-cc652690cbf11779fc4dddd73db9cf8580fafbaf97facefe319aa7151ec4d4d13</citedby><cites>FETCH-LOGICAL-c526t-cc652690cbf11779fc4dddd73db9cf8580fafbaf97facefe319aa7151ec4d4d13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3787048/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3787048/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24098633$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Comer, Christine</creatorcontrib><creatorcontrib>Redmond, Anthony C</creatorcontrib><creatorcontrib>Bird, Howard A</creatorcontrib><creatorcontrib>Hensor, Elizabeth M A</creatorcontrib><creatorcontrib>Conaghan, Philip G</creatorcontrib><title>A home exercise programme is no more beneficial than advice and education for people with neurogenic claudication: results from a randomised controlled trial</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To compare the effectiveness of a physiotherapy programme with a control treatment of advice and education in patients with neurogenic claudication symptoms.
Pragmatic randomised controlled clinical trial.
Primary care-based musculoskeletal service.
Adults aged 50 or over with neurogenic claudication symptoms causing limitation of walking.
Condition-specific home exercises combined with advice and education, or advice and education alone.
The primary outcome was the difference in improvement of symptom severity scores on the Swiss Spinal Stenosis Scale at eight weeks. Secondary outcomes included measures of physical function, pain and general well-being at eight weeks and 12 months.
There was no significant difference between groups in the Swiss Spinal Stenosis symptom severity scale at eight weeks (t = 0.47, p = 0.643): mean change (SD) control group -0.18 (0.47), treatment group -0.10 (0.66), difference (95% CI) 0.08 (-0.19, 0.35); baseline-adjusted difference 0.06 (-0.19, 0.31)]. An unplanned subgroup analysis suggested that for patients with the top 25% of baseline symptom severity scores, the physiotherapy exercise programme resulted in an improvement in the primary outcome, and modest but consistently better secondary outcomes at both time-points compared to the control group. The effectiveness in different subgroups requires further direct evaluation.
In the treatment of patients with neurogenic claudication symptoms, a physiotherapist-prescribed home exercise programme is no more effective than advice and education.
The study was approved by Leeds Central Ethics Committee and informed consent was given by all participating patients.
The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, a worldwide licence to the Publishers and its licensees in perpetuity, in all forms, formats and media (whether known now or created in the future), to i) publish, reproduce, distribute, display and store the Contribution, ii) translate the Contribution into other languages, create adaptations, reprints, include within collections and create summaries, extracts and/or, abstracts of the Contribution, iii) create any other derivative work(s) based on the Contribution, iv) to exploit all subsidiary rights in the Contribution, v) the inclusion of electronic links from the Contribution to third party material where-ever it may be located; and, vi) licence any third party to do any or all of the above.
ISRCTN 78288224 - doi10.1186/ISRCTN35836727; UKCRN 4814.</description><subject>Adaptation</subject><subject>Adaptations</subject><subject>Adults</subject><subject>Aged</subject><subject>Arthritis</subject><subject>Back pain</subject><subject>Biomedical research</subject><subject>Clinical trials</subject><subject>Education</subject><subject>Ethics</subject><subject>Exercise</subject><subject>Exercise Therapy - methods</subject><subject>Exercise Therapy - statistics & numerical data</subject><subject>Female</subject><subject>Health care</subject><subject>Health services</subject><subject>Humans</subject><subject>Informed consent</subject><subject>Intermittent Claudication - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pain</subject><subject>Pain Measurement</subject><subject>Patient Education as Topic - methods</subject><subject>Patient Education as Topic - statistics & numerical data</subject><subject>Patients</subject><subject>Physical fitness</subject><subject>Physical therapy</subject><subject>Physiotherapy</subject><subject>Posture</subject><subject>Primary care</subject><subject>Randomization</subject><subject>Rehabilitation</subject><subject>Spinal cord</subject><subject>Spinal stenosis</subject><subject>Stenosis</subject><subject>Subgroups</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Surveys and Questionnaires</subject><subject>Teaching hospitals</subject><subject>Treatment Outcome</subject><subject>Walking</subject><subject>Well 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Comer, Christine</au><au>Redmond, Anthony C</au><au>Bird, Howard A</au><au>Hensor, Elizabeth M A</au><au>Conaghan, Philip G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A home exercise programme is no more beneficial than advice and education for people with neurogenic claudication: results from a randomised controlled trial</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-09-30</date><risdate>2013</risdate><volume>8</volume><issue>9</issue><spage>e72878</spage><epage>e72878</epage><pages>e72878-e72878</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To compare the effectiveness of a physiotherapy programme with a control treatment of advice and education in patients with neurogenic claudication symptoms.
Pragmatic randomised controlled clinical trial.
Primary care-based musculoskeletal service.
Adults aged 50 or over with neurogenic claudication symptoms causing limitation of walking.
Condition-specific home exercises combined with advice and education, or advice and education alone.
The primary outcome was the difference in improvement of symptom severity scores on the Swiss Spinal Stenosis Scale at eight weeks. Secondary outcomes included measures of physical function, pain and general well-being at eight weeks and 12 months.
There was no significant difference between groups in the Swiss Spinal Stenosis symptom severity scale at eight weeks (t = 0.47, p = 0.643): mean change (SD) control group -0.18 (0.47), treatment group -0.10 (0.66), difference (95% CI) 0.08 (-0.19, 0.35); baseline-adjusted difference 0.06 (-0.19, 0.31)]. An unplanned subgroup analysis suggested that for patients with the top 25% of baseline symptom severity scores, the physiotherapy exercise programme resulted in an improvement in the primary outcome, and modest but consistently better secondary outcomes at both time-points compared to the control group. The effectiveness in different subgroups requires further direct evaluation.
In the treatment of patients with neurogenic claudication symptoms, a physiotherapist-prescribed home exercise programme is no more effective than advice and education.
The study was approved by Leeds Central Ethics Committee and informed consent was given by all participating patients.
The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, a worldwide licence to the Publishers and its licensees in perpetuity, in all forms, formats and media (whether known now or created in the future), to i) publish, reproduce, distribute, display and store the Contribution, ii) translate the Contribution into other languages, create adaptations, reprints, include within collections and create summaries, extracts and/or, abstracts of the Contribution, iii) create any other derivative work(s) based on the Contribution, iv) to exploit all subsidiary rights in the Contribution, v) the inclusion of electronic links from the Contribution to third party material where-ever it may be located; and, vi) licence any third party to do any or all of the above.
ISRCTN 78288224 - doi10.1186/ISRCTN35836727; UKCRN 4814.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24098633</pmid><doi>10.1371/journal.pone.0072878</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2013-09, Vol.8 (9), p.e72878-e72878 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1438042165 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adaptation Adaptations Adults Aged Arthritis Back pain Biomedical research Clinical trials Education Ethics Exercise Exercise Therapy - methods Exercise Therapy - statistics & numerical data Female Health care Health services Humans Informed consent Intermittent Claudication - therapy Male Middle Aged Pain Pain Measurement Patient Education as Topic - methods Patient Education as Topic - statistics & numerical data Patients Physical fitness Physical therapy Physiotherapy Posture Primary care Randomization Rehabilitation Spinal cord Spinal stenosis Stenosis Subgroups Surgery Surgical outcomes Surveys and Questionnaires Teaching hospitals Treatment Outcome Walking Well being |
| title | A home exercise programme is no more beneficial than advice and education for people with neurogenic claudication: results from a randomised controlled trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T18%3A17%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20home%20exercise%20programme%20is%20no%20more%20beneficial%20than%20advice%20and%20education%20for%20people%20with%20neurogenic%20claudication:%20results%20from%20a%20randomised%20controlled%20trial&rft.jtitle=PloS%20one&rft.au=Comer,%20Christine&rft.date=2013-09-30&rft.volume=8&rft.issue=9&rft.spage=e72878&rft.epage=e72878&rft.pages=e72878-e72878&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0072878&rft_dat=%3Cproquest_plos_%3E1443415559%3C/proquest_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1438042165&rft_id=info:pmid/24098633&rft_doaj_id=oai_doaj_org_article_f0f8b0d5ae094c1c9110f59e5d692949&rfr_iscdi=true |