Barriers and Facilitators to Cycling for Lumbar Spinal Stenosis
Barriers and Facilitators to Cycling for Lumbar Spinal Stenosis
The purpose of this study is to determine whether a home-based cycling program for patients
 with lumbar spinal stenosis is a feasible and acceptable
Lumbar spinal stenosis is a prevalent and disabling condition in elderly individuals. Lumbar
 spinal stenosis results in lumbar and/or radicular leg pain when standing and walking, while
 symptoms regress in lumbar flexion positions and at rest. The inability to stand or walk
 impairs functioning and health-related quality of life of elders, and has an important
 healthcare cost. The 2 main treatment options for lumbar spinal stenosis are conservative or
 surgical. Laminectomy may be more effective on pain and function than conservative therapy.
 However, the benefit-risk balance of surgery should be considered in this population with
 numerous co-morbidities, and evidence is inconsistent. Therefore, conservative therapy is
 usually the first line option to avoid or delay surgery. Data regarding exercise therapy are
 scarce. Lumbar-flexion-based exercises are usually recommended. A pilot study suggested that
 lumbar-flexion-based endurance training, namely cycling, could be an effective and safe
 method to improve pain, function and health-related quality of life in elderly patients with
 chronic low back pain but barriers to adhering to the program were detected. Investigators
 aim to assess barriers and facilitators to a 3-month home-based cycling program in lumbar
 spinal stenosis.
Inclusion Criteria:

 -  Fulfilment of International Society for the Study of Lumbar Spine clinical diagnosis
 criteria for lumbar spinal stenosis with the presence of at least 6 out of the 7
 following criteria: "pain in the buttocks or legs while walking"; "flex forward to
 relieve symptoms"; "feel relief when using a shopping cart or bicycle"; "motor or
 sensory disturbance while walking"; "normal and symmetric foot pulses"; "lower
 extremity weakness"; and "low back pain"

 -  Lumbar spinal stenosis qualitatively detected on MRI or CT-scan

 Exclusion Criteria:

 -  Inability to speak or read French

 -  Impossibility or refusal to have an ergometric bicycle at home

 -  Ongoing lumbar-flexion-based endurance training

 -  History of spinal surgery

 -  Cognitive impairment

 -  Neurological or vascular disorder involving the lower limbs

 -  Contraindication to cycling