Publication Date

Spring 2015

Document Type

Project Summary

Degree Name

Doctor of Physical Therapy

Department

Physical Therapy

First Advisor

Russell E. Carter, PT, Ed.D.

Second Advisor

Dale Schuit, PT, Ph.D., MS

Third Advisor

Roberta O'Shea, PT, DPT, Ph.D.

Abstract

Background and Purpose: There is a lack of research demonstrating standardization of treatment protocols for patients with chronic low back pain and lumbar spinal stenosis. The purpose of this case report was to examine the effectiveness of a physical therapy rehabilitation program for a 66-year-old female referred for lumbar radiculopathy and lumbar spinal stenosis.

Case Description: This case report contained interventions focused on lumbar extension exercises, upper and lower extremity and postural control exercises, aerobic training, and modalities, in order to achieve the patient’s goals and to improve quality of life. To measure the outcomes the following tests and measures were chosen: the numerical pain rating scale (NPRS) to measure pain intensity, lumbar range of motion (ROM), lower extremity manual muscle tests, neurodynamic tests including the straight leg raise and slump test, and the Modified Oswestry Disability Index to assess activity limitations.

Outcomes: The patient achieved 6 of the 7 physical therapy goals and partially met 1 of the goals. Lumbar ROM improved in the directions that showed limitation at baseline from moderately limited to within normal limits (WNL). Lower extremity strength improved in all areas by half to a full grade. Numerical pain rating scale score decreased from 8/10 to 6/10. There was no change in the Modified Oswestry Disability Index score.

Discussion: The results of this case report support research showing that physical therapy helps improve ROM and strength in patients with chronic low back pain and lumbar spinal stenosis. Additional research could include studies looking at different types of interventions and compare them to each other to discover which produces superior outcomes.

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