Tomkins-Lane Christy C, Lafave Lynne M Z, Parnell Jill A, Rempel Jocelyn, Moriartey Stephanie, Andreas Yvette, Wilson Philip M, Hepler Charles, Ray Heather A, Hu Richard
Department of Physical Education and Recreation Studies, Mount Royal University, 4825 Mt Royal Gate SW, Calgary, Alberta, Canada T3E 6K6.
Department of Physical Education and Recreation Studies, Mount Royal University, 4825 Mt Royal Gate SW, Calgary, Alberta, Canada T3E 6K6.
Spine J. 2015 Apr 1;15(4):577-86. doi: 10.1016/j.spinee.2014.10.015. Epub 2014 Oct 22.
Owing to mobility limitations, people with lumbar spinal stenosis (LSS) are at risk for diseases of inactivity, including obesity. Therefore, weight management in LSS is critical. Body mass index is the strongest predictor of function in LSS, suggesting that weight loss may promote physical activity and provide a unique treatment option. We propose a lifestyle modification approach of physical activity and nutrition education, delivered through an e-health platform.
The purpose of this study was to develop and pilot an e-health intervention aimed at increasing physical activity and decreasing fat mass in people with LSS.
The study design was based on intervention development and pilot.
Ten overweight or obese individuals with LSS were confirmed clinically and on imaging.
Self-reported measures were food record, Short-Form 36 (SF-36), pain scales, Swiss Spinal Stenosis Symptom and Physical Function Scales, Oswestry Disability Index (ODI), Pain Catastrophizing Questionnaire, Tampa Scale for Kinesiophobia, Center for Epidemiologic Studies(Depression) Scale, Behavioral Regular in Exercise Questionnaire, and Regulation for Eating Behavior Scale and physiologic measures were dual-energy X-ray absorptiometry (DXA), blood draw, 7-day accelerometry, self-paced walking test, and balance test.
The e-health platform was developed.
during Week 1, participants received a pedometer and a personalized consultation with a dietitian and an exercise physiologist. For 12 weeks, participants logged on to the e-health Web site to access personal step goals, nutrition education videos, and a discussion board. Follow-up occurred at Week 13.
Nine participants had a mean age of 67.5±6.7 years (60% women). Significant improvements were observed for fat mass (DXA), trunk fat mass, symptom severity (Swiss Symptom Scale), energy intake, maximum continuous activity (accelerometry), and mental health (SF-36) (p<.05). Nonsignificant improvements were observed for waist circumference, pain, ODI, and obesity biomarkers. Seventy percent lost weight, 50% increased walking capacity, and 60% increased quality of life. The mean increase in steps was 15%.
The spinal stenosis pedometer and nutrition lifestyle intervention was shown to be feasible, attractive to participants, and effective in this small sample. This intervention provides people with LSS the opportunity to participate in their own health management, potentially improving access to care. Efficacy is currently being assessed in a randomized trial.
由于行动受限，腰椎管狭窄症（LSS）患者有患包括肥胖症在内的缺乏运动相关疾病的风险。因此，LSS患者的体重管理至关重要。体重指数是LSS患者功能的最强预测指标，这表明体重减轻可能会促进身体活动并提供一种独特的治疗选择。我们提出了一种通过电子健康平台提供的身体活动和营养教育的生活方式改变方法。
本研究的目的是开发并试点一项电子健康干预措施，旨在增加LSS患者的身体活动并减少脂肪量。
研究设计基于干预措施的开发和试点。
10名超重或肥胖的LSS患者经临床和影像学检查确诊。
自我报告的指标包括食物记录、简明健康调查问卷（SF-36）、疼痛量表、瑞士腰椎管狭窄症症状和身体功能量表、Oswestry功能障碍指数（ODI）、疼痛灾难化问卷、坦帕运动恐惧量表、流行病学研究中心抑郁量表、运动行为规律问卷以及饮食行为调节量表；生理指标包括双能X线吸收法（DXA）、抽血、7天加速度计测量、自定步速行走测试和平衡测试。
开发了电子健康平台。
在第1周，参与者收到一个计步器，并与营养师和运动生理学家进行个性化咨询。在12周内，参与者登录电子健康网站以获取个人步数目标、营养教育视频和一个讨论板。在第13周进行随访。
9名参与者的平均年龄为67.5±6.7岁（60%为女性）。在脂肪量（DXA）、躯干脂肪量、症状严重程度（瑞士症状量表）、能量摄入、最大持续活动量（加速度计测量）和心理健康（SF-36）方面观察到显著改善（p<0.05）。在腰围、疼痛、ODI和肥胖生物标志物方面观察到非显著改善。70%的人体重减轻，50%的人步行能力增加，60%的人生活质量提高。步数平均增加了15%。
在这个小样本中，腰椎管狭窄症计步器和营养生活方式干预措施被证明是可行的、对参与者有吸引力且有效的。这种干预措施为LSS患者提供了参与自身健康管理的机会，有可能改善医疗服务的可及性。目前正在一项随机试验中评估其疗效。
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