James T. Cavanaugh
© 2020 Madison Lostra
Background and Purpose: Lumbar spinal stenosis is an increasingly common diagnosis due to its association with degenerative changes of the lumbar vertebrae and the advancing age of our population. This condition may lead to neurogenic claudication which often results in significant pain and disability. Due to the negative impact on quality of life, surgical intervention is often utilized to reduce symptoms. However, post-surgical management is highly variable. The purpose of this case report was to examine a rehabilitation program used to address functional limitations and reverse impairments in a patient with severe deconditioning due to neurogenic claudication as a result of spinal stenosis. Case Description: The patient was an 86-year-old male who underwent a decompressive laminectomy to treat his neurogenic claudication. He presented with reduced cardiovascular endurance, ambulatory capacity, and lower extremity strength. His goal was to increase his walking capacity and improve his ability to complete activities of daily living. Interventions included resistance, aerobic, task specific, and balance training. Outcomes: After ten visits, the patient increased his lower extremity strength, reduced his Timed Up and Go score by 3.9 seconds, decreased his Five Times Sit to Stand time by 3.45 seconds, and walked 54.5m farther during the Six Minute Walk Test. This case report explored the use of strength, balance, and aerobic training to address the impairments and limitations of a patient who underwent a lumbar laminectomy to treat neurogenic claudication. Although the patient did not meet all goals, he demonstrated functional improvements in his daily life. Future research should focus on identifying interventions that are most advantageous for recovery to guide physical therapy decisions for the management of chronically deconditioned patients.
Lostra, Madison, "The Challenges Of Exercise Selection For A Post-Operative Patient With Severe Deconditioning And Longstanding Neurogenic Claudication: A Case Report" (2020). Case Report Papers. 119.