Effectiveness of Hamstring Release and Neural Mobilisation in Improving Walking Capability and Physical Activity Associated with Intermittent Neurogenic Claudication in Patients with Lumbar Spinal Stenosis: A Quasi-experimental Study

Abstract

Introduction: In India, one of the most prevalent spinal pathologies is Lumbar Spinal Stenosis (LSS). It is characterised by the compression of neural structures in the spinal canal, resulting in symptoms such as neurogenic claudication, lower extremity radiculopathy, and gait impairment. Treatment involves various therapeutic modalities, with present study focusing on an integrated exercise method. Aim: To evaluate the potential efficacy of hamstring release and neural mobilisation in LSS patients. Materials and Methods: This quasi-experimental study was conducted at SGT Medical College Hospital and Research Institute, Gurugram, Haryana, India from September 2021 to May 2022. Total of 30 patients diagnosed with LSS were divided into two groups based on inclusion criteria: group A (experimental) and group B (control). Pain, neural flexibility, walking capacity, disability, and physical activity were assessed at baseline and after the 3rd week of the intervention. Treatment sessions were administered for 30 minutes per day, three times per week (on alternate days), for a duration of three weeks in both groups. Data analysis was done using the Windows version of Statistical Package for Social Sciences version 26.0 (SPSS, Chicago, IL, USA). The paired t-test was used to compare mean data within each group before and after the intervention. The Independent t-test formula was applied to compare pre and postintervention changes between group A and group B. Group B. A significance level of p-value <0.05 was considered statistically significant. Results: Group A and group B had respective mean ages of 37.07±8.66 years and 41.07±8.66 years. Total of 30 LSS patients were treated. Significant differences were observed in the Numeric Pain Rating Scale (NPRS) (p-value<0.0001), Straight Leg Raise (SLR) (p < 0.001), Slump Test (p-value<0.0001), and Self-paced Walking Test (SPWT) (p-value <0.0001). Minimal significance was noted in the Modified Oswestry Disability Index (MODI) (p-value=0.027) and Swiss Spinal Stenosis Questionnaire (SSSQ) (p-value=0.029). Conclusion: Hamstring release and neural mobilisation improve pain, neural flexibility, walking capacity, disability, and physical activity in LSS patients.

Keywords

• neural flexibility
• radiculopathy
• spinal pathologies