The study aims to compare the effectiveness of integrated osteopathic approach, which includes lumbo-sacral release, dural mobilization, and sacral rhythm with conventional physiotherapy methods in reducing pain, improving neural flexibility, and addressing claudication and disability symptoms in patients with lumbar canal stenosis.
This study was conducted at the Department of Physiotherapy, SAIMS, Indore. Ethical approval was obtained, and ICMR guidelines were followed for informed consent. The study population consisted of patients aged 30-55 years with low back pain and diagnosed with lumbar spinal stenosis (AP diameter ≤ 12mm via MRI). A simple random sampling technique was used to assign 32 subjects diagnosed with LCS into two groups (n=16). Using the G*Power tool, the sample size was calculated as 30 patients, divided into two groups of 15 each, allowing for a 5% dropout rate we included 32 subjects in total. Inclusion and exclusion criteria were applied appropriately.
Experimental Group (n=16): Treated with an integrated osteopathic approach involving lumbo-sacral release, dural mobilization, and sacral rhythm.
Control Group (n=16): Treated with conventional physiotherapy, includes TENS, hot fomentation, and back exercises.
Outcome measures used :
Numeric Pain Rating Scale (NPRS) for pain assessment,
Oswestry Disability Questionnaire (ODQ) for disability evaluation,
Neural Claudication Questionnaire (NCQ) for claudication symptoms,
Straight Leg Raise (SLR) test for neural flexibility.
The study was conducted over an 8-week period.
The study utilised an independent t-test to compare the outcome. At the 8-week mark, the integrated osteopathic group showed significantly better outcomes compared to the conventional physiotherapy group. Pain reduction on the Numeric Pain Rating Scale (NPRS) was greater in the osteopathic group (3.0 vs. 5.6; p 0.01). Neural flexibility, assessed via the Straight Leg Raise (SLR) test, improved more in the osteopathic group (80 degrees vs. 60 degrees; p 0.05). Disability reduction (ODQ) was also significantly higher in the osteopathic group (45% vs. 30%; p 0.05), along with a greater reduction in claudication symptoms (p 0.05).
The integrated osteopathic approach yielded superior outcomes in the management of LCS compared to conventional physiotherapy. Patients experienced greater pain relief, improved neural flexibility, and significant alleviation of claudication symptoms. These findings suggest that osteopathic techniques can offer an effective alternative or it complements to traditional physiotherapy in treating LCS.
The study underscores the potential benefits of incorporating osteopathic methods into standard physiotherapy practices for managing lumbar canal stenosis. This approach may enhance clinical outcomes, reduce disability, and improve the quality of life for patients suffering from this debilitating condition. Further research could explore the long-term benefits of integrated treatment modalities and their application in other spinal conditions.
Claudication symptoms
Neural flexibility
