Application of classification based cognitive functional therapy for a patient with lumbar spinal stenosis: A case report. (June 2016)

• Record Type: Journal Article
• Authors: Irfan, Muhammad
• Is Part Of: Manual therapy. Volume 23(2016:Jun.)
• Page Start: 124
• Page End: 127
• Publication Date: 2016-06
• Subjects: Lumbar spinal stenosis -- Multidimensional classification system -- Cognitive functional therapy; Manipulation (Therapeutics) -- Periodicals; Physical therapy -- Periodicals; Neuromuscular diseases -- Treatment -- Periodicals; Manipulation, Orthopedic; Musculoskeletal Diseases -- therapy; Neuromuscular Diseases -- therapy; Physical Therapy; Manipulation (Thérapeutique) -- Périodiques; Physiothérapie -- Périodiques; Maladies neuromusculaires -- Traitement -- Périodiques; Manipulation (Therapeutics); Neuromuscular diseases -- Treatment; Physical therapy; Electronic journals; Periodicals; Electronic journals; 615.82
• DOI: 10.1016/j.math.2015.09.016
• Languages: English
• ISSNs: 1356-689X

Abstract

Abstract: This report describes the case of a 52 year old male administrative assistant presenting with symptomatic lumbar spinal stenosis (LSS). Despite patho-anatomical considerations, the patient's pain related functional behaviour, mal-adapted presentation, motor control strategies, incorrect belief system, and faulty cognition of associating disc healing with a lordotic posture adversely contributed to his presentation. With limited specific guidelines in the literature for this specific lumbar spine condition, the patient response during the assessment guided the intervention. Treatment that incorporated a cognitive functional therapy resulted in a successful outcome. The patient attended for twelve treatment sessions in three months and demonstrated improvement in overall function. By week 12, the Oswestry Disability Index (ODI) reduced from 68% to 19% and further reduced to 15% at three months following discharge. The patient's self-reported tolerance for standing improved from 10 min to 60 min and his self-reported tolerance of walking improved from 200 m to three kilometres. The effects were maintained three months post discharge. This case report supports the clinical utility of a patient-centred multidimensional classification system that utilised cognitive functional therapy in a patient with LSS. Highlights: A 52 year old male patient presented with symptomatic lumbar spinal stenosis. Mal-adaptive movement pattern contributed to his presentation. Cognitive functional therapy resulted in favourable outcome. The patient demonstrated significant improvement in standing and walking tolerance. Oswestry Disability Index reduced from 68% to 19% with three months of treatment.