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Clinical Research Article

Korean J Pain 2021; 34(4): 471-478

Published online October 1, 2021 https://doi.org/10.3344/kjp.2021.34.4.471

Copyright © The Korean Pain Society.

The association between pain, balance, fall, and disability in patients with lumbar spinal stenosis with vascular claudication

Musa Güneş1 , Tarık Özmen1 , Tuğba Moralı Güler2

1Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karabuk University, Karabuk, Turkey
2Department of Neurosurgery, Faculty of Medicine, Karabuk University, Karabuk, Turkey

Correspondence to:Musa Güneş
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karabuk University, Karabuk 78050, Turkey
Tel: +90 (370) 418 9078
Fax: +90 (370) 418 93 53
E-mail: musagunes339@gmail.com

Handling Editor: Jin-Woo Shin

Received: May 11, 2021; Revised: June 29, 2021; Accepted: July 9, 2021

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: The effect of lumbar spinal stenosis (LSS) and peripheral vascular disease (PVD), which occurs with similar degenerative conditions, when seen together, has not been studied. The aim of this study is to examine and compare the relationship between pain, balance, disability, fear of falling, and kinesiophobia in LSS patients with intermittent vascular claudication (IVC).
Methods: Seventy-two patients diagnosed with LSS using magnetic resonance imaging participated in this study. Thirty-five patients with IVC symptoms and showing vascular lesions by lower extremity venous and arterial Doppler ultrasonography imaging were included in the IVC-LSS group. The pain, static balance, dynamic balance, disability, fear of falling, and kinesiophobia were evaluated using the numeric rating scale, single leg stance test, Time Up and Go (TUG), the Oswestry Disability Index (ODI), Fall Efficacy Scale-International (FES-I), and Tampa Scale for Kinesiophobia (TSK), respectively.
Results: Age and female sex were found to be higher in the IVC-LSS group (P = 0.024; P = 0.012). The IVC-LSS group had a shorter single leg stance time and TUG test duration, pain intensity, ODI, FES-I, and TSK scores were higher than patients with LSS (P = 0.001). Pain, fear of falling, and kinesiophobia were moderately correlated with disability in the IVC-LSS group. No relationship was found between pain and dynamic balance. Also, the pain was not related to kinesiophobia.
Conclusions: The findings indicated that IVC causes loss of balance and an increase in pain, disability, fear of falling, and kinesophobia in patients with LSS.

Keywords: Accidental Falls, Catastrophization, Disability Evaluation, Fear, Intermittent Claudication, Low Back Pain, Peripheral Vascular Diseases, Postural Balance, Spinal Stenosis, Ultrasonography, Doppler.