Does type 2 diabetes affect the efficacy of therapeutic exercises for degenerative lumbar spinal stenosis?

• Published in: BMC musculoskeletal disorders 2023-03, Vol.24 (1), p.198-198, Article 198
• Main Authors: Shi, Tengbin, Chen, Zhi, Hu, Dingxiang, Li, Wenwen, Wang, Zhenyu, Liu, Wenge
• Format: Article
• Language: English
• Subjects: Back Pain - complications; Comorbidity; Complications and side effects; Degenerative disc disease; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - therapy; Endodontics; Exercise therapy; Fatty infiltration; Glucose; Humans; Intermittent claudication; Leg; Low back pain; Lumbar spinal stenosis; Lumbar Vertebrae - diagnostic imaging; Magnetic resonance imaging; Metabolism; Multifidus muscle; Musculoskeletal diseases; Orthopedics; Pain; Patient outcomes; Patients; Physical therapists; Physical therapy; Prognosis; Retrospective Studies; Spinal canal; Spinal stenosis; Spinal Stenosis - complications; Spinal Stenosis - therapy; Stenosis; Treatment Outcome; Type 2 diabetes; Walking
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-023-06305-0

Propensity-matched retrospective study. To determine whether type 2 diabetes mellitus (T2D) would affect prognosis in patients with degenerative lumbar spinal stenosis (DLSS) who underwent therapeutic exercises. This study included consecutive patients with or without T2D who underwent therapeutic exercises for symptomatic DLSS from December 2018 to January 2020. Baseline demographics and clinical and radiological data were collected. The 2 groups of patients were further matched in a 1:1 fashion based on the propensity score, balancing the groups on pre-treatment factors including age, sex, leg and back pain, and low back disability. The primary outcomes included self-reported leg pain intensity (Numerical Rating Scale, NRS) and low back disability (Oswestry Disability Index, ODI) and the secondary outcomes included low back pain intensity and walking capacity (self-paced walking test, SPWT) were compared at baseline, 6 weeks, and 12 weeks. Forty-one pairs of patients were selected by propensity matching. After 6-week therapeutic exercises, patients with T2D achieved a lower improvement in leg pain at 6 weeks (NRS leg change, 1.21 ± 0.40 vs. 1.78 ± 0.52, P = 0.021) and 12 weeks (NRS leg change, 1.52 ± 0.92 vs. 2.18 ± 0.96, P = 0.007) above minimal clinically important difference (MCID), with a significant Group × Time interactions (F = 16.32, p