- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04075539
Home-based Cycling for People With Lumbar Spinal Stenosis (FLEXCAL)
Home-based Cycling Using Connected Ergometric Bicycles for People With Lumbar Spinal Stenosis: a Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Lumbar spinal stenosis is a prevalent and disabling condition in elderly people. Lumbar spinal stenosis results in back and leg pain when standing and walking (radicular claudication), while symptoms regress in sitting position. The inability to stand or walk significantly impairs functioning and health-related quality of life of elders, and has an important healthcare cost.
The 2 main treatment options for lumbar spinal stenosis are conservative or surgical treatments. Previous data suggested that laminectomy may be more effective on pain and function than conservative therapy. However, the benefit-risk balance of surgery should be carefully considered in this population with numerous co-morbidities, and evidence is inconsistent. Therefore, conservative therapy is usually the first line option. Data regarding exercise therapy are scarce. Flexion-based exercises are usually recommended. A pilot study suggested that flexion-based endurance training program, namely cycling, could be an effective and safe method to improve pain, function and health-related quality of life in elderly people with chronic lumbar pain. However, barriers to adhering to the program were detected and might have influenced clinical endpoints. Non-pharmacological interventions in spinal conditions are not 'one-size-fits-all' and measures to enhance adherence have to be applied.
The hypothesis is that home-based cycling using connected ergometric bicycles associated with usual care could be more effective than usual care in reducing back-specific activity limitations at 4 months in people with lumbar spinal stenosis.
Study Type
Enrollment (Anticipated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Christelle Nguyen, MD, PhD
- Phone Number: +33 1 58 41 25 35
- Email: christelle.nguyen2@aphp.fr
Study Locations
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Île-de-France
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Paris, Île-de-France, France, 75014
- Assistance Publique - Hôpitaux de Paris, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin
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Contact:
- François Rannou, MD, PhD
- Phone Number: +33 1 58 41 25 35
- Email: francois.rannou@aphp.fr
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- age ≥ 50 year-old
- radicular claudication (i.e. walking-induced low back, buttock and/or leg pain, relieved in siting and/or lumbar flexion positions) diagnosed by a physician
- MRI or CT-scan findings consistent with LSS reported on a written radiology report provided by a board-certified radiologist or a resident in radiology
Exclusion Criteria:
- inability to speak and/or read French language
- inability or refusal to perform ergometric bicycle at home
- patients already having an ergometric bicycle at home
- history of lumbar spine surgery in the previous 12 months
- cognitive disorders
- severe neurologic or vascular disorders involving the lower limbs
- contraindication to a rehabilitation program assessed by medical examination
- people under tutorship or curatorship
- protected adults
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Home-based cycling program associated to usual care
|
Usual care (i.e. standardized prescription of 6 sessions of outpatient physiotherapy), and
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Other: Outpatient physiotherapy
|
A prescription of 6 sessions of outpatient physiotherapy
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in back-specific activity limitations
Time Frame: 4 months after-randomization
|
Mean change from baseline in mean back-specific activity limitations in the previous month using the self-administered Oswestry Disability Index (ODI) total score (0 no limitations and 100 maximal limitations).
|
4 months after-randomization
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in maximal walking distance
Time Frame: 4 months post-randomization
|
Mean change from baseline in mean maximal walking distance (meters) using an adapted version of the self-paced walking-test
|
4 months post-randomization
|
Change in lumbar pain
Time Frame: 4, 6 and 12 months post-randomization
|
Mean change from baseline in mean low back pain intensity in the previous 48 hrs on a self-administered 11-point pain numeric rating scale (0 no pain and 100 maximal pain)
|
4, 6 and 12 months post-randomization
|
Change in radicular pain
Time Frame: 4, 6 and 12 months post-randomization
|
Mean change from baseline in mean radicular pain intensity in the previous 48 hrs on a self-administered 11-point pain numeric rating scale (0 no pain and 100 maximal pain)
|
4, 6 and 12 months post-randomization
|
Change in the physical component of health-related quality of life
Time Frame: 4, 6 and 12 months post-randomization
|
Mean change from baseline in the mean physical component of health-related quality of life assessed by the physical component score of the self-administered 12-Item Short Form Survey (9.95 worst possible and 70.02 best possible)
|
4, 6 and 12 months post-randomization
|
Change in lumbar spinal stenosis-specific activity limitations
Time Frame: 4, 6 and 12 months post-randomization
|
Mean change from baseline in mean LSS-specific activity limitations using the physical function subscore of the self-administered Zurich Claudication Questionnaire (1 no limitations and 4 maximal limitations)
|
4, 6 and 12 months post-randomization
|
Change in back-specific activity limitations
Time Frame: 6 and 12 months post-randomization
|
Mean change from baseline in mean spine-specific activity limitations assessed by the total score of the self-administered Oswestry Disability Index (0 no limitations and 100 maximal limitations)
|
6 and 12 months post-randomization
|
Percentage of patients who undergo spinal surgery
Time Frame: From baseline to 12 months post-randomization
|
Self-reported spinal surgery for lumbar spinal stenosis
|
From baseline to 12 months post-randomization
|
Collaborators and Investigators
Investigators
- Principal Investigator: Christelle Nguyen, MD, PhD, Université de Paris, Faculté de Médecine Paris Descartes
- Study Director: François Rannou, MD, PhD, Université de Paris, Faculté de Médecine Paris Descartes
- Study Chair: Isabelle Boutron, MD, PhD, Université de Paris, Faculté de Médecine Paris Descartes
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- P160147
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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