Lumbosacral spinal stenosis (LSS) is a leading cause of limited mobility, reduced independence, and poor health outcomes in older adults, and is very common in older adult Veterans. Several years ago, major research studies indicated that surgery for LSS was more effective than usual (medical) management. Nonetheless, there are many patients for whom surgery is not the ideal therapy. There have been reports that modifications in daily activities including temporary use of a modified rolling walker and changes in sleep positioning may help relieve LSS. The investigators have assembled a VA team to study this carefully. The investigators will recruit a small group of older adult Veterans with LSS to try out this program; the investigators will monitor them closely for relief of their symptoms and improvements in walking. The investigators will, as part of this small study, try to understand potential barriers to use of this therapy. The investigators will interview the Veterans and healthcare providers to identify problems that may arise in trying this therapy. If this small study works, the investigators plan to expand the effort.
Who can participate
Age range
60 Years – 80 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Veterans receiving care at participating VA
* Ability to read and write English and understand instructions
* Agrees to comply with instructions
* Symptoms for over 3 months
* Diagnosis of Lumbar Spinal Stenosis as the cause of symptoms
* Discomfort involving low back pain and / or neurogenic claudication of legs or thighs
* Back and/or leg symptoms greater than 3/10 provoked by walking and / or standing
* X ray, CT, or MRI performed within the last 12 months shows Lumbar Spinal Stenosis at 1 or 2 levels
* Prior treatment for Spinal Stenosis including therapy, medication, epidural injections, but not surgery
* Relief of pain (standardly within 5 minutes) by sitting down
* Ability to walk 50 feet without a cane or walker
* General health presents ability to increase activity level if Back and / or leg symptoms resolve
* If home has stairs and patient uses multiple levels, must have steady handrail
* Transportation routinely available by car or car service and not by bus
* Home location allows restriction of walking to flat surfaces (lack of hills), with availability to increase ambulation on flat surfaces
Exclusion Criteria:
* Previous Low Back Surgery for SS including decompression or fusion
* Successful Spinal Stenosis Treatment (such as injection) over the prior 3 months
* X ray, CT, or MRI shows Lumbar Spinal Stenosis in 3 or 4 levels
* Prior Lumbar Fracture
* Scoliosis with Cobb angle over 20 degrees on weight bearing AP Views
* Inflammatory arthr…
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
What they're measuring
1
Change in mobility by actigraph (positive, negative, or zero) as determined by the difference in mobility at Week 6 compared to baseline