Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Physical Therapy

Supervisor

Battie, Michele

2nd Supervisor

Rushton, Alison

Co-Supervisor

Abstract

Lumbar spinal stenosis (LSS) is a degenerative disease common in older adults and is associated with significantly reduced health-related quality of life and increased disability. Depression has been found to be associated with poorer health-related outcomes in patients with spinal conditions. A systematic review was conducted to examine the literature regarding the prognostic value of depression for LSS outcomes. Findings suggest small to moderate prognostic value of depressive symptoms for postoperative outcomes in patients with LSS, with strong evidence for disability. Next, a secondary analysis of a cohort study was conducted to investigate two objectives. The first objective was to investigate the prognostic value of depression for disability and physical function outcomes in LSS patients. While the second objective was to investigate social support as a modifier of the relationship between depression and outcomes of disability/function. Results showed that baseline depressive symptoms score was significantly associated with greater disability (ß=0.3, P

Summary for Lay Audience

Lumbar spinal stenosis (LSS) is a common spinal condition associated with symptoms of lower quality of life and increased disability. Psychological factors such as depression have been found to be associated with poorer symptoms in patients with LSS. We conducted a systematic review of all the literature on depression as a predictive factor for outcomes in patients with LSS. There were 22 articles, and nine different outcomes (e.g. pain, physical function, etc.) were studied. The review identified gaps in the current literature and found a small to moderate prognostic value of depressive symptoms in patients with LSS undergoing nonsurgical treatment. We then conducted a study to address these gaps by investigating LSS individuals who were primarily under nonsurgical treatment. This study confirmed that depression had some predictive value for greater disability in individuals with LSS that did not undergo surgical treatment. Additionally, this study looked at social support as a potential modifier for the association between depressive symptoms and disability outcomes. While no association was found, the analysis was limited by a small sample. Future research should investigate other outcomes and look at possible interventions for depression in patients with LSS that could promote better outcomes.

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