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Development and Content Validation of an Exercise-Based Framework for the Management of Lumbar Radiculopathy
Shashwath P Naidu1, Anjali Suresh1, Sarulatha Haridass1
1R L Jalappa College of Physiotherapy, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, India.
Background And Purpose:
Current guidelines for the management of lumbar radiculopathy recommend patient education, staying active, manual therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs) as first-line treatments. Physiotherapy-specific interventions for low back pain that radiates to the leg include specific trunk muscle activation, muscle strengthening and endurance, movement control, centralisation, directional preference exercises and nerve mobilisation. While exercise therapy is widely recognised as an effective non-invasive intervention, there is currently limited evidence for a standardised framework that integrates different evidence-based exercise approaches and clinical expertise into a structured, practically applicable protocol. The purpose of this study was to develop and content-validate a structured, evidence-based exercise framework for the physiotherapy management of lumbar radiculopathy.
Methods:
A comprehensive review of the literature supplemented by expert input with at least 10 years of experience was conducted to identify commonly prescribed exercise interventions for lumbar radiculopathy. Based on the identified impairments and functional deficits associated with the condition, an initial draft framework, which included trunk stabilization, mobility and flexibility training, was constructed. The draft framework was then subjected to expert validation using the content validity index (CVI) and modified kappa to confirm the relevance and perceived ease of performance of exercise by 10 physiotherapists.
Results:
The 4-stage exercise framework demonstrated excellent agreement with high CVI (100%-90%) and modified kappa (1-0.90). While some exercises of phase 2 and phase 3 were considered slightly difficult to perform, they were relevant for the condition.
Discussion:
The developed exercise framework exhibited excellent content validity, supporting its relevance and perceived ease of performance in physiotherapy practice for managing patients with lumbar radiculopathy.
