Patients with Lumbar Spinal Stenosis can present with radicular claudication i.e pain in the legs which can be over one or both legs, on the buttocks, thigh, calf or groin. It may be induced on standing and walking and reduced with sitting or bending forwards. 

If you want to learn more about this topic, you can watch Adam Dobson's lecture here:

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Cycling program for patients with lumbar spinal stenosis
A recent study published by Carlo Ammendolia showed that there was moderate level evidence that exercise therapy, with or without manual therapy, is effective for leg pain, particularly for walking distances.
One such exercise program is called: the flexion endurance program which is essentially a cycling program. Patients who like to flex or find relief in their symptoms from flexing can do cycling as a daily activity. Patients can be motivated to do cycling for over 12 weeks or 16 weeks. It brings the blood flow from the legs into the back.

It can be part of self-management, where therapists can start them off in the clinic, and then they can continue doing it at home, followed by a review of 2 to 3 times over 12 – 16 weeks.

BOOST trial
Another study called the BOOST trial, is probably the best methodological trial ever done on exercise therapy for people with radicular claudication secondary to stenosis. What it shows from preliminary data is that it significantly improves walking distance. So patients who in this case were doing cycling, mobility, and walking significantly improved their ability to walk. In terms of pain, there was a small change within 6 months but the functional element was more significant i.e they could walk further now.  

Motivate
Don’t be afraid to push the patients, do it gradually. We want them to see that they can push their legs, that there is a solution, and that it is not about trying to change the structures necessarily.

If you want to learn more about this topic, you can watch Adam Dobson's lecture here:

Click here

Sources:
‘Lumbar spinal stenosis’ lecture by Adam Dobson