Tomkins-Lane Christy C, Battié Michele C
Department of Physical Education and Recreation Studies, Faculty of Health and Community Studies, Mount Royal University, Calgary, AB, Canada.
J Back Musculoskelet Rehabil. 2013;26(4):345-52. doi: 10.3233/BMR-130390.
Identifying factors associated with walking capacity in people with lumbar spinal stenosis (LSS) may provide a better understanding of neurogenic claudication and inform future rehabilitation research.
To examine factors associated with objectively measured walking capacity in a sample of people with LSS and self-reported walking limitations.
Participants included 49 individuals (65.8 years ± 10) who were at least 45 years of age with clinically diagnosed lumbar spinal stenosis (LSS) confirmed on MRI or CT imaging. All participants completed a Self-Paced Walking Test with visual analog pain scales and body diagrams before and immediately after walking. Questionnaires included the Physical Function and Symptom Severity Scales of the Swiss Spinal Stenosis Questionnaire, the Oswestry Disability Index (ODI) and the Health Utilities Index. Univariate linear relationships were examined, followed by development of a multivariate linear regression model with walking distance (m) as the dependent variable. A post-hoc analysis was also conducted including post-test symptom variables.
Variables retained from univariate analyses included years of leg pain, pre-test leg pain severity, the ODI, balance problems, and quality of life. When these variables were considered for a final model, only the ODI and balance problems were retained (R2=0.33). Other than balance, none of the pre-test symptom variables entered into the final model. Post-hoc analysis including post-test symptom variables found the presence and severity of post-test leg pain to be most highly associated with walking distance. In an explanatory model considering the ODI, balance and these two post-walking factors, only presence of post-test leg pain added to the model (R2=0.42).
Factors found to be most highly associated with walking capacity in LSS were self-reported, pain-related function (ODI), balance problems, and presence of leg pain immediately following walking.
识别与腰椎管狭窄症（LSS）患者步行能力相关的因素，可能有助于更好地理解神经源性间歇性跛行，并为未来的康复研究提供参考。
在一组腰椎管狭窄症患者样本中，研究与客观测量的步行能力及自我报告的步行受限相关的因素。
参与者包括49名年龄至少45岁、经MRI或CT成像确诊为临床腰椎管狭窄症（LSS）的个体（65.8岁±10岁）。所有参与者在步行前和步行后立即完成了一项自定步速步行测试，并使用视觉模拟疼痛量表和身体图表。问卷包括瑞士腰椎管狭窄症问卷的身体功能和症状严重程度量表、Oswestry功能障碍指数（ODI）和健康效用指数。首先检查单变量线性关系，然后以步行距离（米）为因变量建立多元线性回归模型。还进行了事后分析，包括测试后症状变量。
单变量分析保留的变量包括腿痛年限、测试前腿痛严重程度、ODI、平衡问题和生活质量。当将这些变量纳入最终模型时，仅保留了ODI和平衡问题（R2 = 0.33）。除平衡外，测试前症状变量均未纳入最终模型。包括测试后症状变量的事后分析发现，测试后腿痛的存在和严重程度与步行距离的相关性最高。在一个考虑ODI、平衡和这两个步行后因素的解释模型中，只有测试后腿痛的存在增加了模型的解释力（R2 = 0.42）。
发现与腰椎管狭窄症患者步行能力最相关的因素是自我报告的、与疼痛相关的功能（ODI）、平衡问题以及步行后立即出现的腿痛。
