Schneider Michael J, Terhorst Lauren, Murphy Donald, Stevans Joel M, Hoffman Rachel, Cambron Jerrilyn A
Associate Professor, Department of Physical Therapy and Clinical and Translational Sciences Institute, University of Pittsburgh, Pittsburgh, PA.
Associate Professor, Department of Occupational Therapy and Clinical and Translational Sciences Institute, University of Pittsburgh, Pittsburgh, PA.
J Manipulative Physiol Ther. 2016 Feb;39(2):88-94. doi: 10.1016/j.jmpt.2016.01.001. Epub 2016 Feb 19.
The purpose of this study was to explore potential baseline physical examination and demographic predictors of clinical outcomes in patients with lumbar spinal stenosis.
This was a secondary analysis of data obtained from a pilot randomized controlled trial. Primary and secondary outcome measures were the Swiss Spinal Stenosis (SSS) Questionnaire and visual analog scale (VAS) for leg pain. Multiple regression models were used to assess 2 different outcomes: SSS at completion of care and VAS at completion of care. Separate regression models were built for each of the 2 outcomes to identify the best subset of variables that predicted improvement. Predictors with a significant contribution were retained in a final "best" model.
Three variables were identified as having an association with SSS score at completion of care: baseline SSS score, qualitative description of leg pain, and age (adjusted R(2) = 33.2). Four variables were identified as having an association with VAS score at completion of care: baseline VAS score, qualitative description of leg pain, body mass index, and age (adjusted R(2) = 38.3).
This study provides preliminary evidence supporting an association between certain baseline characteristics and nonsurgical clinical outcomes in patients with lumbar spinal stenosis.
本研究旨在探索腰椎管狭窄症患者临床结局的潜在基线体格检查和人口统计学预测因素。
这是一项对从一项初步随机对照试验中获得的数据进行的二次分析。主要和次要结局指标分别为瑞士腰椎管狭窄症（SSS）问卷和腿痛视觉模拟量表（VAS）。使用多元回归模型评估两种不同的结局：护理结束时的SSS和护理结束时的VAS。针对这两种结局分别构建回归模型，以确定预测改善情况的最佳变量子集。具有显著贡献的预测因素被保留在最终的“最佳”模型中。
确定了三个与护理结束时的SSS评分相关的变量：基线SSS评分、腿痛的定性描述和年龄（调整后R² = 33.2）。确定了四个与护理结束时的VAS评分相关的变量：基线VAS评分、腿痛的定性描述、体重指数和年龄（调整后R² = 38.3）。
本研究提供了初步证据，支持腰椎管狭窄症患者某些基线特征与非手术临床结局之间存在关联。
