Tanishima Shinji, Weishi Li, Jianzhong Hu, Jie Zhao, Huilin Yang, Nagashima Hideki
Division of Orthopedic Surgery, Department of Sensory of Motor Organs, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan.
Department of Orthopaedics, Peking University Third Hospital, Beijing, China.
Asian Spine J. 2022 Jun;16(3):411-418. doi: 10.31616/asj.2020.0505. Epub 2021 May 10.
This is a multicenter, prospective study.
This study aimed to evaluate the reproducibility of the walking test for patients with lumbar spinal stenosis (LSS).
Walking test is one of the useful procedures to investigate cauda equina syndrome with lumbar spinal stenosis. One the other hands, there were few studies to investigate the reproducibility of this test.
In this study, we prospectively examined 70 LSS patients with intermittent claudication symptoms at a multicenter outpatient clinic. A walking test was administered at baseline and week 4 to assess patients' walking distance and lower limb pain and numbness. Immediately after the walking test, patients were asked to use the Visual Analog Scale (VAS) to rate their pain and numbness in the front, back, outside, inside, and hip of the lower legs. The reproducibility of the walking test was evaluated using Cohen's κ analysis and intraclass correlation coefficients (ICCs). Meanwhile, the Swiss Spinal Stenosis (SSS) Questionnaire was used to evaluate the severity of the stenosis.
The walking distance ICC at baseline and at week 4 remained unchanged at 0.7, with acceptable interobserver reliabilities for lower limb pain and numbness in both legs. The average VAS score for lower leg pain was 23.2±25.2 mm at baseline and 27.4±28.8 mm at week 4, while the corresponding average VAS score for numbness was 23.4±26.7 mm at baseline and 24.8±25.2 mm at week 4. The ICC score was 0.7 for leg pain and 0.7 for numbness. The mean SSS was 30.2±5.5 at baseline and 29.2±5.2 at week 4, and there was no significant difference in the severity.
The walking test for LSS has acceptable reproducibility.
这是一项多中心前瞻性研究。
本研究旨在评估腰椎管狭窄症（LSS）患者步行试验的可重复性。
步行试验是研究腰椎管狭窄症马尾神经综合征的有用方法之一。另一方面，很少有研究探讨该试验的可重复性。
在本研究中，我们在多中心门诊对70例有间歇性跛行症状的LSS患者进行了前瞻性检查。在基线和第4周进行步行试验，以评估患者的步行距离以及下肢疼痛和麻木情况。步行试验结束后，立即要求患者使用视觉模拟量表（VAS）对小腿前侧、后侧、外侧、内侧及臀部的疼痛和麻木程度进行评分。使用Cohen's κ分析和组内相关系数（ICC）评估步行试验的可重复性。同时，使用瑞士腰椎管狭窄症（SSS）问卷评估狭窄的严重程度。
基线和第4周时步行距离的ICC均保持在0.7不变，双腿下肢疼痛和麻木的观察者间信度均可接受。小腿疼痛的平均VAS评分在基线时为23.2±25.2mm，第4周时为27.4±28.8mm，而相应的麻木平均VAS评分在基线时为23.4±26.7mm，第4周时为24.8±25.2mm。腿痛和麻木的ICC评分均为0.7。基线时SSS平均评分为30.2±5.5，第4周时为29.2±5.2，严重程度无显著差异。
LSS患者的步行试验具有可接受的可重复性。
