NeuroSpine Surgery Research Group (NSURG), Sydney, Australia.
NeuroSpine Clinic, Prince of Wales Private Hospital, Suite 7, Level 7, Randwick, NSW, 2031, Australia.
J Orthop Surg Res. 2021 Jul 1;16(1):419. doi: 10.1186/s13018-021-02546-8.
Walking is a fundamental part of living, and its importance is not limited by age or medical status. Reduced walking speed (WS), or gait velocity, is a sign of advancing age, various disease states, cognitive impairment, mental illness and early mortality. Activity levels, as defined in the literature as "daily step count" (DSC), is also a relevant measure of health status. A deterioration in our walking metrics, such as reduced WS and DSC, is associated with poor health outcomes. These objective measures are of such importance, that walking speed has been dubbed "the 6th vital sign". We report a new objective measure that scores walking using the relevant metrics of walking speed and daily step count, into an easy-to-understand score from 0 (nil mobility) to 100 (excellent mobility), termed the Simplified Mobility Score (SMoS™). We have provided equal weighting to walking speed and daily step count, using a simple algorithm to score each metric out of 50.
Gait data was collected from 182 patients presenting to a tertiary hospital spinal unit with complaints of pain and reduced mobility. Walking speed was measured from a timed walk along an unobstructed pathway. Daily step count information was obtained from patients who had enabled step count tracking on their devices. The SMoS of the sample group were compared to expected population values calculated from the literature using 2-tailed Z tests.
There were significantly reduced SMoS in patients who presented to the spinal unit than those expected at each age group for both genders, except for the 50-59 age bracket where no statistically significant reduction was observed. Even lower scores were present in those that went on to have surgical management. There was a significant correlation of SMoS scores with subjective disability scores such as the Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) in this cohort.
The SMoS is a simple and effective scoring tool which is demonstrably altered in spinal patients across age and gender brackets and correlates well with subjective disability scores. The SMoS has the potential to be used as a screening tool in primary and specialised care settings.
行走是生活的基本组成部分，其重要性不受年龄或身体状况的限制。步行速度（WS）或步态速度的降低是衰老、各种疾病状态、认知障碍、精神疾病和早逝的标志。活动水平，如文献中定义的“日常步数”（DSC），也是健康状况的相关衡量标准。我们行走指标的恶化，如步行速度降低和 DSC 降低，与健康状况不佳有关。这些客观指标非常重要，以至于步行速度被称为“第六生命体征”。我们报告了一种新的客观衡量标准，该标准使用与步行速度和日常步数相关的指标对行走进行评分，得出一个易于理解的从 0（无活动能力）到 100（活动能力极好）的分数，称为简化移动评分（SMoS）。我们使用简单的算法为每个指标评分 50，对步行速度和日常步数进行了同等加权。
从 182 名因疼痛和活动能力下降到三级医院脊柱科就诊的患者中收集步态数据。步行速度通过沿无障碍通道进行定时行走来测量。日常步数信息是从已在设备上启用步数跟踪的患者那里获得的。使用双侧 Z 检验，将样本组的 SMoS 与文献中计算的预期人群值进行比较。
与每个年龄组的预期值相比，就诊于脊柱科的患者的 SMoS 明显降低，除了 50-59 岁年龄组外，没有观察到统计学上的显著降低。那些接受手术治疗的患者的得分更低。在该队列中，SMoS 评分与主观残疾评分（如 Oswestry 残疾指数（ODI）和视觉模拟评分（VAS））之间存在显著相关性。
SMoS 是一种简单有效的评分工具，在不同年龄和性别组的脊柱患者中明显改变，与主观残疾评分相关性良好。SMoS 有可能在初级和专科保健环境中用作筛选工具。
