Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, The University of Oxford, West Wing Level 6, Oxford, OX3 9DU, UK.
Oxford Spinal Surgery Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Eur Spine J. 2024 Nov;33(11):4229-4234. doi: 10.1007/s00586-024-08330-6. Epub 2024 Jun 24.
To establish the prevalence and agreement between reported and observed leg weakness in people with sciatica. To establish which factors mediate any identified difference between reported and observed leg weakness in people with sciatica.
68 people with a clinical diagnosis of sciatica, records from spinal service, secondary care NHS Hospital, England, UK reviewed. Primary outcome measures were the sciatica bothersome index for reported leg weakness and the Medical Research Council scale for observed weakness. Agreement was established with Cohen's Kappa and intraclass correlation coefficient. Potential factors that may mediate a difference between reported and observed weakness included leg pain, sciatica bothersome index sensory subscale, age, hospital anxiety and depression subscale for anxiety.
85% of patients reported weakness but only 34% had observed weakness. Cohen's Kappa (0.066, 95% CI - 0.53, 0.186; p = 0.317)] and ICC 0.213 (95% CI - 0.26, 0.428, p = 0.040) both showed poor agreement between reported and observed weakness. The difference between reported and observed measures of weakness was mediated by the severity of leg pain (b = 0.281, p = 0.024) and age (b = 0.253, p = 0.042).
There is a high prevalence of reported leg weakness in people with sciatica, which is not reflected in observed clinical measures of weakness. Differences between reported and observed weakness may be driven by the severity of leg pain and age. Further work needs to establish whether other objective measures can detect patient reported weakness.
确定坐骨神经痛患者报告的和观察到的腿部无力的患病率和一致性。确定哪些因素可以调解坐骨神经痛患者报告的和观察到的腿部无力之间的任何差异。
对英国英格兰一家二级保健 NHS 医院的脊柱科就诊记录中，68 例临床诊断为坐骨神经痛的患者进行了回顾性分析。主要结局指标是报告的腿部无力的坐骨神经痛困扰指数和观察到的无力的医学研究理事会量表。采用 Cohen's Kappa 和组内相关系数来确定一致性。可能调解报告的和观察到的无力之间差异的潜在因素包括腿部疼痛、坐骨神经痛困扰指数感觉子量表、年龄、医院焦虑和抑郁量表焦虑分量表。
85%的患者报告有无力感，但只有 34%的患者观察到无力感。Cohen's Kappa（0.066，95%CI-0.53，0.186；p=0.317）和 ICC 0.213（95%CI-0.26，0.428，p=0.040）均显示报告的和观察到的无力之间的一致性较差。报告的和观察到的无力之间的差异由腿部疼痛的严重程度（b=0.281，p=0.024）和年龄（b=0.253，p=0.042）介导。
坐骨神经痛患者报告的腿部无力的患病率很高，但这并未反映在观察到的临床无力测量中。报告的和观察到的无力之间的差异可能由腿部疼痛的严重程度和年龄驱动。需要进一步研究以确定其他客观测量方法是否可以检测到患者报告的无力。
