Ishizuka Daigo, Nozaki Susumu, Minezaki Hiroshi, Ota Tsuyoshi, Asakawa Yasuyoshi
Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.
Department of Physical Therapy, Faculty of Rehabilitation Science, Faculty of Health Sciences, University of Human Sciences, Saitama, Japan.
Ann Geriatr Med Res. 2025 Mar;29(1):83-90. doi: 10.4235/agmr.24.0128. Epub 2024 Nov 19.
Lumbar spinal stenosis (LSS) impairs activities of daily living (ADL) in older adults. Factors associated with ADL impairment in LSS have not been identified. This study aimed to ascertain the pre-admission living conditions in older adults with LSS and investigate the factors associated with impairment in ADL.
A total of 261 community-dwelling older adults aged ≥65 years with LSS, scheduled for surgery were included. The Oswestry Disability Index (ODI) was used to assess ADL impairment. The Life-Space Assessment was used to assess the extent and frequency of outings. Pain, numbness, continuous walking distance, and health-related quality of life as psychosomatic functions. Falls self-efficacy and the degree of social isolation were assessed as social life status. Factors associated with ADL impairment were examined using multiple logistic regression analysis.
Significant differences were found in psychosomatic functioning, living space, and falls self-efficacy depending on the presence or absence of ADL impairment. The ODI sub-components showed a stronger degree of impairment in pain intensity, walking, standing, and social life. There were significant differences in the frequency of going outside the home and inside the neighborhood, ADL impairment was shown to affect the frequency of outings within close proximity to their lives. Numbness was associated with ADL impairment (odds ratio=1.2; 95% confidence interval 1.1-1.4).
Assessing the degree of numbness is important in predicting ADL impairment in older adults with LSS. Additionally, assessing the living conditions and taking an appropriate approach before admission can help prevent ADL impairment.
腰椎管狭窄症（LSS）会损害老年人的日常生活活动（ADL）。尚未确定与LSS患者ADL受损相关的因素。本研究旨在确定LSS老年患者入院前的生活状况，并调查与ADL受损相关的因素。
纳入261名计划接受手术的≥65岁社区居住LSS老年患者。采用奥斯威斯功能障碍指数（ODI）评估ADL受损情况。采用生活空间评估法评估出行的范围和频率。将疼痛、麻木、持续行走距离以及作为身心功能的健康相关生活质量纳入评估。将跌倒自我效能感和社会隔离程度作为社会生活状况进行评估。采用多元逻辑回归分析检查与ADL受损相关的因素。
根据是否存在ADL受损，在身心功能、生活空间和跌倒自我效能感方面发现了显著差异。ODI子成分在疼痛强度、行走、站立和社会生活方面显示出更强的受损程度。在走出家门和邻里范围内的频率方面存在显著差异，ADL受损被证明会影响其生活附近区域的出行频率。麻木与ADL受损相关（比值比=1.2；95%置信区间1.1-1.4）。
评估麻木程度对于预测LSS老年患者的ADL受损很重要。此外，在入院前评估生活状况并采取适当措施有助于预防ADL受损。
