Minetama Masakazu, Kawakami Mamoru, Teraguchi Masatoshi, Nakagawa Masafumi, Yamamoto Yoshio, Nakatani Tomohiro, Sakon Nana, Matsuo Sachika, Nakagawa Yukihiro
Spine Care Center, Wakayama Medical University Kihoku Hospital, Wakayama, Japan.
Department of Orthopaedic Surgery, Saiseikai Wakayama Hospital, Wakayama, Japan.
Eur Spine J. 2025 Sep 19. doi: 10.1007/s00586-025-09302-0.
To investigate the relationships between changes in objective physical function and changes in patient-reported outcome measurements (PROMs) in patients with lumbar spinal stenosis (LSS) undergoing lumbar surgery.
This study was a secondary analysis of a randomized controlled trial, in which patients with LSS undergoing lumbar surgery received an inpatient postoperative rehabilitation program. Objective physical assessments included gait speed, a Timed Up and Go test (TUG), handgrip and knee muscle strength, and bioelectrical impedance analysis for skeletal muscle at 3 months. PROMs included the Zurich Claudication Questionnaire (ZCQ), a numerical rating scale for back pain, leg pain, and leg numbness, the Japanese Orthopedic Association Back Pain Evaluation Questionnaire, and the 36-item Short-Form survey (SF-36) at 3 and 12 months.
A total of 80 patients (40 males and 40 females, average age 70.4 years) were included. At 3 and 12 months, changes in gait speed, TUG, and knee extensor strength showed some small but significant correlations with changes in the ZCQ and SF-36 physical functioning subscales (r = 0.23-0.42). Multivariable linear regression analyses revealed some significant associations between changes in objective physical assessments (gait speed, TUG, hand grip, and knee muscle strength) and PROMs (ZCQ, NRS, and SF-36 physical functioning subscale). However, these associations were limited in strength (standardized β = |0.24-0.34|, adjusted R² = 0.03-0.13).
The findings of this study showed limited associations between changes in objective physical assessments and changes in PROMs in patients with LSS who underwent lumbar surgery and postoperative rehabilitation.
UMIN000030881.
探讨接受腰椎手术的腰椎管狭窄症（LSS）患者客观身体功能变化与患者报告结局测量指标（PROMs）变化之间的关系。
本研究是一项随机对照试验的二次分析，其中接受腰椎手术的LSS患者接受了住院术后康复计划。客观身体评估包括3个月时的步态速度、定时起立行走测试（TUG）、握力和膝关节肌肉力量，以及骨骼肌生物电阻抗分析。PROMs包括苏黎世间歇性跛行问卷（ZCQ）、背痛、腿痛和腿部麻木的数字评分量表、日本骨科协会背痛评估问卷，以及3个月和12个月时的36项简短调查问卷（SF-36）。
共纳入80例患者（40例男性和40例女性，平均年龄70.4岁）。在3个月和12个月时，步态速度、TUG和膝关节伸肌力量的变化与ZCQ和SF-36身体功能分量表的变化显示出一些小但显著的相关性（r = 0.23 - 0.42）。多变量线性回归分析显示，客观身体评估（步态速度、TUG、握力和膝关节肌肉力量）的变化与PROMs（ZCQ、NRS和SF-36身体功能分量表）之间存在一些显著关联。然而，这些关联的强度有限（标准化β = |0.24 - 0.34|，调整后R² = 0.03 - 0.13）。
本研究结果表明，接受腰椎手术和术后康复的LSS患者，其客观身体评估变化与PROMs变化之间的关联有限。
UMIN000030881。
