Predictors of objectively measured walking capacity in people with degenerative lumbar spinal stenosis

Background: Identifying factors associated with walking capacity in people with lumbar spinal stenosis (LSS) may provide a better understanding of neurogenic claudication and inform future rehabilitation research.

Objective: To examine factors associated with objectively measured walking capacity in a sample of people with LSS and self-reported walking limitations.

Methods: Participants included 49 individuals (65.8 years ± 10) who were at least 45 years of age with clinically diagnosed lumbar spinal stenosis (LSS) confirmed on MRI or CT imaging. All participants completed a Self-Paced Walking Test with visual analog pain scales and body diagrams before and immediately after walking. Questionnaires included the Physical Function and Symptom Severity Scales of the Swiss Spinal Stenosis Questionnaire, the Oswestry Disability Index (ODI) and the Health Utilities Index. Univariate linear relationships were examined, followed by development of a multivariate linear regression model with walking distance (m) as the dependent variable. A post-hoc analysis was also conducted including post-test symptom variables.

Results: Variables retained from univariate analyses included years of leg pain, pre-test leg pain severity, the ODI, balance problems, and quality of life. When these variables were considered for a final model, only the ODI and balance problems were retained (R2=0.33). Other than balance, none of the pre-test symptom variables entered into the final model. Post-hoc analysis including post-test symptom variables found the presence and severity of post-test leg pain to be most highly associated with walking distance. In an explanatory model considering the ODI, balance and these two post-walking factors, only presence of post-test leg pain added to the model (R2=0.42).

Conclusions: Factors found to be most highly associated with walking capacity in LSS were self-reported, pain-related function (ODI), balance problems, and presence of leg pain immediately following walking.