Relationship between ambulatory performance and self-rated disability in patients with lumbar spinal stenosis

Spine (Phila Pa 1976). 2012 Jul 1;37(15):1316-23. doi: 10.1097/BRS.0b013e31824a8314.

Abstract

Study design: A cross-sectional study.

Objective: To identify the relationship between performance measures derived from accelerometry and subjective reports of pain, disability, and health in patients with lumbar spinal stenosis (LSS).

Summary of background data: Accelerometers have emerged as a measure of performance, providing the ability to characterize the pattern and magnitude of real-life activity, and sedentarism. Pain and loss of function, particularly ambulation, are common in LSS. The extent to which pain, perceived disability, and self-rated health relate to performance in patients with LSS is not well known.

Methods: Data regarding self-reported pain, disability (Oswestry Disability Index, Roland-Morris Disability Questionnaire, and Disabilities of the Arm, Shoulder, and Hand), and health (36-Item Short Form Health Survey [SF-36]) were collected from patients with LSS (n = 33). Physical activity, ambulation, and inactivity performance measures were derived from 7-day accelerometer records. Correlation and stepwise regression were used.

Results: The physical function subscale of the SF-36, a non-pathology-specific outcome, had the best overall correlation to physical activity and ambulation (average r = 0.53) compared with pain (average r = 0.32) and disability (average r = -0.45) outcomes. Stepwise regression models for performance were predominantly single-variable models (4 of 8 models); pain was not selected as a predictor. A second non-pathology-specific outcome, the Disabilities of Arm Shoulder and Hand, improved the prediction of performance in 5 of 8 models.

Conclusion: Subjective measures of pain and disability had limited ability to account for real-life performance in patients with LSS. Future research is required to identify determinants of performance in patients with LSS because barriers to activity may not be disease-specific.

MeSH terms

  • Accelerometry / methods
  • Aged
  • Cross-Sectional Studies
  • Disability Evaluation*
  • Humans
  • Linear Models
  • Lumbar Vertebrae / physiopathology*
  • Middle Aged
  • Pain Measurement / methods
  • Self Report
  • Spinal Stenosis / physiopathology*
  • Surveys and Questionnaires
  • Walking / physiology*