Validity and Reproducibility of Self-report Measures of Walking Capacity in Lumbar Spinal Stenosis

Abstract

This study provides new information to help guide health professionals and researchers in the selection of appropriate outcome tools when examining walking in an LSS population. Study results support the use of the Physical Function Scale, self-reported walking distance, and the walking specific items from the ODI and the Physical Function Scale.

Only walking matters—assessment following lumbar stenosis decompression

“…The mean Pfirrmann grade of patients having surgery was 3.97 (2)(3)(4)(5), and the mean olisthesis was 4.9 mm (2.4-10.6). Both these radiological factors did not influence the walking distance (Table 2).…”

“…SPWT has been already validated against other patient-reported outcome measures in patients with lumbar canal stenosis [4], and we felt performing them again would not add anything to our study. We also wanted to test something simple that the patients would understand and relate to.…”

“…1). This test has been validated already [4]; hence, no other outcome measures were used. When the patients could not walk any more, a note of the walking distance was made as well as symptoms that stopped them from walking.…”

“…An accurate assessment of the walking distance is an important part of consultation. Such a measurement has been described and validated as a self-paced walking test (SPWT) in patients with lumbar canal stenosis [4]. 'Timed up and go test' (TUG) involves measuring the time it takes for a patient to rise from a sitting position, walk 3 m and return to sitting position in the same chair [5].…”

Evaluation of outcome measures for neurogenic claudication

“…These moderate correlations between PRO measures of walking capacity in everyday life and treadmill tests of walking capacity are consistent with the view that selfreported and performance-based measures assess different aspects of physical function that can provide complementary information. [19][20][21]23 Considering that our patients generally favored a treatment that allows them to walk with less pain over one that allows them to walk farther, it is important to identify the outcome measure that can most validly measure pain when walking for clinical trials of analgesic treatments for neurogenic claudication. Asking patients to rate their highest pain when walking in everyday life was relatively moderately correlated (r 5 0.304, p , 0.0001) with the final pain rating on the treadmill test (i.e., the point at which the patient decided to stop walking or after 15 minutes, whichever came first).…”