TY - JOUR
T1 - Stride length of elderly patients with lumbar spinal stenosis
T2 - Multi-center study using the Two-Step test
AU - Fujita, Nobuyuki
AU - Sakurai, Aiko
AU - Miyamoto, A.
AU - Michikawa, Takehiro
AU - Otaka, Y.
AU - Suzuki, Satoshi
AU - Tsuji, Osahiko
AU - Nagoshi, Narihito
AU - Okada, Eijiro
AU - Yagi, Mitsuru
AU - Tsuji, Takashi
AU - Kono, Hitoshi
AU - Ishii, Ken
AU - Nakamura, Masaya
AU - Matsumoto, M.
AU - Watanabe, Kota
N1 - Funding Information:
This study is supported by the research grant ( 2016-2 ) from Japanese Orthopaedic Association (Ken Ishii, Principal Investigator; Nobuyuki Fujita, Co-Investigator). Relevant financial activities outside this work is supported by AYUMI Pharmaceutical Corporation , Janssen Pharma KK , Pfizer Japan , Eli Lilly Japan , Shionogi Pharma , Asahikasei Pharma , Medtronic , Nuvasive, and Stryker (Takashi Tsuji).
Funding Information:
This study is supported by the research grant (2016-2) from Japanese Orthopaedic Association (Ken Ishii, Principal Investigator; Nobuyuki Fujita, Co-Investigator). Relevant financial activities outside this work is supported by AYUMI Pharmaceutical Corporation, Janssen Pharma KK, Pfizer Japan, Eli Lilly Japan, Shionogi Pharma, Asahikasei Pharma, Medtronic, Nuvasive, and Stryker (Takashi Tsuji).
Publisher Copyright:
© 2019 The Japanese Orthopaedic Association
PY - 2019/9
Y1 - 2019/9
N2 - Background: Short stride length is one of clinical symptoms associated with lumbar spinal stenosis (LSS). Short stride is a risk factor for falls; therefore, identification of factors associated with short stride is critical for fall prevention in LSS patients. Although the Two-Step test can conveniently assess maximal stride length, it has not become widely used; therefore, its data are limited. We identified the potential factors associated with short stride of elderly LSS patients using Two-Step test. Methods: Clinical data of patients aged >65 years who planned to undergo surgery for LSS were prospectively collected at multiple institutions. Patients were assessed with the Two-Step test and Timed Up-and-Go Test prior to surgery; 357 consecutive patients were enrolled. We determined the cut-off value of the Two-Step test score for short stride, referring to the Timed Up-and-Go Test score of 13.5 s, used to indicate high risk of falls in elderly individuals. Logistic regression model was constructed to identify factors associated with short stride. Results: The Two-Step test score showed moderate-to-strong inverse correlation with that of Timed Up-and-Go Test (r = −0.65, p < 0.001). Using the tentative Two-Step test cut-off value (0.93) for short stride, multivariable analysis showed that age ≥80 years (OR = 2.3, 95% CI:1.1–4.8), a score of <60 for lumbar function in Japanese Orthopedic Association Back Pain Evaluation Questionnaire (OR = 2.7, 95% CI:1.5–4.7), motor deficit (OR = 2.7, 95% CI:1.2–6.1), and sagittal vertical axis ≥50 mm (OR = 2.1, 95% CI:1.2–3.5) were factors significantly associated with short stride in elderly patients with LSS. Conclusions: Using the Two-Step test, we found that 80 years old and over, lumbar dysfunction, motor deficit of the lower extremities, and forward-bent posture were associated with short stride in LSS patients. Therefore, elderly LSS patients with these conditions may have a higher risk for falls.
AB - Background: Short stride length is one of clinical symptoms associated with lumbar spinal stenosis (LSS). Short stride is a risk factor for falls; therefore, identification of factors associated with short stride is critical for fall prevention in LSS patients. Although the Two-Step test can conveniently assess maximal stride length, it has not become widely used; therefore, its data are limited. We identified the potential factors associated with short stride of elderly LSS patients using Two-Step test. Methods: Clinical data of patients aged >65 years who planned to undergo surgery for LSS were prospectively collected at multiple institutions. Patients were assessed with the Two-Step test and Timed Up-and-Go Test prior to surgery; 357 consecutive patients were enrolled. We determined the cut-off value of the Two-Step test score for short stride, referring to the Timed Up-and-Go Test score of 13.5 s, used to indicate high risk of falls in elderly individuals. Logistic regression model was constructed to identify factors associated with short stride. Results: The Two-Step test score showed moderate-to-strong inverse correlation with that of Timed Up-and-Go Test (r = −0.65, p < 0.001). Using the tentative Two-Step test cut-off value (0.93) for short stride, multivariable analysis showed that age ≥80 years (OR = 2.3, 95% CI:1.1–4.8), a score of <60 for lumbar function in Japanese Orthopedic Association Back Pain Evaluation Questionnaire (OR = 2.7, 95% CI:1.5–4.7), motor deficit (OR = 2.7, 95% CI:1.2–6.1), and sagittal vertical axis ≥50 mm (OR = 2.1, 95% CI:1.2–3.5) were factors significantly associated with short stride in elderly patients with LSS. Conclusions: Using the Two-Step test, we found that 80 years old and over, lumbar dysfunction, motor deficit of the lower extremities, and forward-bent posture were associated with short stride in LSS patients. Therefore, elderly LSS patients with these conditions may have a higher risk for falls.
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U2 - 10.1016/j.jos.2019.01.006
DO - 10.1016/j.jos.2019.01.006
M3 - Article
C2 - 30737067
AN - SCOPUS:85061006574
SN - 0949-2658
VL - 24
SP - 787
EP - 792
JO - Journal of Orthopaedic Science
JF - Journal of Orthopaedic Science
IS - 5
ER -