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- Title
Stride length of elderly patients with lumbar spinal stenosis: Multi-center study using the Two-Step test.
- Authors
Fujita, Nobuyuki; Sakurai, Aiko; Miyamoto, Azusa; Michikawa, Takehiro; Otaka, Yohei; Suzuki, Satoshi; Tsuji, Osahiko; Nagoshi, Narihito; Okada, Eijiro; Yagi, Mitsuru; Tsuji, Takashi; Kono, Hitoshi; Ishii, Ken; Nakamura, Masaya; Matsumoto, Morio; Watanabe, Kota
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
SPINAL stenosis; OLDER patients; ACCIDENTAL fall prevention; LEG; INVERSE relationships (Mathematics)
- Publication
Journal of Orthopaedic Science, 2019, Vol 24, Issue 5, p787
- ISSN
0949-2658
- Publication type
journal article
- DOI
10.1016/j.jos.2019.01.006