Stride length of elderly patients with lumbar spinal stenosis

Multi-center study using the Two-Step test

Nobuyuki Fujita, Aiko Sakurai, A. Miyamoto, Takehiro Michikawa, Yohei Otaka, Satoshi Suzuki, Osahiko Tsuji, Narihito Nagoshi, Eijiro Okada, Mitsuru Yagi, Takashi Tsuji, Hitoshi Kono, Ken Ishii, Masaya Nakamura, M. Matsumoto, Kota Watanabe

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)787-792
Number of pages6
JournalJournal of Orthopaedic Science
Volume24
Issue number5
DOIs
Publication statusPublished - 01-09-2019

Fingerprint

Spinal Stenosis
Exercise Test
Logistic Models
Back Pain
Posture
Orthopedics
Lower Extremity

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Fujita, Nobuyuki ; Sakurai, Aiko ; Miyamoto, A. ; Michikawa, Takehiro ; Otaka, Yohei ; Suzuki, Satoshi ; Tsuji, Osahiko ; Nagoshi, Narihito ; Okada, Eijiro ; Yagi, Mitsuru ; Tsuji, Takashi ; Kono, Hitoshi ; Ishii, Ken ; Nakamura, Masaya ; Matsumoto, M. ; Watanabe, Kota. / Stride length of elderly patients with lumbar spinal stenosis : Multi-center study using the Two-Step test. In: Journal of Orthopaedic Science. 2019 ; Vol. 24, No. 5. pp. 787-792.
@article{4340c08aaf884912bf4aadc27eeb83a7,
title = "Stride length of elderly patients with lumbar spinal stenosis: Multi-center study using the Two-Step test",
abstract = "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.",
author = "Nobuyuki Fujita and Aiko Sakurai and A. Miyamoto and Takehiro Michikawa and Yohei Otaka and Satoshi Suzuki and Osahiko Tsuji and Narihito Nagoshi and Eijiro Okada and Mitsuru Yagi and Takashi Tsuji and Hitoshi Kono and Ken Ishii and Masaya Nakamura and M. Matsumoto and Kota Watanabe",
year = "2019",
month = "9",
day = "1",
doi = "10.1016/j.jos.2019.01.006",
language = "English",
volume = "24",
pages = "787--792",
journal = "Journal of Orthopaedic Science",
issn = "0949-2658",
publisher = "Springer Japan",
number = "5",

}

Fujita, N, Sakurai, A, Miyamoto, A, Michikawa, T, Otaka, Y, Suzuki, S, Tsuji, O, Nagoshi, N, Okada, E, Yagi, M, Tsuji, T, Kono, H, Ishii, K, Nakamura, M, Matsumoto, M & Watanabe, K 2019, 'Stride length of elderly patients with lumbar spinal stenosis: Multi-center study using the Two-Step test', Journal of Orthopaedic Science, vol. 24, no. 5, pp. 787-792. https://doi.org/10.1016/j.jos.2019.01.006

Stride length of elderly patients with lumbar spinal stenosis : Multi-center study using the Two-Step test. / Fujita, Nobuyuki; Sakurai, Aiko; Miyamoto, A.; Michikawa, Takehiro; Otaka, Yohei; Suzuki, Satoshi; Tsuji, Osahiko; Nagoshi, Narihito; Okada, Eijiro; Yagi, Mitsuru; Tsuji, Takashi; Kono, Hitoshi; Ishii, Ken; Nakamura, Masaya; Matsumoto, M.; Watanabe, Kota.

In: Journal of Orthopaedic Science, Vol. 24, No. 5, 01.09.2019, p. 787-792.

Research output: Contribution to journalArticle

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, Yohei

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

PY - 2019/9/1

Y1 - 2019/9/1

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.

UR - http://www.scopus.com/inward/record.url?scp=85061006574&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061006574&partnerID=8YFLogxK

U2 - 10.1016/j.jos.2019.01.006

DO - 10.1016/j.jos.2019.01.006

M3 - Article

VL - 24

SP - 787

EP - 792

JO - Journal of Orthopaedic Science

JF - Journal of Orthopaedic Science

SN - 0949-2658

IS - 5

ER -