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 - 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.
UR - https://www.scopus.com/pages/publications/85061006574
UR - https://www.scopus.com/pages/publications/85061006574#tab=citedBy
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 -