Predictors of Walking Performance and Walking Capacity in People With Lumbar Spinal Stenosis, Low Back Pain, and Asymptomatic Controls

• Published in: Archives of physical medicine and rehabilitation Vol. 93; no. 4; pp. 647 - 653
• Main Authors: Tomkins-Lane, Christy C., PhD, Holz, Sara Christensen, MD, Yamakawa, Karen S., MS, Phalke, Vaishali V., MD, Quint, Doug J., MD, Miner, Jennifer, MBA, Haig, Andrew J., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-04-2012; Elsevier
• Subjects: Aged; Aged, 80 and over; Analysis of Variance; Biological and medical sciences; Body Mass Index; Case-Control Studies; Disability Evaluation; Diseases of the osteoarticular system; Diseases of the spine; Electromyography; Female; Humans; Linear Models; Low Back Pain - physiopathology; Lumbar Vertebrae - pathology; Magnetic Resonance Imaging; Male; Medical sciences; Metabolic diseases; Michigan; Middle Aged; Miscellaneous; Obesity; Obesity - physiopathology; Pain; Pain Measurement; Physical Medicine and Rehabilitation; Physiology; Predictive Value of Tests; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Retrospective Studies; Risk Factors; Sex Factors; Spinal Stenosis - physiopathology; Surveys and Questionnaires; Walking; Walking - physiology; Michigan; Obesity; magnetic resonance imaging; MRI; VAS; visual analog scale; LSS; Body mass index; Walking; Pain; lumbar spinal stenosis; Physiology; Rehabilitation; BMI; Performance evaluation; Lumbar spine; Low back pain; Diseases of the osteoarticular system; Nutrition disorder; Asymptomatic; Spine disease; Lumbar spinal stenosis; Reeducation; Orthopedics; Rachialgia; Predictive factor; Nutritional status
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2011.09.023

Abstract Tomkins-Lane CC, Holz SC, Yamakawa KS, Phalke VV, Quint DJ, Miner J, Haig AJ. Predictors of walking performance and walking capacity in people with lumbar spinal stenosis, low back pain, and asymptomatic controls. Objective To examine predictors of community walking performance and walking capacity in people with lumbar spinal stenosis (LSS), compared with people with low back pain and asymptomatic control subjects. Design Retrospective analysis. Setting University spine program. Participants Participants (N=126; 50 LSS, 44 low back pain, 32 asymptomatic control subjects) aged 55 to 80 years were studied. Interventions Not applicable. Main Outcome Measures Seven-day community walking distance measured by pedometer (walking performance) and a 15-minute walking test (walking capacity). All participants had lumbosacral magnetic resonance imaging, electrodiagnostic testing, and a history and physical examination, including a history of pain and neurologic symptoms, a straight leg raise test, and tests for directional symptoms, reflexes, strength, and nerve tension signs. The study questionnaire included demographic information, a history of back/leg pain, and questions about walking, exercise frequency, and pain level, as well as the standardized Quebec Back Pain Disability Scale. Results Body mass index (BMI), pain, age, and female sex predicted walking performance ( r2 =.41) and walking capacity ( r2 =.41). The diagnosis of LSS itself had no clear relationship with either walking variable. Compared with the asymptomatic group, LSS participants had significantly lower values for all walking parameters, with the exception of stride length, while there was no significant difference between the LSS and low back pain groups. Conclusions BMI, pain, female sex, and age predict walking performance and capacity in people with LSS, those with low back pain, and asymptomatic control subjects. While pain was the strongest predictor of walking capacity, BMI was the strongest predictor of walking performance. Average pain, rather than leg pain, was predictive of walking performance and capacity. Obesity and pain are modifiable predictors of walking deficits that could be targets for future intervention studies aimed at increasing walking performance and capacity in both the low back pain and LSS populations.