PMID- 33650839
OWN - NLM
STAT- MEDLINE
DCOM- 20210706
LR  - 20231019
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Print)
IS  - 0362-2436 (Linking)
VI  - 46
IP  - 12
DP  - 2021 Jun 15
TI  - Responsiveness of Outcome Measures in Nonsurgical Patients with Lumbar Spinal 
      Stenosis: A Secondary Analysis From a Randomized Controlled Trial.
PG  - 788-795
LID - 10.1097/BRS.0000000000003920 [doi]
AB  - STUDY DESIGN: Secondary analysis from a randomized controlled trial on 
      nonsurgical interventions for patients with lumbar spinal stenosis (LSS). 
      OBJECTIVE: The aim of this study was to assess the responsiveness of the 
      Self-Paced Walking Test (SPWT), Swiss Spinal Stenosis Questionnaire (SSS), and 
      Oswestry Disability Index (ODI) and determine their minimal clinically important 
      differences (MCID) in nonsurgical LSS patients. SUMMARY OF BACKGROUND DATA: 
      Limited information is available about the responsiveness of these tests in 
      nonsurgical LSS population. METHODS: A total of 180 participants completed the 
      SPWT, SSS, and ODI at baseline, 2, and 6 months. Responsiveness was assessed by 
      distribution-based method, including effect size and standardized response mean, 
      and anchor-based method, using the patient global index of change (PGIC) as the 
      external anchor to distinguish responders and non-responders. Areas under the 
      curve (AUC) were calculated along with MCIDs for "minimal" and "moderate 
      improvement" subgroups. RESULTS: The following values represent 2- and 6-month 
      analyses of each outcome measure, respectively. Standard effect sizes: 0.48 and 
      0.50 for SPWT, -0.42 and -0.36 for SSS, and -0.29 and -0.25 for ODI. Spearman 
      correlation coefficients between PGIC and outcomes were: 0.44 and 0.39 for SPWT, 
      -0.53 and -0.55 for SSS, and -0.46 and -0.54 for ODI. MCIDs for the "minimal 
      improvement" subgroup were: 375.9 and 319.3 ms for SPWT, -5.3 and -5.8 points for 
      SSS, and -9.3 and -10.8 points for ODI. AUCs was 0.68 to 0.76. MCIDs for the 
      "moderate improvement" subgroup were: 344.2 and 538.2 m for SPWT, -5.5 and -7.5 
      points for SSS, and -9.1 and -13.6 points for ODI. AUCs ranged from 0.68 to 0.76. 
      CONCLUSION: The SPWT, SSS, and ODI are responsive outcome measures to assess 
      nonsurgical patients with LSS. This finding, along with the reported MCIDs, can 
      help clinicians to monitor changes in their patients' walking and physical 
      function over time and make clinical decisions. They also provide researchers 
      with reference for future studies in LSS.Level of Evidence: 2.
CI  - Copyright (c) 2020 The Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Carlesso, Cristiane
AU  - Carlesso C
AD  - Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA.
FAU - Piva, Sara R
AU  - Piva SR
AD  - Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA.
FAU - Smith, Clair
AU  - Smith C
AD  - Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA.
FAU - Ammendolia, Carlo
AU  - Ammendolia C
AD  - DC, PhD. Institute for Health Policy, Management and Evolution, University of 
      Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada.
FAU - Schneider, Michael J
AU  - Schneider MJ
AD  - Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Disability Evaluation
MH  - Humans
MH  - Lumbar Vertebrae/*physiopathology
MH  - Randomized Controlled Trials as Topic
MH  - *Spinal Stenosis/physiopathology/therapy
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
MH  - Walk Test
PMC - PMC8154167
EDAT- 2021/03/03 06:00
MHDA- 2021/07/07 06:00
PMCR- 2021/05/26
CRDT- 2021/03/02 09:34
PHST- 2021/03/03 06:00 [pubmed]
PHST- 2021/07/07 06:00 [medline]
PHST- 2021/03/02 09:34 [entrez]
PHST- 2021/05/26 00:00 [pmc-release]
AID - 00007632-202106150-00003 [pii]
AID - SPINE161940 [pii]
AID - 10.1097/BRS.0000000000003920 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2021 Jun 15;46(12):788-795. doi: 
      10.1097/BRS.0000000000003920.