PMID- 34039891
OWN - NLM
STAT- MEDLINE
DCOM- 20220329
LR  - 20230831
IS  - 2380-0194 (Electronic)
IS  - 2380-0186 (Linking)
VI  - 35
IP  - 3
DP  - 2022 Apr 1
TI  - Responsiveness and Minimal Clinically Important Difference of the 6-minute Walk 
      Distance in Patients Undergoing Lumbar Spinal Canal Stenosis Surgery.
PG  - E345-E350
LID - 10.1097/BSD.0000000000001196 [doi]
AB  - STUDY DESIGN: This was a retrospective review of prospectively collected data. 
      OBJECTIVE: We aimed to evaluate the responsiveness of the 6-minute walk distance 
      (6MWD) and determine the threshold of the minimal clinically important difference 
      (MCID) in the 6MWD in patients who underwent surgery for lumbar spinal canal 
      stenosis (LSS) surgery. SUMMARY OF BACKGROUND DATA: The 6MWD rapidly and 
      objectively assesses the walking distance in patients with LSS. To date, no study 
      has assessed the MCID in the 6MWD in patients who underwent LSS surgery. 
      MATERIALS AND METHODS: A total of 41 patients (16 women; average age: 69.4 y, SD: 
      7.8 y) were included and assessed preoperatively and at 6 months postoperatively. 
      We evaluated the 6MWD and Oswestry Disability Index (ODI), which is a 
      health-related patientrReported outcome, used as an anchor to calculate the MCID 
      for in the 6MWD. We used 2 different approaches to examine the responsiveness of 
      the 6MWD: internal and external responsiveness. The external responsiveness was 
      assessed in 2 ways: one based on the anchoring questionnaire and the other based 
      on the scale distribution of the scale. The anchor-based approach was evaluated 
      using the Spearman rank correlation coefficient and the receiver operating 
      characteristic curve. The distribution-based approach was evaluated using the 
      minimal detectable change. RESULTS: The ODI scores and 6MWD for each anchor 
      significantly improved postoperatively. The correlation coefficient between 
      changes in the 6MWD and ODI was r=-0.58. The area under the receiver operating 
      characteristic curve for the ODI anchor was 0.70 (95% confidence interval: 
      0.52-0.89), and the cutoff value for the ODI anchor was 50 m (sensitivity=0.57, 
      specificity=0.71). In the distribution-based approach, the minimal detectable 
      change for the 6MWD was 105.9 m. CONCLUSIONS: Both the internal and the external 
      responsiveness of the 6MWD were validated using the ODI. Therefore, the MCID in 
      the 6MWD in patients undergoing LSS surgery ranges from 50 to 105.9 m. LEVEL OF 
      EVIDENCE: Level III.
CI  - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Takenaka, Hiroto
AU  - Takenaka H
AD  - Department of Rehabilitation, Asahi Hospital, Kasugai.
AD  - Department of Physical and Occupational Therapy, Nagoya University Graduate 
      School of Medicine, Nagoya.
FAU - Kamiya, Mitsuhiro
AU  - Kamiya M
AD  - Department of Orthopedic Surgery, Asahi Hospital, Kasugai, Aichi Prefecture, 
      Japan.
FAU - Sugiura, Hideshi
AU  - Sugiura H
AD  - Department of Physical and Occupational Therapy, Nagoya University Graduate 
      School of Medicine, Nagoya.
FAU - Nishihama, Kasuri
AU  - Nishihama K
AD  - Department of Rehabilitation, Asahi Hospital, Kasugai.
FAU - Ito, Atsuki
AU  - Ito A
AD  - Department of Rehabilitation, Asahi Hospital, Kasugai.
FAU - Suzuki, Junya
AU  - Suzuki J
AD  - Department of Rehabilitation, Asahi Hospital, Kasugai.
FAU - Hanamura, Shuntaro
AU  - Hanamura S
AD  - Department of Orthopedic Surgery, Asahi Hospital, Kasugai, Aichi Prefecture, 
      Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Clin Spine Surg
JT  - Clinical spine surgery
JID - 101675083
SB  - IM
MH  - Aged
MH  - Constriction, Pathologic
MH  - Female
MH  - Humans
MH  - Lumbar Vertebrae/surgery
MH  - *Minimal Clinically Important Difference
MH  - Spinal Canal
MH  - *Spinal Stenosis/surgery
MH  - Treatment Outcome
MH  - Walking
COIS- The authors declare no conflict of interest.
EDAT- 2021/05/28 06:00
MHDA- 2022/03/30 06:00
CRDT- 2021/05/27 05:54
PHST- 2020/12/21 00:00 [received]
PHST- 2021/04/14 00:00 [accepted]
PHST- 2021/05/28 06:00 [pubmed]
PHST- 2022/03/30 06:00 [medline]
PHST- 2021/05/27 05:54 [entrez]
AID - 01933606-202204000-00008 [pii]
AID - 10.1097/BSD.0000000000001196 [doi]
PST - ppublish
SO  - Clin Spine Surg. 2022 Apr 1;35(3):E345-E350. doi: 10.1097/BSD.0000000000001196.