PMID- 36728803
OWN - NLM
STAT- MEDLINE
DCOM- 20230330
LR  - 20231107
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 48
IP  - 8
DP  - 2023 Apr 15
TI  - Minimal Clinically Important Difference of the 6-Minute Walk Distance in Patients 
      Undergoing Lumbar Spinal Canal Stenosis Surgery: 12 Months Follow-Up.
PG  - 559-566
LID - 10.1097/BRS.0000000000004566 [doi]
AB  - STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: We 
      evaluated the responsiveness of the 6-minute walk distance (6MWD) and determined 
      the threshold of the minimal clinically important difference (MCID) in patients 
      who underwent lumbar spinal stenosis (LSS) surgery. SUMMARY OF BACKGROUND DATA: 
      Little evidence exists on the MCID of 6MWD after LSS surgery. The 6MWD is an 
      objective gait assessment that can be measured quickly. MATERIALS AND METHODS: In 
      total, 126 patients (74 men; average age, 72.2 +/- 6.5 yr) were included and 
      assessed preoperatively and at 12 months postoperatively. We used the Oswestry 
      Disability Index (ODI), as an anchor to calculate the MCID for the 6MWD and 
      measured internal and external responsiveness of the 6MWD. The external 
      responsiveness was assessed in 2 ways: (1) One based on the anchoring 
      questionnaire and (2) another based on the scale distribution. The anchor-based 
      approach was evaluated using the Spearman rank correlation coefficient and 
      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 change in the 6MWD 
      was significantly correlated with change in the ODI (6 mo, r = -0.45; 12 mo, r = 
      -0.49). The receiver-operating characteristic analysis demonstrated good 
      discriminative properties for the 6MWD using the ODI anchor (6 mo, 0.72; 12 mo, 
      0.78). The cutoff values for 6MWD were 102.3 and 57.5 at 6 and 12 months, 
      respectively. In the distribution-based approach, the minimal detectable change 
      for the 6MWD was 95.7 m. CONCLUSIONS: We validated both the internal and external 
      responsiveness of the 6MWD using the ODI and estimated the MCID in the 6MWD for 
      patients undergoing LSS surgery. However, there was lower validity for the MCID 
      among those participants with the high walking ability and low disability at 
      baseline.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Takenaka, Hiroto
AU  - Takenaka H
AUID- ORCID: 0000-0002-9320-1893
AD  - Department of Rehabilitation, Asahi Hospital, Kasugai, Aichi, Japan.
AD  - Department of Physical and Occupational Therapy, Nagoya University Graduate 
      School of Medicine, Higashi-ku, Nagoya, Aichi, Japan.
FAU - Kamiya, Mitsuhiro
AU  - Kamiya M
AD  - Department of Orthopedic surgery, Asahi Hospital, Kasugai, Aichi, Japan.
FAU - Sugiura, Hideshi
AU  - Sugiura H
AD  - Department of Physical and Occupational Therapy, Nagoya University Graduate 
      School of Medicine, Higashi-ku, Nagoya, Aichi, Japan.
FAU - Nishihama, Kasuri
AU  - Nishihama K
AD  - Department of Rehabilitation, Asahi Hospital, Kasugai, Aichi, Japan.
FAU - Suzuki, Junya
AU  - Suzuki J
AD  - Department of Rehabilitation, Asahi Hospital, Kasugai, Aichi, Japan.
FAU - Hanamura, Shuntaro
AU  - Hanamura S
AD  - Department of Orthopedic surgery, Asahi Hospital, Kasugai, Aichi, Japan.
LA  - eng
PT  - Journal Article
DEP - 20221228
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Male
MH  - Humans
MH  - Aged
MH  - *Spinal Stenosis/surgery
MH  - Follow-Up Studies
MH  - Minimal Clinically Important Difference
MH  - Constriction, Pathologic
MH  - Walking
MH  - Surveys and Questionnaires
MH  - Spinal Canal
MH  - Treatment Outcome
MH  - Lumbar Vertebrae/surgery
COIS- The authors report no conflicts of interest.
EDAT- 2023/02/03 06:00
MHDA- 2023/03/30 06:11
CRDT- 2023/02/02 10:11
PHST- 2022/09/03 00:00 [received]
PHST- 2022/12/09 00:00 [accepted]
PHST- 2023/03/30 06:11 [medline]
PHST- 2023/02/03 06:00 [pubmed]
PHST- 2023/02/02 10:11 [entrez]
AID - 00007632-202304150-00007 [pii]
AID - 10.1097/BRS.0000000000004566 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2023 Apr 15;48(8):559-566. doi: 
      10.1097/BRS.0000000000004566. Epub 2022 Dec 28.