Stride length of elderly patients with lumbar spinal stenosis: Multi-center study using the Two-Step test
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...
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| Veröffentlicht in: | Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2019-09, Vol.24 (5), p.787-792 |
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| creator | Fujita, Nobuyuki Sakurai, Aiko Miyamoto, Azusa Michikawa, Takehiro Otaka, Yohei Suzuki, Satoshi Tsuji, Osahiko Nagoshi, Narihito Okada, Eijiro Yagi, Mitsuru Tsuji, Takashi Kono, Hitoshi Ishii, Ken Nakamura, Masaya Matsumoto, Morio Watanabe, Kota |
| description | 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.
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.
The Two-Step test score showed moderate-to-strong inverse correlation with that of Timed Up-and-Go Test (r = −0.65, p |
| doi_str_mv | 10.1016/j.jos.2019.01.006 |
| format | Article |
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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.
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.
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.</description><identifier>ISSN: 0949-2658</identifier><identifier>EISSN: 1436-2023</identifier><identifier>DOI: 10.1016/j.jos.2019.01.006</identifier><identifier>PMID: 30737067</identifier><language>eng</language><publisher>Japan: Elsevier B.V</publisher><subject>Accidental Falls - prevention & control ; Aged ; Female ; Gait ; Humans ; Lumbar Vertebrae - physiopathology ; Male ; Spinal Stenosis - physiopathology ; Surveys and Questionnaires ; Walk Test</subject><ispartof>Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 2019-09, Vol.24 (5), p.787-792</ispartof><rights>2019 The Japanese Orthopaedic Association</rights><rights>Copyright © 2019 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c377t-5795c916c4ad9d81f733fe6502a71d9f1fbc66aa6a8bef47fc2641d0c52eb7943</citedby><cites>FETCH-LOGICAL-c377t-5795c916c4ad9d81f733fe6502a71d9f1fbc66aa6a8bef47fc2641d0c52eb7943</cites><orcidid>0000-0002-4830-4690</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27915,27916</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30737067$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fujita, Nobuyuki</creatorcontrib><creatorcontrib>Sakurai, Aiko</creatorcontrib><creatorcontrib>Miyamoto, Azusa</creatorcontrib><creatorcontrib>Michikawa, Takehiro</creatorcontrib><creatorcontrib>Otaka, Yohei</creatorcontrib><creatorcontrib>Suzuki, Satoshi</creatorcontrib><creatorcontrib>Tsuji, Osahiko</creatorcontrib><creatorcontrib>Nagoshi, Narihito</creatorcontrib><creatorcontrib>Okada, Eijiro</creatorcontrib><creatorcontrib>Yagi, Mitsuru</creatorcontrib><creatorcontrib>Tsuji, Takashi</creatorcontrib><creatorcontrib>Kono, Hitoshi</creatorcontrib><creatorcontrib>Ishii, Ken</creatorcontrib><creatorcontrib>Nakamura, Masaya</creatorcontrib><creatorcontrib>Matsumoto, Morio</creatorcontrib><creatorcontrib>Watanabe, Kota</creatorcontrib><title>Stride length of elderly patients with lumbar spinal stenosis: Multi-center study using the Two-Step test</title><title>Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association</title><addtitle>J Orthop Sci</addtitle><description>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.
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.
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.
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.</description><subject>Accidental Falls - prevention & control</subject><subject>Aged</subject><subject>Female</subject><subject>Gait</subject><subject>Humans</subject><subject>Lumbar Vertebrae - physiopathology</subject><subject>Male</subject><subject>Spinal Stenosis - physiopathology</subject><subject>Surveys and Questionnaires</subject><subject>Walk Test</subject><issn>0949-2658</issn><issn>1436-2023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFu1DAQhi0EotvCA3BBPnJJGDuJHcMJVUCRiji0nC3HHrdeeZNgO1T79rjawpHTHOb7_9F8hLxh0DJg4v2-3S-55cBUC6wFEM_IjvWdaDjw7jnZgepVw8UwnpHznPcATA5qeEnOOpCdBCF3JNyUFBzSiPNduaeLpxgdpnikqykB55LpQ6iLuB0mk2hew2wizQXnJYf8gX7fYgmNrSDWbdnckW45zHe03CO9fViam4IrLZjLK_LCm5jx9dO8ID-_fL69vGquf3z9dvnpurGdlKUZpBqsYsL2xik3Mi-7zqMYgBvJnPLMT1YIY4QZJ_S99JaLnjmwA8dJqr67IO9OvWtafm31sD6EbDFGM-OyZc05VzCOchwryk6oTUvOCb1eUziYdNQM9KNhvdfVsH40rIHparhm3j7Vb9MB3b_EX6UV-HgCsD75O2DS2VaRFl1IaIt2S_hP_R8gBI2m</recordid><startdate>201909</startdate><enddate>201909</enddate><creator>Fujita, Nobuyuki</creator><creator>Sakurai, Aiko</creator><creator>Miyamoto, Azusa</creator><creator>Michikawa, Takehiro</creator><creator>Otaka, Yohei</creator><creator>Suzuki, Satoshi</creator><creator>Tsuji, Osahiko</creator><creator>Nagoshi, Narihito</creator><creator>Okada, Eijiro</creator><creator>Yagi, Mitsuru</creator><creator>Tsuji, Takashi</creator><creator>Kono, Hitoshi</creator><creator>Ishii, Ken</creator><creator>Nakamura, Masaya</creator><creator>Matsumoto, Morio</creator><creator>Watanabe, Kota</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4830-4690</orcidid></search><sort><creationdate>201909</creationdate><title>Stride length of elderly patients with lumbar spinal stenosis: Multi-center study using the Two-Step test</title><author>Fujita, Nobuyuki ; Sakurai, Aiko ; Miyamoto, Azusa ; Michikawa, Takehiro ; Otaka, Yohei ; Suzuki, Satoshi ; Tsuji, Osahiko ; Nagoshi, Narihito ; Okada, Eijiro ; Yagi, Mitsuru ; Tsuji, Takashi ; Kono, Hitoshi ; Ishii, Ken ; Nakamura, Masaya ; Matsumoto, Morio ; Watanabe, Kota</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c377t-5795c916c4ad9d81f733fe6502a71d9f1fbc66aa6a8bef47fc2641d0c52eb7943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Accidental Falls - prevention & control</topic><topic>Aged</topic><topic>Female</topic><topic>Gait</topic><topic>Humans</topic><topic>Lumbar Vertebrae - physiopathology</topic><topic>Male</topic><topic>Spinal Stenosis - physiopathology</topic><topic>Surveys and Questionnaires</topic><topic>Walk Test</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fujita, Nobuyuki</creatorcontrib><creatorcontrib>Sakurai, Aiko</creatorcontrib><creatorcontrib>Miyamoto, Azusa</creatorcontrib><creatorcontrib>Michikawa, Takehiro</creatorcontrib><creatorcontrib>Otaka, Yohei</creatorcontrib><creatorcontrib>Suzuki, Satoshi</creatorcontrib><creatorcontrib>Tsuji, Osahiko</creatorcontrib><creatorcontrib>Nagoshi, Narihito</creatorcontrib><creatorcontrib>Okada, Eijiro</creatorcontrib><creatorcontrib>Yagi, Mitsuru</creatorcontrib><creatorcontrib>Tsuji, Takashi</creatorcontrib><creatorcontrib>Kono, Hitoshi</creatorcontrib><creatorcontrib>Ishii, Ken</creatorcontrib><creatorcontrib>Nakamura, Masaya</creatorcontrib><creatorcontrib>Matsumoto, Morio</creatorcontrib><creatorcontrib>Watanabe, Kota</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fujita, Nobuyuki</au><au>Sakurai, Aiko</au><au>Miyamoto, Azusa</au><au>Michikawa, Takehiro</au><au>Otaka, Yohei</au><au>Suzuki, Satoshi</au><au>Tsuji, Osahiko</au><au>Nagoshi, Narihito</au><au>Okada, Eijiro</au><au>Yagi, Mitsuru</au><au>Tsuji, Takashi</au><au>Kono, Hitoshi</au><au>Ishii, Ken</au><au>Nakamura, Masaya</au><au>Matsumoto, Morio</au><au>Watanabe, Kota</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stride length of elderly patients with lumbar spinal stenosis: Multi-center study using the Two-Step test</atitle><jtitle>Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association</jtitle><addtitle>J Orthop Sci</addtitle><date>2019-09</date><risdate>2019</risdate><volume>24</volume><issue>5</issue><spage>787</spage><epage>792</epage><pages>787-792</pages><issn>0949-2658</issn><eissn>1436-2023</eissn><abstract>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.
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.
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.
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.</abstract><cop>Japan</cop><pub>Elsevier B.V</pub><pmid>30737067</pmid><doi>10.1016/j.jos.2019.01.006</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-4830-4690</orcidid></addata></record> |
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| subjects | Accidental Falls - prevention & control Aged Female Gait Humans Lumbar Vertebrae - physiopathology Male Spinal Stenosis - physiopathology Surveys and Questionnaires Walk Test |
| title | Stride length of elderly patients with lumbar spinal stenosis: Multi-center study using the Two-Step test |
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