Do postoperative changes in physical function affect patient-reported outcomes in patients with lumbar spinal...

To investigate the relationships between changes in objective physical function and changes in patient-reported outcome measurements (PROMs) in patients with lumbar spinal stenosis (LSS) undergoing lumbar surgery.

This study was a secondary analysis of a randomized controlled trial, in which patients with LSS undergoing lumbar surgery received an inpatient postoperative rehabilitation program. Objective physical assessments included gait speed, a Timed Up and Go test (TUG), handgrip and knee muscle strength, and bioelectrical impedance analysis for skeletal muscle at 3 months. PROMs included the Zurich Claudication Questionnaire (ZCQ), a numerical rating scale for back pain, leg pain, and leg numbness, the Japanese Orthopedic Association Back Pain Evaluation Questionnaire, and the 36-item Short-Form survey (SF-36) at 3 and 12 months.

A total of 80 patients (40 males and 40 females, average age 70.4 years) were included. At 3 and 12 months, changes in gait speed, TUG, and knee extensor strength showed some small but significant correlations with changes in the ZCQ and SF-36 physical functioning subscales (r = 0.23-0.42). Multivariable linear regression analyses revealed some significant associations between changes in objective physical assessments (gait speed, TUG, hand grip, and knee muscle strength) and PROMs (ZCQ, NRS, and SF-36 physical functioning subscale). However, these associations were limited in strength (standardized β = |0.24-0.34|, adjusted R² = 0.03-0.13).

The findings of this study showed limited associations between changes in objective physical assessments and changes in PROMs in patients with LSS who underwent lumbar surgery and postoperative rehabilitation.

UMIN000030881.