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Evaluation of clinical lumbar instability using the treadmill
Y Tokuhashi1, H Matsuzaki, S Sano
1Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo, Japan.
Spine
|November 1, 1993
Summary
Treadmill testing effectively evaluates clinical lumbar instability by reproducing pain during walking, offering a better measure than traditional X-rays. This method aids in determining surgical fusion indications for degenerative lumbar disease.
Area of Science:
- Orthopedics
- Physical Therapy
- Biomechanical Engineering
Background:
- Clinical signs of lumbar instability are poorly defined and may not correlate with radiographic findings.
- Degenerative lumbar disease often presents with pain aggravated by physical activity.
Purpose of the Study:
- To evaluate the efficacy of treadmill testing for assessing clinical lumbar instability.
- To compare treadmill testing with flexion-extension radiography for diagnosing lumbar instability.
- To determine the utility of treadmill testing in guiding fusion surgery decisions.
Main Methods:
- 82 patients with degenerative lumbar disease underwent treadmill testing to provoke low-back pain or lower extremity pain during walking.
- Symptom reproduction and provocation were graded.
- 15 patients were re-evaluated with treadmill testing after body casting to assess surgical indications.
Main Results:
- Treadmill testing demonstrated a stronger correlation with clinical lumbar instability symptoms than flexion-extension radiography.
- Symptom reproduction and provocation on the treadmill provided a more dominant reflection of clinical instability.
- Post-casting re-evaluation using the treadmill was valuable for determining fusion surgery indications.
Conclusions:
- Treadmill-based symptom provocation and reproduction tests are a valuable functional evaluation method for clinical lumbar instability.
- This method offers a more reliable assessment of lumbar instability compared to standard radiographic evaluation.
- Treadmill testing can aid in surgical decision-making for patients with degenerative lumbar disease.