Longitudinal construct validity and responsiveness of measures of walking capacity in individuals with lumbar spinal stenosis |
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| Authors: | Christy C Tomkins-Lane Michele C Battié Luciana G Macedo |
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| Institution: | 1. Mount Royal University, U243E, 4825 Mount Royal Gate SW, Calgary, Alberta, Canada T3E 6K6;2. Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 3-48 Corbett Hall, Edmonton, Alberta, Canada T6G 2G4;1. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada;2. Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy;3. Martiniclinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;4. Department of Urology, Ruhr-University Bochum, Germany;5. Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA;6. Department of Urology, Mayo Clinic, Rochester, NY, USA;7. Department of Urology, University of Montreal Health Centre, Montreal, Canada;8. Department of Surgery, Division of Urology, Brigham and Women''s Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA;1. Istanbul University, Istanbul Medical Faculty, Department of Surgery, Capa, Istanbul, 34398, Turkey;2. Istanbul University, Istanbul Medical Faculty, Department of Medical Oncology, Capa, Istanbul, 34398, Turkey;3. Istanbul University, Istanbul Medical Faculty, Department of Pathology, Capa, Istanbul, 34398, Turkey;4. Istanbul University, Istanbul Medical Faculty, Department of Radiation Oncology, Capa, Istanbul, 34398, Turkey;1. Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;2. School of Public Health, National Defense Medical Center, Taipei, Taiwan;3. Division of Hematology/Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan;1. Institute of Sportsciences, Goethe-University, Ginnheimer Landstraße 39, D-60487 Frankfurt am Main, Germany;2. Juni-Prof. Institute of Sport- and Exercise Science, Allmandring 28, University of Stuttgart, D-70569 Stuttgart, Germany;3. Julianne Utz, Holzhauserstr. 13, D-70563 Stuttgart, Germany;4. BNI Blindnavigation International, Ayestraße 2, D-88441 Mittelbiberach, Germany;5. Prof., Institute of Sport and Exercise Science, Chair Exercise and Health Sciences, University of Stuttgart, Nobelstraße 15, D-70569 Stuttgart, Germany;1. AP–HP, Hopital Universitaire La Pitié-Salpêtrière, Service de neurologie 2-Mazarin, 47-83, boulevard de l’Hôpital, 75013 Paris, France;2. Sorbonne Universités, UPMC Université Paris 06, UM 75, ICM, 47, boulevard de l’Hôpital, 75013 Paris, France;3. Inserm, U 1127, ICM, 47, boulevard de l’Hôpital, 75013 Paris, France;4. CNRS, UMR 7225, ICM, 47, boulevard de l’Hôpital, 75013 Paris, France;5. ICM, 47, boulevard de l’Hôpital, 75013 Paris, France;6. Service de Neuro-oncologie, Hôpital Neurologique, Hospices Civils de Lyon, 3, quai des Célestins, 69002 Lyon, France;7. Université Claude-Bernard Lyon 1, 43, boulevard du 11 Novembre 1918, 69100 Villeurbanne, France;1. Comité Régional Handisport de Provence-Alpes Côte d’Azur, Les Campenules Bât H, 59, boulevard Pierre-Menard, 13011 Marseille, France;2. Université de Toulon, LAMHESS, France;3. Université Côte d’Azur, LAMHESS, Nice, France;4. UMR CNRS 8201, université de Valenciennes, LAMIH, 59313 Valenciennes, France;5. EA 6310, université de Limoges, HAVAE, 87000 Limoges, France;6. EA 3300, université Picardie-Jules-Verne, APERE, 80000 Amiens, France |
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| Abstract: | Background contextWalking capacity is a primary outcome indicator for individuals with lumbar spinal stenosis (LSS). Therefore, there is a demand for psychometrically sound measures of walking that are responsive to change.PurposeThe primary objective of this study was to examine longitudinal construct validity of the Physical Function Scale of the Swiss Spinal Stenosis Questionnaire (PF Scale), the Oswestry Disability Index (ODI), and the walking capacity items from these scales specifically for the assessment of walking capacity in LSS using the objective Self-Paced Walking Test (SPWT) as the external standard. A secondary objective was to examine responsiveness of measures of walking using a self-reported walking capacity change scale as the external criterion standard.Study designPatients were prospectively enrolled.Patient sampleTwenty-six patients were included in this study (17 women and 9 men), with an average age of 68.5 years (SD, 9.2). All participants had LSS diagnosed by a spine specialist surgeon based on both clinical examination and imaging, as well as self-reported walking limitations (neurogenic claudication).Outcome measuresThe self-reported outcome measures included in this study were PF Scale, ODI, and self-reported walking capacity change score.Functional measuresThe functional measure used in the study was SPWT.MethodsLongitudinal construct validity was assessed using the correlational method. Internal responsiveness was examined using Guyatt responsiveness index and external responsiveness using receiver operating characteristic analysis. Change in the SPWT and the self-reported walking capacity change score were used as external criteria for the analysis.ResultsThe highest correlations with change in the SPWT were 0.78 for the ODI walking item and 0.78 for the walking capacity change score. Changes in the PF Scale and ODI score were correlated with change in the criterion SPWT at r=0.56 and r=0.70, respectively. There were no differences observed between the PF Scale and ODI for any of the responsiveness indices.ConclusionsThe PF Scale, ODI, and walking capacity change score are able to detect changes in walking capacity in people with LSS. The individual walking capacity item from the ODI appears to be the most valid and responsive to changes in measured walking and may be a reasonable alternative for measuring walking when an objective test such as the SPWT is not feasible. |
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| Keywords: | Validity Responsiveness Spinal stenosis Walking Outcomes Neurogenic claudication |
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