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DO WALKING TESTS ACCURATELY ASSESS RESPONSIVENESS TO TREATMENTS FOR NEUROGENIC CLAUDICATION?: GP206.

Rainville, James1; Childs, Lisa1; Suri, Pradeep1; Pena, Enrique2; Jouve, Cristin1; Limke, Janet1; Hunter, David3

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Spine Journal Meeting Abstracts: October 2011 - Volume - Issue - [no page #]
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INTRODUCTION: Walking limitations produced by neurogenic claudication (NC) are quantifiable using motorized treadmill test (MTT) and indoor level walking test (ILWT). This study assessed the responsiveness of MTT and ILWT for assessing change following treatments.

METHODS: 50 adults with NC that were undergoing surgery (20%) or conservative treatment (80%) were recruited. Mean age was 68. 58% were male. NC included leg pain (88%), paresthesias (58%), weakness (38%), and unsteadiness (38%). Outcomes included 0‐10 pain scores, Oswestry Disability Index (ODI), Spinal Stenosis Questionnaire (SSQ), estimated walking abilities and rating of overall change in status. MTT used a level track and ILWT were conducted in a 52 meter rectangular hallway. Walking speeds were self‐selected and test endpoints were: a) NC, b) fatigue, c) completed 30 minutes. Both walking tests were performed on the same day in random order.

RESULTS: 39 of the 50 subjects completed pre‐ and post‐treatment evaluations. 72% reported improvement following treatment which was confirmed by significant mean differences for leg pain (2.0), SSQ symptoms (.49), SSQ physical function (.55), ODI (12), estimated walking time (14 min) and distance (1209 m). All subjects could perform ILWT, but 5 subjects could not safely performing MTT. Subjects completing MTT without symptoms increased from 13% to 34%. However, mean MTT walking times and distances did not change. Test completers increased from 6% to 46 % for ILWT, and mean differences in walking time (6 min) and distance (387 m) were significant. However, standardized response means (SRM) for ILWT time and distances were not different for improved vs. not improved subjects, nor did they correlate with SRM of any self‐reported measures.

DISCUSSION: ILWT can assess responsiveness to common treatments of NC at a group level better than MTT. However, on an individual level, ILWT has limited ability to accurately assess change in overall status.

© 2011 Lippincott Williams & Wilkins, Inc.