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Physical Performance Tests Provide Distinct Information in Both Predicting and Assessing Patient-Reported Outcomes Following Lumbar Spine Surgery.

Publication ,  Journal Article
Master, H; Pennings, JS; Coronado, RA; Henry, AL; O'Brien, MT; Haug, CM; Skolasky, RL; Riley, LH; Neuman, BJ; Cheng, JS; Aaronson, OS ...
Published in: Spine (Phila Pa 1976)
December 1, 2020

STUDY DESIGN: Secondary analysis of randomized controlled trial data. OBJECTIVE: The aim of this study was to examine whether preoperative physical performance is an independent predictor of patient-reported disability and pain at 12 months after lumbar spine surgery. SUMMARY OF BACKGROUND DATA: Patient-reported outcome measures (PROMs) are commonly used to assess clinical improvement after lumbar spine surgery. However, there is evidence in the orthopedic literature to suggest that PROMs should be supplemented with physical performance tests to accurately evaluate long-term outcomes. METHODS: A total of 248 patients undergoing surgery for degenerative lumbar spine conditions were recruited from two institutions. Physical performance tests (5-Chair Stand and Timed Up and Go) and PROMs of disability (Oswestry Disability Index: ODI) and back and leg pain (Brief Pain Inventory) were assessed preoperatively and at 12 months after surgery. RESULTS: Physical performance tests and PROMs significantly improved over 12 months following lumbar spine surgery (P < 0.01). Weak correlations were found between physical performance tests and disability and pain (ρ = 0.15 to 0.32, P < 0.05). Multivariable regression analyses controlling for age, education, preoperative outcome score, fusion, previous spine surgery, depressive symptoms, and randomization group found that preoperative 5-Chair Stand test was significantly associated with disability and back pain at 12-month follow-up. Each additional 10 seconds needed to complete the 5-Chair Stand test were associated with six-point increase in ODI (P = 0.047) and one-point increase in back pain (P = 0.028) scores. The physical performance tests identified an additional 14% to 19% of patients as achieving clinical improvement that were not captured by disability or pain questionnaires. CONCLUSION: Results indicate that physical performance tests may provide distinct information in both predicting and assessing clinical outcomes in patients undergoing lumbar spine surgery. Our findings suggest that the 5-Chair Stand test may be a useful test to include within a comprehensive risk assessment before surgery and as an outcome measure at long-term follow-up. LEVEL OF EVIDENCE: 3.

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Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

December 1, 2020

Volume

45

Issue

23

Start / End Page

E1556 / E1563

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surveys and Questionnaires
  • Physical Therapy Modalities
  • Physical Functional Performance
  • Patient Reported Outcome Measures
  • Pain Measurement
  • Outcome Assessment, Health Care
  • Orthopedics
  • Neurosurgical Procedures
  • Middle Aged
 

Citation

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Chicago
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Master, H., Pennings, J. S., Coronado, R. A., Henry, A. L., O’Brien, M. T., Haug, C. M., … Archer, K. R. (2020). Physical Performance Tests Provide Distinct Information in Both Predicting and Assessing Patient-Reported Outcomes Following Lumbar Spine Surgery. Spine (Phila Pa 1976), 45(23), E1556–E1563. https://doi.org/10.1097/BRS.0000000000003665
Master, Hiral, Jacquelyn S. Pennings, Rogelio A. Coronado, Abigail L. Henry, Michael T. O’Brien, Christine M. Haug, Richard L. Skolasky, et al. “Physical Performance Tests Provide Distinct Information in Both Predicting and Assessing Patient-Reported Outcomes Following Lumbar Spine Surgery.Spine (Phila Pa 1976) 45, no. 23 (December 1, 2020): E1556–63. https://doi.org/10.1097/BRS.0000000000003665.
Master H, Pennings JS, Coronado RA, Henry AL, O’Brien MT, Haug CM, et al. Physical Performance Tests Provide Distinct Information in Both Predicting and Assessing Patient-Reported Outcomes Following Lumbar Spine Surgery. Spine (Phila Pa 1976). 2020 Dec 1;45(23):E1556–63.
Master, Hiral, et al. “Physical Performance Tests Provide Distinct Information in Both Predicting and Assessing Patient-Reported Outcomes Following Lumbar Spine Surgery.Spine (Phila Pa 1976), vol. 45, no. 23, Dec. 2020, pp. E1556–63. Pubmed, doi:10.1097/BRS.0000000000003665.
Master H, Pennings JS, Coronado RA, Henry AL, O’Brien MT, Haug CM, Skolasky RL, Riley LH, Neuman BJ, Cheng JS, Aaronson OS, Devin CJ, Wegener ST, Archer KR. Physical Performance Tests Provide Distinct Information in Both Predicting and Assessing Patient-Reported Outcomes Following Lumbar Spine Surgery. Spine (Phila Pa 1976). 2020 Dec 1;45(23):E1556–E1563.

Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

December 1, 2020

Volume

45

Issue

23

Start / End Page

E1556 / E1563

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surveys and Questionnaires
  • Physical Therapy Modalities
  • Physical Functional Performance
  • Patient Reported Outcome Measures
  • Pain Measurement
  • Outcome Assessment, Health Care
  • Orthopedics
  • Neurosurgical Procedures
  • Middle Aged