Catherine T Schmidt1, Rachel E Ward2, Pradeep Suri3, Dan K Kiely4, Pengsheng Ni5, Dennis E Anderson6, Jonathan F Bean7. 1. Center for Interprofessional Studies and Innovation, Massachusetts General Hospital Institute of Health Professions, Boston, MA. Electronic address: cschmidt@mghihp.edu. 2. New England Geriatric Research Education and Clinical Center, Veterans Administration Boston Healthcare System, Boston, MA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA. 3. Division of Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, WA; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA. 4. Spaulding Rehabilitation Hospital, Cambridge, MA. 5. Health and Disability Research Institute, Boston University, Boston, MA. 6. Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA; Department of Orthopedic Surgery, Harvard Medical School, Boston, MA. 7. New England Geriatric Research Education and Clinical Center, Veterans Administration Boston Healthcare System, Boston, MA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA; Spaulding Rehabilitation Hospital, Cambridge, MA.
Abstract
OBJECTIVES: To identify differences in health factors, neuromuscular attributes, and performance-based mobility among community-dwelling older adults with symptomatic lumbar spinal stenosis; and to determine which neuromuscular attributes are associated with performance-based measures of mobility. DESIGN: Cross-sectional; secondary data analysis of a cohort study. SETTING: Outpatient rehabilitation center. PARTICIPANTS: Community-dwelling adults aged ≥65 years with self-reported mobility limitations and symptomatic lumbar spinal stenosis (N=54). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Short Physical Performance Battery score, habitual gait speed, and chair stand test. RESULTS: Symptomatic lumbar spinal stenosis was classified using self-reported symptoms of neurogenic claudication and imaging. Among 430 community-dwelling older adults, 54 (13%) met criteria for symptomatic lumbar spinal stenosis. Compared with participants without symptomatic lumbar spinal stenosis, those with symptomatic lumbar spinal stenosis had more comorbidities, higher body mass index, greater pain, and less balance confidence. Participants with symptomatic lumbar spinal stenosis had greater impairment in trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion range of motion (ROM), knee extension ROM, and ankle ROM compared with participants without symptomatic lumbar spinal stenosis. Five neuromuscular attributes were associated with performance-based mobility among participants with symptomatic lumbar spinal stenosis: trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry. CONCLUSIONS: Community-dwelling older adults with self-reported mobility limitations and symptomatic lumbar spinal stenosis exhibit poorer health characteristics, greater neuromuscular impairment, and worse mobility when compared with those without symptomatic lumbar spinal stenosis. Poorer trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry were associated with performance-based mobility among participants with symptomatic lumbar spinal stenosis.
OBJECTIVES: To identify differences in health factors, neuromuscular attributes, and performance-based mobility among community-dwelling older adults with symptomatic lumbar spinal stenosis; and to determine which neuromuscular attributes are associated with performance-based measures of mobility. DESIGN: Cross-sectional; secondary data analysis of a cohort study. SETTING:Outpatient rehabilitation center. PARTICIPANTS: Community-dwelling adults aged ≥65 years with self-reported mobility limitations and symptomatic lumbar spinal stenosis (N=54). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Short Physical Performance Battery score, habitual gait speed, and chair stand test. RESULTS: Symptomatic lumbar spinal stenosis was classified using self-reported symptoms of neurogenic claudication and imaging. Among 430 community-dwelling older adults, 54 (13%) met criteria for symptomatic lumbar spinal stenosis. Compared with participants without symptomatic lumbar spinal stenosis, those with symptomatic lumbar spinal stenosis had more comorbidities, higher body mass index, greater pain, and less balance confidence. Participants with symptomatic lumbar spinal stenosis had greater impairment in trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion range of motion (ROM), knee extension ROM, and ankle ROM compared with participants without symptomatic lumbar spinal stenosis. Five neuromuscular attributes were associated with performance-based mobility among participants with symptomatic lumbar spinal stenosis: trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry. CONCLUSIONS: Community-dwelling older adults with self-reported mobility limitations and symptomatic lumbar spinal stenosis exhibit poorer health characteristics, greater neuromuscular impairment, and worse mobility when compared with those without symptomatic lumbar spinal stenosis. Poorer trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry were associated with performance-based mobility among participants with symptomatic lumbar spinal stenosis.
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