Hand grip strength can predict clinical outcomes and risk of falls after decompression and instrumented posterolateral fusion for lumbar spinal stenosis.

Autor: Kwon JW; Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, South Korea; Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang, South Korea., Lee BH; Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, South Korea., Lee SB; Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, South Korea., Sung S; Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, South Korea., Lee CU; Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, South Korea., Yang JH; Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, South Korea., Park MS; Department of Orthopedic Surgery, Hallym University College of Medicine, Gyeonggi-do, South Korea., Byun J; Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, South Korea., Lee HM; Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, South Korea., Moon SH; Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: SHMOON@yuhs.ac.
Jazyk: angličtina
Zdroj: The spine journal : official journal of the North American Spine Society [Spine J] 2020 Dec; Vol. 20 (12), pp. 1960-1967. Date of Electronic Publication: 2020 Jul 02.
DOI: 10.1016/j.spinee.2020.06.022
Abstrakt: Background Context: There has been limited research on the association between hand grip strength (HGS) as one of the diagnostic criteria for sarcopenia and surgical outcomes of lumbar spinal stenosis (LSS).
Purpose: We aimed to determine the effect of HGS on surgical outcomes and risk of fall in patients with LSS.
Study Design: This is a retrospective observational study.
Patient Sample: We included 200 patients who underwent spinal surgery for LSS.
Outcome Measures: We recorded clinical outcome parameters, including Oswestry Disability Index (ODI), Euro-QOL (EQ-5D), and visual analog scale (VAS) scores for back or leg pain. To assess the risk of fall we used HGS and four functional mobility tests (alternative step test, six-meter walk test, timed up and go test, sit-to-stand test).
Materials and Methods: ODI, EQ-5D, and VAS scores for back and leg pain were assessed preoperatively and 1 year after surgery. The four functional mobility tests were assessed at each time point during the 1-year follow-up period to assess the risk of fall in patients with LSS. We divided the patient cohort according to sex and allocated them into two different groups based on HGS: high HGS (≥26 kg for men, n=26; ≥18 kg for women, n=35), and low HGS (<26 kg for men, n=48; <18 kg for women, n=91). The pre- and postoperative ODI, EQ-5D, and VAS scores for back and leg pain, as well as the functional mobility test results, and demographic data were compared between the two groups using independent t tests. Correlations between HGS and clinical outcome parameters were analyzed using Pearson correlation.
Results: In women and men, HGS correlated with the preoperative/postoperative ODI (r 1 =-0.217/r 2 =-0.345 in women, and r 1 =-0.384/r 2 =-0.411 in men) and EQ-5D scores (r 1 =0.190/r 2 =0.309 in women, and r 1 =0.373/r 2 =0.467 in men). HGS also correlated with the four postoperative results for the functional mobility tests: alternative step test (r=-0.238 in women, r=-0.431 in men), six-meter walk test (r=-0.232 in women, r=-0.282 in men), timed up and go test (r=-0.285 in women, r=-0.359 in men), and sit-to-stand test (r=-0.238 in women, r=-0.251 in men). The preoperative and postoperative ODI and EQ-5D scores in the high HGS group were superior to those in the low HGS group. Among the four functional mobility tests, preoperative and postoperative six-meter walk test results showed improvements in the high HGS group.
Conclusions: Considering the multifactorial nature of falls, HGS may be a useful surrogate marker for predicting the risk of falls and clinical outcomes in patients with LSS.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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