The relationship between objective and subjective evaluation criteria in lumbar spinal stenosis

Objectives: We evaluated the relationship between function¬al objective and patient-based subjective assessments and quality of life in patients with lumbar spinal stenosis (LSS). Methods: Thirty patients (25 females, 5 males; mean age 62+9 years; range 41-78 years) were prospectively studied. All were diagnosed as having LSS by clinical and radiologi¬cal evaluations. Pain was assessed by a visual analog scale. The patients were evaluated by two-staged treadmill exercise tolerance (TET) test, SF-36 health status survey, and Oswestry Disability Index (ODI). The relationships between the TET test, which is an objective functional assessment, and patient-based assessments (SF-36 and ODI), pain and age were investigated. R e su l t s : There were significant differences between the func¬tional grades of the patients at the speed of 1.9 km/hour with respect to ODI scores, the physical component scale of SF-36, age, and the preferred speed of the patients (p<0.05). These dif¬ferences emerged from the fourth functional stage (p<0.01). Oswestry disability scores and the physical component scores of SF-36 worsened in parallel with the stages of the TET test. The preferred speed of the patients at the TET test was positively correlated with the physical component scores of SF-36 and negatively correlated with Oswestry disability scores (p<0.05). There was a negative correlation between the physical compo¬nent scores of SF-36 and Oswestry disability scores (p<0.05). Conclusion: The TET test used to determine the functional capacity seems to be correlated well with subjective patient- based assessments. This objective tool, when combined with subjective assessments, may be helpful in the evaluation and treatment of patients with LSS.