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Lower Extremity Motor Deficits Are Underappreciated in Patient-Reported Outcome Measures: Added Value of Objective Outcome Measures
OBJECTIVE: The patient-reported outcome measure (PROM)-based evaluation in lumbar degenerative disc disease (DDD) is today’s gold standard but has limitations. We studied the impact of lower extremity motor deficits (LEMDs) on PROMs and a new objective outcome measure. METHODS: We evaluated patients...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Spinal Neurosurgery Society
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136100/ https://www.ncbi.nlm.nih.gov/pubmed/32054148 http://dx.doi.org/10.14245/ns.1938368.184 |
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author | Stienen, Martin Nikolaus Maldaner, Nicolai Sosnova, Marketa Joswig, Holger Corniola, Marco Vincenzo Regli, Luca Hildebrandt, Gerhard Schaller, Karl Gautschi, Oliver Pascal |
author_facet | Stienen, Martin Nikolaus Maldaner, Nicolai Sosnova, Marketa Joswig, Holger Corniola, Marco Vincenzo Regli, Luca Hildebrandt, Gerhard Schaller, Karl Gautschi, Oliver Pascal |
author_sort | Stienen, Martin Nikolaus |
collection | PubMed |
description | OBJECTIVE: The patient-reported outcome measure (PROM)-based evaluation in lumbar degenerative disc disease (DDD) is today’s gold standard but has limitations. We studied the impact of lower extremity motor deficits (LEMDs) on PROMs and a new objective outcome measure. METHODS: We evaluated patients with lumbar DDD from a prospective 2-center database. LEMDs were graded according to the British Medical Research Council (BMRC; 5 [normal] –0 [no movement]). The PROM-based evaluation included pain (visual analogue scale), disability (Oswestry Disability Index [ODI] & Roland-Morris Disability Index [RMDI]), and health-related quality of life (HRQoL; Short-Form 12 physical component summary/mental component summary & EuroQol-5D index). Objective functional impairment (OFI) was determined as age- and sex-adjusted Timed-Up and Go (TUG) test value. RESULTS: One hundred five of 375 patients (28.0%) had a LEMD. Patients with LEMD had slightly higher disability (ODI: 52.8 vs. 48.2, p = 0.025; RMDI: 12.6 vs. 11.3, p = 0.034) but similar pain and HRQoL scores. OFI T-scores were significantly higher in patients with LEMD (144.2 vs. 124.3, p = 0.006). When comparing patients with high- (BMRC 0–2) vs. low-grade LEMD (BMRC 3–4), no difference was evident for the PROM-based evaluation (all p > 0.05) but patients with high-grade LEMD had markedly higher OFI T-scores (280.9 vs. 136.0, p = 0.001). Patients with LEMD had longer TUG test times and OFI T-scores than matched controls without LEMDs. CONCLUSION: Our data suggest that PROMs fail to sufficiently account for LEMD-associated disability, which is common and oftentimes bothersome to patients. The objective functional evaluation with the TUG test appears to be more sensitive to LEMD-associated disability. An objective functional evaluation of patients with LEMD appears reasonable. |
format | Online Article Text |
id | pubmed-7136100 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Korean Spinal Neurosurgery Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-71361002020-04-09 Lower Extremity Motor Deficits Are Underappreciated in Patient-Reported Outcome Measures: Added Value of Objective Outcome Measures Stienen, Martin Nikolaus Maldaner, Nicolai Sosnova, Marketa Joswig, Holger Corniola, Marco Vincenzo Regli, Luca Hildebrandt, Gerhard Schaller, Karl Gautschi, Oliver Pascal Neurospine Original Article OBJECTIVE: The patient-reported outcome measure (PROM)-based evaluation in lumbar degenerative disc disease (DDD) is today’s gold standard but has limitations. We studied the impact of lower extremity motor deficits (LEMDs) on PROMs and a new objective outcome measure. METHODS: We evaluated patients with lumbar DDD from a prospective 2-center database. LEMDs were graded according to the British Medical Research Council (BMRC; 5 [normal] –0 [no movement]). The PROM-based evaluation included pain (visual analogue scale), disability (Oswestry Disability Index [ODI] & Roland-Morris Disability Index [RMDI]), and health-related quality of life (HRQoL; Short-Form 12 physical component summary/mental component summary & EuroQol-5D index). Objective functional impairment (OFI) was determined as age- and sex-adjusted Timed-Up and Go (TUG) test value. RESULTS: One hundred five of 375 patients (28.0%) had a LEMD. Patients with LEMD had slightly higher disability (ODI: 52.8 vs. 48.2, p = 0.025; RMDI: 12.6 vs. 11.3, p = 0.034) but similar pain and HRQoL scores. OFI T-scores were significantly higher in patients with LEMD (144.2 vs. 124.3, p = 0.006). When comparing patients with high- (BMRC 0–2) vs. low-grade LEMD (BMRC 3–4), no difference was evident for the PROM-based evaluation (all p > 0.05) but patients with high-grade LEMD had markedly higher OFI T-scores (280.9 vs. 136.0, p = 0.001). Patients with LEMD had longer TUG test times and OFI T-scores than matched controls without LEMDs. CONCLUSION: Our data suggest that PROMs fail to sufficiently account for LEMD-associated disability, which is common and oftentimes bothersome to patients. The objective functional evaluation with the TUG test appears to be more sensitive to LEMD-associated disability. An objective functional evaluation of patients with LEMD appears reasonable. Korean Spinal Neurosurgery Society 2020-03 2020-01-26 /pmc/articles/PMC7136100/ /pubmed/32054148 http://dx.doi.org/10.14245/ns.1938368.184 Text en Copyright © 2020 by the Korean Spinal Neurosurgery Society This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Stienen, Martin Nikolaus Maldaner, Nicolai Sosnova, Marketa Joswig, Holger Corniola, Marco Vincenzo Regli, Luca Hildebrandt, Gerhard Schaller, Karl Gautschi, Oliver Pascal Lower Extremity Motor Deficits Are Underappreciated in Patient-Reported Outcome Measures: Added Value of Objective Outcome Measures |
title | Lower Extremity Motor Deficits Are Underappreciated in Patient-Reported Outcome Measures: Added Value of Objective Outcome Measures |
title_full | Lower Extremity Motor Deficits Are Underappreciated in Patient-Reported Outcome Measures: Added Value of Objective Outcome Measures |
title_fullStr | Lower Extremity Motor Deficits Are Underappreciated in Patient-Reported Outcome Measures: Added Value of Objective Outcome Measures |
title_full_unstemmed | Lower Extremity Motor Deficits Are Underappreciated in Patient-Reported Outcome Measures: Added Value of Objective Outcome Measures |
title_short | Lower Extremity Motor Deficits Are Underappreciated in Patient-Reported Outcome Measures: Added Value of Objective Outcome Measures |
title_sort | lower extremity motor deficits are underappreciated in patient-reported outcome measures: added value of objective outcome measures |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136100/ https://www.ncbi.nlm.nih.gov/pubmed/32054148 http://dx.doi.org/10.14245/ns.1938368.184 |
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