#240 Using Outcome Measures to Indicate Motion in the Lumbar Spine
Lumbar Therapies and Outcomes
Poster Presented by: F. Ruiz
F.K. Ruiz (1)
D.D. Bohl (1)
M.L. Webb (1)
J.N. Grauer (1)
(1) Yale University School of Medicine, Orthopaedics and Rehabilitation, New Haven, CT, USA
Lumbar pathology is often associated with axial pain or neurologic complaints. It is often presumed that such pain is associated with decreased lumbar motion, however this correlation is not well established. The utility of various outcome measures that are used in both research and clinical practice have been studied, but the connection with range of motion has not been well documented.
The current study was performed to objectively assess the postulated correlation of lumbar complaints (based on standardized outcome measures) with extremes of lumbar range of motion (ROM) and functional range of motion with activities of daily living (fROM) as assessed with an electrogoniometer.
Subjects slated to undergo a lumbar intervention (injection, decompression, and/or fusion) were voluntarily enrolled in the study. Pain and disability scores were assessed with Visual Analog Scale (VAS) for axial, lower extremity, and combined axial and lower extremity and the Oswestry-Disability Index (ODI). A previously validated electrogoniometer was used to measure ROM (extremes of motion in three planes) and fROM (functional motion during 15 simulated activities of daily living). Pain and disability scores were analyzed for correlation with the motion assessments using linear regression analyses.
28 males and 42 females were enrolled with an average age of 56.8 years (range 18-90). ODI and VAS were correlated (p< 0.001). Combined axial and lower extremity VAS correlated with lateral and rotational ROM (p< 0.05), but not flexion/extension or any fROM. Similar findings were noted for separately analyzed axial and lower extremity VAS. On the other hand, ODI was correlated with decrease ROM in all planes and fROM in the planes of greatest motion for 9 of 15 ADLs in at least one direction (p< 0.05).
Extremes of lumbar motion and motions associated with activity of daily living are of growing clinical interest. Even though ODI and VAS correlate with one another, ODI appears to be a better predictor of these motion parameters than VAS (axial, lower extremity, or combined) and may be more useful in the clinical setting when considering functional movement parameters.