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Objective measures of outcome and functional impairment for degenerative diseases of the lumbar spine - systematic review of the literature
EANS Academy. Stienen M. 09/26/19; 275920; EP02058
Dr. Martin Stienen
Dr. Martin Stienen

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Abstract
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Background: Subjective patient-reported outcome measure (PROM)-based assessments have limitations and can be complimented by objective measures of function. We aimed to provide an overview on the available objective measures of function for patients with degenerative diseases of the lumbar spine.
Methods: We conducted a systematic review of the literaturesearching PubMed, Web of Science, EMBASE and SCOPUS databases. We included articles on human subjects with degenerative diseases of the lumbar spine that reported on objective measures of function.
Results: Of 2389 identified articles, 82 were included in the final analysis. There was a significant increase of 0.12 per year in the number of publications dealing with objective measures of function since 1989 (95% CI 0.08-0.16, p< 0.001). Our search revealed 21 different types of objective measures, predominantly applied to patients with lumbar spinal stenosis (n=67; 81.7%), chronic/unspecific low back pain (n=28; 34.2%) and lumbar disc herniation (n=22; 26.8%). The Timed-Up-and-Go (TUG) test was the most frequently applied measure (n=26 publications; 31.7%; cumulative number of reported subjects: 5181), followed by Motorized Treadmill Tests (MTT; n=25 publications; 30.5%, 1499 subjects) and with each n=9 publications (11.0%) the Five-Repetition Sit-To-Stand test (5R-STS; 955 subjects), as well as accelometry analyses (336 subjects). The reliability and validity of many of the less-applied objective measures was uncertain. There was profound heterogeneity in their application and interpretation of results.
Conclusions: Clinical studies on patients with lumbar degenerative diseases increasingly employ objective measures of function, which offer high potential for improving the quality of outcome measurement in patient-care and research. This review provides an overview on available options. Our findings call for an agreement and standardization in terms of test selection, conduction and analysis to facilitate comparison of results across cohorts.
Background: Subjective patient-reported outcome measure (PROM)-based assessments have limitations and can be complimented by objective measures of function. We aimed to provide an overview on the available objective measures of function for patients with degenerative diseases of the lumbar spine.
Methods: We conducted a systematic review of the literaturesearching PubMed, Web of Science, EMBASE and SCOPUS databases. We included articles on human subjects with degenerative diseases of the lumbar spine that reported on objective measures of function.
Results: Of 2389 identified articles, 82 were included in the final analysis. There was a significant increase of 0.12 per year in the number of publications dealing with objective measures of function since 1989 (95% CI 0.08-0.16, p< 0.001). Our search revealed 21 different types of objective measures, predominantly applied to patients with lumbar spinal stenosis (n=67; 81.7%), chronic/unspecific low back pain (n=28; 34.2%) and lumbar disc herniation (n=22; 26.8%). The Timed-Up-and-Go (TUG) test was the most frequently applied measure (n=26 publications; 31.7%; cumulative number of reported subjects: 5181), followed by Motorized Treadmill Tests (MTT; n=25 publications; 30.5%, 1499 subjects) and with each n=9 publications (11.0%) the Five-Repetition Sit-To-Stand test (5R-STS; 955 subjects), as well as accelometry analyses (336 subjects). The reliability and validity of many of the less-applied objective measures was uncertain. There was profound heterogeneity in their application and interpretation of results.
Conclusions: Clinical studies on patients with lumbar degenerative diseases increasingly employ objective measures of function, which offer high potential for improving the quality of outcome measurement in patient-care and research. This review provides an overview on available options. Our findings call for an agreement and standardization in terms of test selection, conduction and analysis to facilitate comparison of results across cohorts.
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