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01-10-2016 | Clinical Article - Spine

Pre- and postoperative correlation of patient-reported outcome measures with standardized Timed Up and Go (TUG) test results in lumbar degenerative disc disease

Authors: Oliver P. Gautschi, Holger Joswig, Marco V. Corniola, Nicolas R. Smoll, Karl Schaller, Gerhard Hildebrandt, Martin N. Stienen

Published in: Acta Neurochirurgica | Issue 10/2016

Abstract

Background

The Timed Up and Go (TUG) test is a reliable tool for evaluating objective functional impairment (OFI) in patients with degenerative disc disease before a surgical intervention. The aim of this study is to assess the validity of the TUG test to measure change in function postoperatively.

Methods

In a prospective two-center study, OFI was assessed by the TUG test in patients scheduled for lumbar spine surgery, as well as 3 days (D3) and 6 weeks (W6) postoperatively. At each time point, the TUG test results were correlated with established subjective measures of pain intensity (visual analogue scale (VAS) for back and leg pain), functional impairment (Oswestry Disability Index (ODI)) and health-related quality of life (HRQoL; Short Form-12 (SF12)).

Results

The patient cohort comprised 136 patients with a mean age of 57.7 years; 76 were males, 54 had a microdiscectomy for lumbar disc herniation, 58 a decompression for a lumbar spinal stenosis, 24 had a surgical fusion procedure. The mean OFI t-score was 125.1 before surgery, and as patients improved on the subjective measures in the postoperative interval, the OFI t-score likewise decreased to 118.8 (D3) and 103.4 (W6). The Pearson correlation coefficient (PCC) between the OFI t-score and VAS leg pain was 0.187 preoperatively (p = 0.029) and 0.252 at W6 (p = 0.003). The PCC between OFI t-score and the ODI was 0.324 preoperatively (p < 0.001) and 0.413 at W6 (p < 0.001). The PCC between OFI t-score and physical HRQoL (SF12) was −0.091 preoperatively (p = 0.293) and −0.330 at W6 (p < 0.001).

Conclusions

The TUG test is sensitive to change, and reflects the postoperative functional outcome even more exact than preoperatively, as indicated by better correlation coefficients of the OFI t-score with subjective measures of pain intensity, functional impairment and HRQoL.

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Chiarotto A, Deyo RA, Terwee CB, Boers M, Buchbinder R, Corbin TP, Costa LO, Foster NE, Grotle M, Koes BW, Kovacs FM, Lin CW, Maher CG, Pearson AM, Peul WC, Schoene ML, Turk DC, van Tulder MW, Ostelo RW (2015) Core outcome domains for clinical trials in non-specific low back pain. Eur Spine J 24:1127–1142CrossRefPubMed

Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY (2008) Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. Spine J 8:968–974CrossRefPubMed

DeVine J, Norvell DC, Ecker E, Fourney DR, Vaccaro A, Wang J, Andersson G (2011) Evaluating the correlation and responsiveness of patient-reported pain with function and quality-of-life outcomes after spine surgery. Spine 36:S69–74CrossRefPubMed

Deyo RA, Battie M, Beurskens AJ, Bombardier C, Croft P, Koes B, Malmivaara A, Roland M, Von Korff M, Waddell G (1998) Outcome measures for low back pain research. A proposal for standardized use. Spine 23:2003–2013CrossRefPubMed

Gautschi OP, Corniola MV, Schaller K, Smoll NR, Stienen MN (2014) The need for an objective outcome measurement in spine surgery—the timed-up-and-go test. Spine J 14:2521–2522CrossRefPubMed

Gautschi OP, Corniola MV, Joswig H, Smoll NR, Chau I, Jucker D, Stienen MN (2015) The Timed Up and Go test for lumbar degenerative disc disease. J Clin Neurosci 22:1943–1948

Gautschi OP, Smoll NR, Corniola MV, Joswig H, Chau I, Hildebrandt G, Schaller K, Stienen MN (2016) Validity and reliability of a measurement of objective functional impairment in lumbar degenerative disc disease: the Timed Up and Go (TUG) test. Neurosurgery 79:270–278

Gautschi OP, Corniola MV, Smoll NR, Joswig H, Schaller K, Hildebrandt G, Stienen MN (2016) Sex differences in subjective and objective measures of pain, functional impairment and health-related quality of life in patients with lumbar degenerative disc disease. Pain 157:1065–1071

Gautschi OP, Stienen MN, Corniola MV, Joswig H, Schaller K, Hildebrandt G, Smoll NR (2016) Assessment of the minimum clinically important difference in the Timed Up and Go (TUG) test after surgery for lumbar degenerative disc disease. Neurosurgery. doi:10.1227/NEU.0000000000001320

10.

Hakkinen A, Kautiainen H, Jarvenpaa S, Arkela-Kautiainen M, Ylinen J (2007) Changes in the total Oswestry Index and its ten items in females and males pre- and post-surgery for lumbar disc herniation: a 1-year follow-up. Eur Spine J 16:347–352CrossRefPubMed

11.

Jaeschke R, Singer J, Guyatt GH (1989) Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials 10:407–415CrossRefPubMed

12.

Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, Bouter LM, de Vet HC (2008) Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine 33:90–94CrossRefPubMed

13.

Parker SL, Godil SS, Shau DN, Mendenhall SK, McGirt MJ (2013) Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article. J Neurosurg Spine 18:154–160CrossRefPubMed

14.

Stratford PW, Binkley JM, Riddle DL, Guyatt GH (1998) Sensitivity to change of the Roland–Morris back pain questionnaire: part 1. Phys Ther 78:1186–1196PubMed

Title: Pre- and postoperative correlation of patient-reported outcome measures with standardized Timed Up and Go (TUG) test results in lumbar degenerative disc disease
Authors: Oliver P. Gautschi
Holger Joswig
Marco V. Corniola
Nicolas R. Smoll
Karl Schaller
Gerhard Hildebrandt
Martin N. Stienen
Publication date: 01-10-2016
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 10/2016
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-016-2899-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Pre- and postoperative correlation of patient-reported outcome measures with standardized Timed Up and Go (TUG) test results in lumbar degenerative disc disease

Abstract

Background

Methods

Results

Conclusions

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Springer Medicine

Abstract

Background

Methods

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