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Lumbar spinal stenosis associated with progression of locomotive syndrome and lower extremity muscle weakness

Authors Kasukawa Y, Miyakoshi N, Hongo M, Ishikawa Y, Kudo D, Kijima H, Kimura R, Ono Y, Takahashi Y, Shimada Y

Received 17 January 2019

Accepted for publication 13 June 2019

Published 5 August 2019 Volume 2019:14 Pages 1399—1405

DOI https://doi.org/10.2147/CIA.S201974

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Bik-Wai Bilvick Tai

Peer reviewer comments 2

Editor who approved publication: Dr Richard Walker


Yuji Kasukawa, Naohisa Miyakoshi, Michio Hongo, Yoshinori Ishikawa, Daisuke Kudo, Hiroaki Kijima, Ryota Kimura, Yuichi Ono, Yasuhiro Takahashi, Yoichi Shimada

Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan

Purpose: The purpose of this study was to evaluate the association between the early stages of lumbar spinal stenosis (LSS) and the risk of locomotive syndrome, as well as its effect upon muscle strength of the back, upper extremities, and lower extremities.
Patients and methods: LSS was diagnosed with a self-administered, self-reported history questionnaire. Participants (n=113) who agreed to be tested by the diagnostic support tool for LSS underwent three risk tests for locomotive syndrome: a stand-up test, a two-step test, and a 25-question Geriatric Locomotive Function Scale (GLFS-25), as well as measurements of the strength of their grip, back extensor, hip flexor, and knee extensor muscles.
Results: Twenty-three participants were diagnosed with LSS by the questionnaire. Results of the stand-up test in the LSS group were significantly worse than those in the no-LSS group (P=0.003). The results of the two-step test and the total score on the GLFS-25 in the LSS group were significantly worse than those in the no-LSS group (P=0.002 and P<0.0001, respectively). The stages of locomotive syndrome assessed by the stand-up test, two-step test, and the GLFS-25 were significantly worse in the LSS group than in the no-LSS group (P=0.0004, P=0.0007, and P<0.0001, respectively). Hip flexor and knee extensor strength, but not grip and back extensor strength, in the LSS group were significantly lower than that in the no-LSS group.
Conclusions: LSS diagnosed using the self-reported support tool worsened the stage of locomotive syndrome in older people. Furthermore, participants with LSS had significant lower extremity weakness.

Keywords: lumbar spinal stenosis, locomotive syndrome, locomotive syndrome risk test, grip strength, back extensor strength, lower extremity muscle strength

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