External Validation of the Timed Up and Go Test as Measure of Objective Functional Impairment in Patients With Lumbar Degenerative Disc Disease

Neurosurgery ◽  
2021 ◽  
Vol 89 (Supplement_2) ◽  
pp. S96-S96
Author(s):  
Martin N Stienen ◽  
Nicolai Maldaner ◽  
Marketa Sosnova ◽  
Anna M Zeitlberger ◽  
Michal Ziga ◽  
...  
Keyword(s):  
Functional Impairment ◽  
Degenerative Disc Disease ◽  
External Validation ◽  
Disc Disease ◽  
Timed Up And Go ◽  
Lumbar Degenerative Disc Disease ◽  
Degenerative Disc ◽  
Objective Functional Impairment ◽  
Objective Functional

External Validation of the Timed Up and Go Test as Measure of Objective Functional Impairment in Patients With Lumbar Degenerative Disc Disease

Neurosurgery ◽  
2020 ◽  
Author(s):  
Martin N Stienen ◽  
Nicolai Maldaner ◽  
Marketa Sosnova ◽  
Anna M Zeitlberger ◽  
Michal Ziga ◽  
...  
Keyword(s):  
Functional Impairment ◽  
Degenerative Disc Disease ◽  
External Validation ◽  
Test Time ◽  
Test Results ◽  
Disc Disease ◽  
Timed Up And Go ◽  
Lumbar Degenerative Disc Disease ◽  
Objective Functional Impairment ◽  
Objective Functional

Abstract BACKGROUND The Timed Up and Go (TUG) test is the most commonly applied objective measure of functional impairment in patients with lumbar degenerative disc disease (DDD). OBJECTIVE To demonstrate external content validity of the TUG test. METHODS Consecutive adult patients, scheduled for elective lumbar spine surgery, were screened for enrollment into a prospective observational study. Disease severity was estimated by patient-reported outcome measures (PROMs; Visual Analog Scales [VAS], Core Outcome Measures Index [COMI] back, Zurich Claudication Questionnaire [ZCQ]) and the TUG test. Pearson correlation coefficients (PCCs) were used to describe the relationship between logarithmic TUG test raw values and PROMs RESULTS A total of 70 patients (mean age 55.9 ± 15.4 yr; 38.6% female; 27.1% previous spine surgery; 28.6% lower extremity motor deficits) with lumbar disc herniation (50%), lumbar spinal stenosis (34.3%), or instability requiring spinal fusion (15.7%) were included. The mean TUG test time was 10.8 ± 4.4 s; age- and sex-adjusted objective functional impairment (OFI) T-score was 134.2 ± 36.9. A total of 12 (17.1%) patients had mild, 14 (20%) moderate, and 9 (12.9%) severe OFI, while 35 (50%) had TUG test results within the normal population range (no OFI). PCCs between TUG test time and VAS back pain were r = 0.37 (P = .002), VAS leg pain r = 0.37 (P = .002), COMI back r = 0.50 (P < .001), ZCQ symptom severity r = 0.41 (P < .001), and ZCQ physical function r = 0.36 (P = .002). CONCLUSION This external validation demonstrated similar OFI rates and PCCs between logarithmic TUG test results and PROMs compared to the original article from 2016. These findings support the TUG test being a quick, easy-to-use objective test, which provides the physician with a robust estimate of pain and functional impairment.

Validity and Reliability of a Measurement of Objective Functional Impairment in Lumbar Degenerative Disc Disease

Neurosurgery ◽  
2015 ◽  
Vol 79 (2) ◽  
pp. 270-278 ◽  
Author(s):  
Oliver P. Gautschi ◽  
Nicolas R. Smoll ◽  
Marco V. Corniola ◽  
Holger Joswig ◽  
Ivan Chau ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Functional Impairment ◽  
Degenerative Disc Disease ◽  
Short Form ◽  
Intraclass Correlation ◽  
Disc Disease ◽  
Lumbar Degenerative Disc Disease ◽  
Degenerative Disc ◽  
Objective Functional Impairment ◽  
Objective Functional

Abstract BACKGROUND: There are few objective measures of functional impairment to support clinical decision making in lumbar degenerative disc disease (DDD). OBJECTIVE: We present the validation (and reliability measures) of the Timed Up and Go (TUG) test. METHODS: In a prospective, 2-center study, 253 consecutive patients were assessed using the TUG test. A representative cohort of 110 volunteers served as control subjects. The TUG test values were assessed for validity and reliability. RESULTS: The TUG test had excellent intra- (intraclass correlation coefficient: 0.97) and interrater reliability (intraclass correlation coefficient: 0.99), with a standard error of measurement of 0.21 and 0.23 seconds, respectively. The validity of the TUG test was demonstrated by a good correlation with the Visual Analog Scale (VAS) back (Pearson's correlation coefficient [PCC]: 0.25) and VAS (PCC: 0.29) leg pain, functional impairment (Roland-Morris Disability Index [PCC: 0.38] and Oswestry Disability Index [PCC: 0.34]), as well as with health-related quality of life (Short Form-12 Mental Component Summary score [PCC: −0.25], Short Form-12 Physical Component Summary score [PCC: −0.32], and EQ-5D [PCC: −0.28]). The upper limit of “normal” was 11.52 seconds. Mild (lower than the 33rd percentile), moderate (33rd to 66th percentiles), and severe objective functional impairment (higher than the 66th percentile) as determined by the TUG test was <13.4 seconds, 13.4 to 18.4 seconds, and >18.4 seconds, respectively. CONCLUSION: The TUG test is a quick, easy-to-use, valid, and reliable tool to evaluate objective functional impairment in patients with lumbar degenerative disc disease. In the clinical setting, patients scoring a TUG test time of over 12 seconds can be considered to have functional impairment.

scholarly journals Validation of the baseline severity stratification of objective functional impairment in lumbar degenerative disc disease

2017 ◽  
Vol 26 (5) ◽  
pp. 598-604 ◽  
Author(s):  
Martin N. Stienen ◽  
Nicolas R. Smoll ◽  
Holger Joswig ◽  
Marco V. Corniola ◽  
Karl Schaller ◽  
...  
Keyword(s):  
Functional Impairment ◽  
Degenerative Disc Disease ◽  
Leg Pain ◽  
Disc Disease ◽  
Lumbar Degenerative Disc Disease ◽  
Degenerative Disc ◽  
Baseline Severity ◽  
Vas Score ◽  
Objective Functional Impairment ◽  
Objective Functional

OBJECTIVEThe Timed Up and Go (TUG) test is a simple, objective, and standardized method to measure objective functional impairment (OFI) in patients with lumbar degenerative disc disease (DDD). The objective of the current work was to validate the OFI baseline severity stratification (BSS; with levels of “none,” “mild,” “moderate,” and “severe”).METHODSData were collected in a prospective IRB-approved 2-center study. Patients were assessed with a comprehensive panel of scales for measuring pain (visual analog scale [VAS] for back and leg pain), functional impairment (Roland-Morris Disability Index [RMDI] and Oswestry Disability Index [ODI]), and health-related quality of life (HRQOL; EQ-5D and SF-12). OFI BSS was determined using age- and sex-adjusted cutoff values.RESULTSA total of 375 consecutive patients scheduled for lumbar spine surgery were included. Each 1-step increase on the OFI BSS corresponded to an increase of 0.53 in the back pain VAS score, 0.69 in the leg pain VAS score, 1.81 points in the RMDI, and 5.93 points in the ODI, as well as to a decrease in HRQOL of −0.073 in the EQ-5D, −1.99 in the SF-12 physical component summary (PCS), and −1.62 in the SF-12 mental component summary (MCS; all p < 0.001). Patients with mild, moderate, and severe OFI had increased leg pain by 0.90 (p = 0.044), 1.54 (p < 0.001), and 1.94 (p < 0.001); increased ODI by 7.99 (p = 0.004), 12.64 (p < 0.001), and 17.13 (p < 0.001); and decreased SF-12 PCS by −2.57 (p = 0.049), −3.63 (p = 0.003), and −6.23 (p < 0.001), respectively.CONCLUSIONSThe OFI BSS is a valid measure of functional impairment for use in daily clinical practice. The presence of OFI indicates the presence of significant functional impairment on subjective outcome measures.

Evaluation of the 6-minute walking test as a smartphone app-based self-measurement of objective functional impairment in patients with lumbar degenerative disc disease

2020 ◽  
Vol 33 (6) ◽  
pp. 779-788 ◽  
Author(s):  
Nicolai Maldaner ◽  
Marketa Sosnova ◽  
Anna M. Zeitlberger ◽  
Michal Ziga ◽  
Oliver P. Gautschi ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Functional Impairment ◽  
Degenerative Disc Disease ◽  
Smartphone App ◽  
Disc Disease ◽  
Lumbar Degenerative Disc Disease ◽  
Walking Test ◽  
Z Scores ◽  
Objective Functional Impairment ◽  
Objective Functional

OBJECTIVEDigital transformation enables new possibilities to assess objective functional impairment (OFI) in patients with lumbar degenerative disc disease (DDD). This study examines the psychometric properties of an app-based 6-minute walking test (6WT) and determines OFI in patients with lumbar DDD.METHODSThe maximum 6-minute walking distance (6WD) was determined in patients with lumbar DDD. The results were expressed as raw 6WDs (in meters), as well as in standardized z-scores referenced to age- and sex-specific values of spine-healthy volunteers. The 6WT results were assessed for reliability and content validity using established disease-specific patient-reported outcome measures.RESULTSSeventy consecutive patients and 330 volunteers were enrolled. The mean 6WD was 370 m (SD 137 m) in patients with lumbar DDD. Significant correlations between 6WD and the Core Outcome Measures Index for the back (r = −0.31), Zurich Claudication Questionnaire (ZCQ) symptom severity (r = −0.32), ZCQ physical function (r = −0.33), visual analog scale (VAS) for back pain (r = −0.42), and VAS for leg pain (r = −0.32) were observed (all p < 0.05). The 6WT revealed good test-retest reliability (intraclass correlation coefficient 0.82), and the standard error of measurement was 58.3 m. A 4-tier severity stratification classified patients with z-scores > −1 (no OFI), −1 to −1.9 (mild OFI), −2 to −2.9 (moderate OFI), and ≤ −3 (severe OFI).CONCLUSIONSThe smartphone app-based self-measurement of the 6WT is a convenient, reliable, and valid way to determine OFI in patients with lumbar DDD. The 6WT app facilitates the digital evaluation and monitoring of patients with lumbar DDD.

The timed up and go test for lumbar degenerative disc disease

2015 ◽  
Vol 22 (12) ◽  
pp. 1943-1948 ◽  
Author(s):  
Oliver P. Gautschi ◽  
Marco V. Corniola ◽  
Holger Joswig ◽  
Nicolas R. Smoll ◽  
Ivan Chau ◽  
...  
Keyword(s):  
Degenerative Disc Disease ◽  
Disc Disease ◽  
Timed Up And Go ◽  
Lumbar Degenerative Disc Disease ◽  
Degenerative Disc
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