The Association of Neuromuscular Attributes with Performance-based Mobility among Community-dwelling Older Adults with Symptomatic Lumbar Spinal Stenosis

Publication date: Available online 2 April 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Catherine T. Schmidt, Rachel E. Ward, Pradeep Suri, Dan K. Kiely, Ni Pensheng, Dennis E. Anderson, Jonathan F. Bean
ObjectiveTo identify differences in health factors, neuromuscular attributes and performance-based mobility among community-dwelling older adults with symptomatic lumbar spinal stenosis (SLSS); and to determine which neuromuscular attributes are associated with performance-based measures of mobility. We hypothesized that: (1) community-dwelling older adults with SLSS would have poorer health, greater neuromuscular impairment and worse mobility; and (2) greater impairment in trunk extensor muscle endurance, leg strength, leg speed and knee flexion range of motion (ROM) would be associated with performance-based mobility. Design: Cross-sectional; secondary data analysis of a cohort studySettingoutpatient rehabilitation centerParticipantsCommunity-dwelling adults > 65 years with self-reported mobility limitations and SLSSInterventionsN/AMain Outcome MeasuresShort Physical Performance Battery Score, Habitual Gait Speed, and Chair Stand TestResultsSLSS was classified using self-reported symptoms of neurogenic claudication and imaging. Among 430 community-dwelling older adults 54(13%) met criteria for SLSS. Compared to participants without SLSS, those with SLSS had more comorbidities, higher BMI, greater pain and less balance confidence. Participants with SLSS had greater impairment in trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion range of motion (ROM), knee extension ROM, and ankle ROM compared to participants without SLSS. Five neuromuscular attributes were associated with performance-based mobility among participants with SLSS: trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry.ConclusionsCommunity-dwelling older adults with self-reported mobility limitations with SLSS exhibit poorer health characteristics, greater neuromuscular impairment and worse mobility when compared to those without SLSS. Poorer trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry were associated with performance-based mobility among participants with SLSS.



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