Step Count in Patients With Lumbar Spinal Stenosis: Accuracy During Walking and Nonwalking Activities.


Journal

Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646

Informations de publication

Date de publication:
01 09 2022
Historique:
received: 11 01 2022
accepted: 19 04 2022
pubmed: 23 7 2022
medline: 17 8 2022
entrez: 22 7 2022
Statut: ppublish

Résumé

This is a method development and validation study. The purpose of this study was to develop and test a method for step detection using accelerometer data in patients with lumbar spinal stenosis (LSS). There are 2 objectives: (1) to describe a method for step detection from accelerations measured at the wrist, hip, lower back, thigh and ankle; (2) to assess the accuracy of the method during walking with and without walking aids and during nonwalking activities. Loss of walking ability is one of the main symptoms of LSS, and there is no validated measure to assess walking activity in daily living in patients with LSS. Thirty patients with LSS performed a standardized movement protocol that included walking with and without walking aids and performing nonwalking activities while wearing accelerometers on five different wear-sites. After the walking tests, a method was designed for optimal step detection and compared with a gold standard of observed step count. The method for step detection applied to accelerations from the lower back, hip, thigh, and ankle provided an accurate step counts during continuous walking without walking aids. Accuracy diminished at all wear-sites when walking with walking aids, except the ankle. The wrist provided the most inaccurate step count, and the accelerometers on the thigh and ankle were prone to falsely detecting steps during bicycling. The ankle-worn accelerometer provided the most accurate step count, but wrongly registered steps during nonwalking activities. The developed step detection method shows potential as a measure of walking activity why further development and testing under free-living conditions should be performed.

Sections du résumé

STUDY DESIGN
This is a method development and validation study.
OBJECTIVES
The purpose of this study was to develop and test a method for step detection using accelerometer data in patients with lumbar spinal stenosis (LSS). There are 2 objectives: (1) to describe a method for step detection from accelerations measured at the wrist, hip, lower back, thigh and ankle; (2) to assess the accuracy of the method during walking with and without walking aids and during nonwalking activities.
SUMMARY OF BACKGROUND DATA
Loss of walking ability is one of the main symptoms of LSS, and there is no validated measure to assess walking activity in daily living in patients with LSS.
MATERIALS AND METHODS
Thirty patients with LSS performed a standardized movement protocol that included walking with and without walking aids and performing nonwalking activities while wearing accelerometers on five different wear-sites. After the walking tests, a method was designed for optimal step detection and compared with a gold standard of observed step count.
RESULTS
The method for step detection applied to accelerations from the lower back, hip, thigh, and ankle provided an accurate step counts during continuous walking without walking aids. Accuracy diminished at all wear-sites when walking with walking aids, except the ankle. The wrist provided the most inaccurate step count, and the accelerometers on the thigh and ankle were prone to falsely detecting steps during bicycling.
CONCLUSION
The ankle-worn accelerometer provided the most accurate step count, but wrongly registered steps during nonwalking activities. The developed step detection method shows potential as a measure of walking activity why further development and testing under free-living conditions should be performed.

Identifiants

pubmed: 35867584
doi: 10.1097/BRS.0000000000004385
pii: 00007632-202209010-00003
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1203-1211

Informations de copyright

Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest.

Références

Verbiest H. Stenosis of the lumbar vertebral canal and sciatica. Neurosurg Rev. 1980;3:75–89.
Suri P, Rainville J, Kalichman L, Katz JN. Does this older adult with lower extremity pain have the clinical syndrome of lumbar spinal stenosis? JAMA. 2010;304:2628–36.
Gobbens RJ. Associations of ADL and IADL disability with physical and mental dimensions of quality of life in people aged 75 years and older. PeerJ. 2018;6:e5425. doi:10.7717/peerj.5425
doi: 10.7717/peerj.5425
Warburton DER. Health benefits of physical activity: the evidence. Can Med Assoc J. 2006;174:801–809.
Lavie CJ, Ozemek C, Carbone S, Katzmarzyk PT, Blair SN. Sedentary behavior, exercise, and cardiovascular health. Circ Res. 2019;124:799–815.
Bock J-O, König H-H, Brenner H, et al. Associations of frailty with health care costs—results of the ESTHER cohort study. BMC Health Serv Res. 2016;16:128. doi:10.1186/s12913-016-1360-3
doi: 10.1186/s12913-016-1360-3
Schulte TL, Schubert T, Winter C, et al. Step activity monitoring in lumbar stenosis patients undergoing decompressive surgery. Eur Spine J. 2010;19:1855–1864.
Tomkins-Lane CC. Changes in objectively measured walking performance, function and pain following surgery for spondylolisthesis with lumbar spinal stenosis. Conference Abstract. Spine J. 2013;1:S133. http://dx.doi.org/10.1016/j.spinee.2013.07.344
doi: 10.1016/j.spinee.2013.07.344
Tomkins-Lane CC, Lafave LM, Parnell JA, et al. The spinal stenosis pedometer and nutrition lifestyle intervention (SSPANLI): development and pilot. Spine J. 2015;15:577–586.
Conway J, Tomkins CC, Haig AJ. Walking assessment in people with lumbar spinal stenosis: capacity, performance, and self-report measures. Spine J. 2011;11:816–823.
Winter CC, Brandes M, Muller C, et al. Walking ability during daily life in patients with osteoarthritis of the knee or the hip and lumbar spinal stenosis: a cross sectional study. BMC Musculoskelet Disord. 2010;11:233. doi:10.1186/1471-2474-11-233
doi: 10.1186/1471-2474-11-233
Minetama M, Kawakami M, Teraguchi M, et al. Supervised physical therapy vs. home exercise for patients with lumbar spinal stenosis: a randomized controlled trial. Spine J. 2019;19:1310–1318.
Mobbs RJ, Phan K, Maharaj M, Rao PJ. Physical activity measured with accelerometer and self-rated disability in lumbar spine surgery: a prospective study. Glob Spine J. 2016;6:459–464.
Gilmore SJ, Hahne AJ, Davidson M, McClelland JA. Predictors of substantial improvement in physical function six months after lumbar surgery: is early post-operative walking important? A prospective cohort study. BMC Musculoskelet Disord. 2019;20:418 418.
Tomkins-Lane CC, Holz SC, Yamakawa KS, et al. Predictors of walking performance and walking capacity in people with lumbar spinal stenosis, low back pain, and asymptomatic controls. Arch Phys Med Rehabil. 2012;93:647–653.
Tomkins-Lane CC, Lafave LMZ, Parnell JA, et al. The spinal stenosis pedometer and nutrition lifestyle intervention (SSPANLI): development and pilot. Spine J. 2015;15:577–586.
Pryce R, Johnson M, Goytan M, Passmore S, Berrington N, Kriellaars D. Relationship between ambulatory performance and self-rated disability in patients with lumbar spinal stenosis. Spine (Phila Pa 1976). 2012;37:1316–1323.
Chakravorty A, Mobbs RJ, Anderson DB, et al. The role of wearable devices and objective gait analysis for the assessment and monitoring of patients with lumbar spinal stenosis: systematic review. BMC Musculoskelet Disord. 2019;20:288. doi:10.1186/s12891-019-2663-4
doi: 10.1186/s12891-019-2663-4
Gilmore SJ, Davidson M, Hahne AJ, McClelland JA. The validity of using activity monitors to detect step count after lumbar fusion surgery. Disabil Rehabil. 2020;42:863–868.
Stienen MN, Ho AL, Staartjes VE, et al. Objective measures of functional impairment for degenerative diseases of the lumbar spine: a systematic review of the literature. Spine J. 2019;19:1276–1293.
World Health Organisation. Towards a Common Language for Functioning, Disability and Health ICF. 2002.
Tomkins CC, Battie MC, Rogers T, Jiang H, Petersen S. A criterion measure of walking capacity in lumbar spinal stenosis and its comparison with a treadmill protocol. Spine (Phila Pa 1976). 2009;34:2444–2449.
Rainville J, Childs LA, Pena EB, et al. Quantification of walking ability in subjects with neurogenic claudication from lumbar spinal stenosis—a comparative study. Spine J. 2012;12:101–109.
Nagai K, Aoyama T, Yamada M, et al. Quantification of changes in gait characteristics associated with intermittent claudication in patients with lumbar spinal stenosis. J Spinal Disord Tech. 2014;27:E136–E142.
Papadakis NC, Christakis DG, Tzagarakis GN, et al. Gait variability measurements in lumbar spinal stenosis patients: part B. Preoperative versus postoperative gait variability. Physiol Meas. 2009;30:1187–1195.
Stucki G, Daltroy L, Liang MH, Lipson SJ, Fossel AH, Katz JN. Measurement properties of a self-administered outcome measure in lumbar spinal stenosis. Spine (Phila Pa 1976). 1996;21:796–803.
Pratt RK, Fairbank JC, Virr A. The reliability of the Shuttle Walking Test, the Swiss Spinal Stenosis Questionnaire, the Oxford Spinal Stenosis Score, and the Oswestry Disability Index in the assessment of patients with lumbar spinal stenosis. Spine (Phila Pa 1976). 2002;27:84–91.
Comer CM, Conaghan PG, Tennant A. Internal construct validity of the Swiss Spinal Stenosis questionnaire: Rasch analysis of a disease-specific outcome measure for lumbar spinal stenosis. Spine (Phila Pa 1976). 2011;36:1969–1976.
Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000;25:2940–2952; discussion 2952.
Roland M, Morris R. A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine (Phila Pa 1976). 1983;8:141–144.
Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine (Phila Pa 1976). 2000;25:3115–3124.
Jespersen AB, Gustafsson M. Correlation between the Oswestry Disability Index and objective measurements of walking capacity and performance in patients with lumbar spinal stenosis: a systematic literature review. Eur Spine J. 2018;27:1604–1613.
Larsen RT, Korfitsen CB, Juhl CB, Andersen HB, Langberg H, Christensen J. Criterion validity for step counting in four consumer-grade physical activity monitors among older adults with and without rollators. Eur Rev Aging Phys Act. 2020;17:1. doi:10.1186/s11556-019-0235-0
doi: 10.1186/s11556-019-0235-0
Hergenroeder AL, Barone Gibbs B, Kotlarczyk MP, Perera S, Kowalsky RJ, Brach JS. Accuracy and acceptability of commercial-grade physical activity monitors in older adults. J Aging Phys Act. 2019;27:222–229.
Burton E, Hill KD, Lautenschlager NT, et al. Reliability and validity of two fitness tracker devices in the laboratory and home environment for older community-dwelling people. BMC Geriatr. 2018;18:103. doi:10.1186/s12877-018-0793-4
doi: 10.1186/s12877-018-0793-4
Floegel TA, Florez-Pregonero A, Hekler EB, Buman MP. Validation of consumer-based hip and wrist activity monitors in older adults with varied ambulatory abilities. J Gerontol A Biol Sci Med Sci. 2017;72:229–236.
Johnson M. Activity monitors step count accuracy in community-dwelling older adults. Gerontol Geriatr Med. 2015;1:2333721415601303. doi:10.1177/2333721415601303
doi: 10.1177/2333721415601303
Bassett DR Jr, Toth LP, LaMunion SR, Crouter SE. Step counting: a review of measurement considerations and health-related applications. Sports Med. 2017;47:1303–1315.
Tedesco S, Sica M, Ancillao A, Timmons S, Barton J, O’Flynn B. Accuracy of consumer-level and research-grade activity trackers in ambulatory settings in older adults. PLoS One. 2019;14:e0216891.
Hergenroeder AL, Barone Gibbs B, Kotlarczyk MP, Kowalsky RJ, Perera S, Brach JS. Accuracy of objective physical activity monitors in measuring steps in older adults. Gerontol Geriatr Med. 2018;4:2333721418781126. doi:10.1177/2333721418781126
doi: 10.1177/2333721418781126
McCullagh R, Dillon C, O’Connell AM, Horgan NF, Timmons S. Step-count accuracy of 3 motion sensors for older and frail medical inpatients. Arch Phys Med Rehabil. 2017;98:295–302.
Phillips LJ, Petroski GF, Markis NE. A comparison of accelerometer accuracy in older adults. Res Gerontol Nurs. 2015;8:213–219.
Simpson L, Eng J, Klassen T, et al. Capturing step counts at slow walking speeds in older adults: comparison of ankle and waist placement of measuring device. J Rehabil Med. 2015;47:830–835.
Martien S, Delecluse C, Seghers J, Boen F. Counting steps in institutionalized older adults during daily life activities: the validation of two motion sensors. J Aging Phys Act. 2015;23:383–390.
Fortune E, Lugade VA, Amin S, Kaufman KR. Step detection using multi- versus single tri-axial accelerometer-based systems. Physiol Meas. 2015;36:2519–2535.
Magistro D, Brustio PR, Ivaldi M, et al. Validation of the ADAMO Care Watch for step counting in older adults. PLoS ONE. 2018;13:e0190753.
O’Connell S, ÓLaighin G, Quinlan LR. When a step is not a step! Specificity analysis of five physical activity monitors. PLoS One. 2017;12:e0169616 e0169616.
Papadakis NC, Christakis DG, Tzagarakis GN, et al. Gait variability measurements in lumbar spinal stenosis patients: part A. Comparison with healthy subjects. Physiol Meas. 2009;30:1171–1186.
The Regional Committees on Health Research Ethics for Southern Denmark. 2020. Available at: https://komite.regionsyddanmark.dk/wm373913 . Accessed July 14, 2020.
Tomkins-Lane C, Melloh M, Lurie J, et al. ISSLS Prize Winner: consensus on the clinical diagnosis of lumbar spinal stenosis: results of an International Delphi Study. Spine (Phila Pa 1976). 2016;41:1239–1246.
AX3 GUI. Version 43. Git Hub Open Movement Team at Newcastle University, United Kingdom. 2019. Available at: https://github.com/digitalinteraction/openmovement/tree/master/Downloads/AX3 . Accessed November 23, 2021.
Tomkins-Lane C, Battié M, Rogers T, Jiang H, Petersen S. A criterion measure of walking capacity in lumbar spinal stenosis and its comparison with a treadmill protocol. Spine 10/01. 2009;34:2444–2449.
Lauridsen HH, Hartvigsen J, Manniche C, Korsholm L, Grunnet-Nilsson N. Danish version of the Oswestry Disability Index for patients with low back pain. Part 1: cross-cultural adaptation, reliability and validity in two different populations. Eur Spine J. 2006;15:1705–1716.
Lauridsen HH, Hartvigsen J, Manniche C, Korsholm L, Grunnet-Nilsson N. Danish version of the Oswestry disability index for patients with low back pain. Part 2: sensitivity, specificity and clinically significant improvement in two low back pain populations. Eur Spine J. 2006;15:1717–1728.
Johnston W, Judice PB, Molina García P, et al. Recommendations for determining the validity of consumer wearable and smartphone step count: expert statement and checklist of the INTERLIVE network. Br J Sports Med. 2021;55:780–93.
de Vet HCW, Terwee CB, Mokkink LB, Knol Dl, eds. Validity. In: Measurement in Medicine: A Practical Guide Practical Guides to Biostatistics and Epidemiology. Cambridge: Cambridge University Press; 2011:150–201.
Toth LP, Park S, Springer CM, Feyerabend MD, Steeves JA, Bassett DR. Video-recorded validation of wearable step counters under free-living conditions. Med Sci Sports Exerc. 2018;50:1315–1322.
Hartung V, Sarshar M, Karle V, et al. Validity of consumer activity monitors and an algorithm using smartphone data for measuring steps during different activity types. Int J Environ Res Public Health. 2020;17:9314.
Karabulut M, Crouter SE, Bassett DR. Comparison of two waist-mounted and two ankle-mounted electronic pedometers. Eur J Appl Physiol. 2005;95:335–343.
Migueles JH, Cadenas-Sanchez C, Ekelund U, et al. Accelerometer data collection and processing criteria to assess physical activity and other outcomes: a systematic review and practical considerations. Sports Med. 2017;47:1821–1845.
Keadle SK, Shiroma EJ, Freedson PS, Lee IM. Impact of accelerometer data processing decisions on the sample size, wear time and physical activity level of a large cohort study. BMC Public Health. 2014;14:1210–1210.
John D, Morton A, Arguello D, Lyden K, Bassett D. “What Is a Step?” Differences in how a step is detected among three popular activity monitors that have impacted physical activity research. Sensors. 2018;18:1206. doi:10.3390/s18041206
doi: 10.3390/s18041206
Rosenberger ME, Fulton JE, Buman MP, et al. The 24-hour activity cycle. Med Sci Sports Exerc. 2019;51:454–464.
Skotte J, Korshøj M, Kristiansen J, Hanisch C, Holtermann A. Detection of physical activity types using triaxial accelerometers. J Phys Act Health. 2014;11:76–84.
Hettiarachchi P, Aili K, Holtermann A, Stamatakis E, Svartengren M, Palm P. Validity of a non-proprietary algorithm for identifying lying down using raw data from thigh-worn triaxial accelerometers. Sensors. 2021;21:904. doi:10.3390/s21030904
doi: 10.3390/s21030904
Ammendolia C, Côté P, Southerst D, et al. Comprehensive nonsurgical treatment versus self-directed care to improve walking ability in lumbar spinal stenosis: a randomized trial. Arch Phys Med Rehabil. 2018;99:2408–2419.e2.
Nord TKU, Grönlund P, Reuterwall C. Exercise reduced the need for operation in lumbar spinal stenosis. Circulatory load in the form of cycling gave good effect. Läkartidningen. 2015;112:C7XP.
Pauwels C, Roren A, Gautier A, et al. Home-based cycling program tailored to older people with lumbar spinal stenosis: barriers and facilitators. Ann Phys Rehabil Med. 2018;61:144–150.

Auteurs

Malin E A K Gustafsson (MEAK)

Medical Research Unit, Spine Center of Southern Denmark, University Hospital of Southern Denmark, Middelfart.
Department of Regional Health Research, University of Southern, Odense, Denmark.

Berit Schiøttz-Christensen (B)

Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.

Niels Wedderkopp (N)

Department of Regional Health Research, University of Southern, Odense, Denmark.
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense.

Jan C Brønd (JC)

Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH