Correlation between the Oswestry Disability Index and objective measurements of walking capacity and performance in patients with lumbar spinal stenosis: a systematic literature review.

PURPOSE: The Oswestry Disability Index (ODI) plays a significant role in lumbar spinal stenosis research and is used to assess patient's walking limitations. The World Health Organisation describes the constructs of walking capacity and performance and recommend measuring both to fully describe patient's walking ability. Objective methods to assess walking capacity and performance is being investigated and used alongside the traditional use of PROs. This review of the literature was made to provide an overview of relations between the ODI and outcome measures of walking capacity and performance in spinal stenosis research, and to provide a strategy for improving such measures in future research. METHODS: The review was conducted according to the Prisma Statement. In February 2017, a search was performed in Pubmed, Embase and Cochrane database. Authors independently screened articles by title, abstract, and full text, and studies were included if both authors agreed. Articles with correlation analysis between the ODI, walking capacity and performance measures by accelerometer or GPS were included. RESULTS: The results support a correlation between the ODI and walking capacity measures. The available studies using ODI and accelerometers were too few to reach a conclusion regarding correlation between ODI and walking performance. No articles with GPS measure were identified. CONCLUSIONS: The ODI should not stand alone when evaluating walking limitations in patients with lumbar spinal stenosis. To enable a comprehensive assessment of walking ability, a walking test should be used to assess walking capacity and accelerometers should be investigated and standardized in measuring walking performance. These slides can be retrieved under Electronic Supplementary Material.

Walking performance in individuals with lumbar spinal stenosis-possible outcome measures and assessment of known-group validity.

BACKGROUND CONTEXT: One of the primary goals of treatments received by individuals with lumbar spinal stenosis with neurogenic claudication is to improve walking ability. Thus, a thorough and valid assessment of walking ability in patients with lumbar spinal stenosis is needed. Duration of continuous walking and steps per day could be relevant when evaluating walking ability in daily living. PURPOSE: To describe and evaluate a method for estimating continuous walking periods in daily living and to evaluate the known-group validity of steps per day in individuals with lumbar spinal stenosis. STUDY DESIGN: This is a cross-sectional observational study. PATIENT SAMPLE: The study contains three study groups: individuals with lumbar spinal stenosis, individuals with low back pain, and a background population from the Lolland-Falster Health Study (LOFUS). OUTCOME MEASURES: Participants in all three study groups wore an accelerometer on the thigh for seven days. METHODS: Accelerometer data were processed to summarize the continuous walking periods according to their length: the number of short (4-9 seconds), moderate (10-89 seconds), and extended (≥90 seconds) continuous walking periods per day, and the number of steps per day. Results from the three groups were compared using negative binomial regression with lumbar spinal stenosis as the reference level. RESULTS: Continuous walking periods of moderate length were observed 1.48 (95% CI 1.27, 1.72) times more often in individuals from the background population than in individuals with LSS. Continuous walking periods of extended length were observed 1.53 (95% CI 1.13, 2.06) times more often by individuals with low back pain and 1.60 (95% CI 1.29, 1.99) times more often by individuals from the background population. The number of steps per day was 1.22 (95% CI 1.03, 1.46) times larger in individuals with LBP and 1.35 (95% CI 1.20, 1.53) times larger in individuals from background population. CONCLUSIONS: The impact of neurogenic claudication on walking ability in daily living seems possible to describe by continuous walking periods along with steps per day. The results support known-group validity of steps per day. This is the next step toward a clinically relevant and comprehensive assessment of walking in daily living in individuals with lumbar spinal stenosis.

Unlocking the secret life of blue mussels: Exploring connectivity in the Skagerrak through biophysical modeling and population genomics.

Knowledge of functional dispersal barriers in the marine environment can be used to inform a wide variety of management actions, such as marine spatial planning, restoration efforts, fisheries regulations, and invasive species management. Locations and causes of dispersal barriers can be studied through various methods, including movement tracking, biophysical modeling, demographic models, and genetics. Combining methods illustrating potential dispersal, such as biophysical modeling, with realized dispersal through, e.g., genetic connectivity estimates, provides particularly useful information for teasing apart potential causes of observed barriers. In this study, we focus on blue mussels (Mytilus edulis) in the Skagerrak-a marginal sea connected to the North Sea in Northern Europe-and combine biophysical models of larval dispersal with genomic data to infer locations and causes of dispersal barriers in the area. Results from both methods agree; patterns of ocean currents are a major structuring factor in the area. We find a complex pattern of source-sink dynamics with several dispersal barriers and show that some areas can be isolated despite an overall high dispersal capability. Finally, we translate our finding into management advice that can be used to sustainably manage this ecologically and economically important species in the future.

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

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.

Tree traits and canopy closure data from an experiment with 34 planted species native to Sabah, Borneo.

The data presented in this paper is supporting the research article "Life history traits predict the response to increased light among 33 tropical rainforest tree species" [3]. We show basic growth and survival data collected over the 6 years duration of the experiment, as well as data from traits inventories covering 12 tree traits collected prior to and after a canopy reduction treatment in 2013. Further, we also include canopy closure and forest light environment data from measurements with hemispherical photographs before and after the treatment.

The exposure of the Great Barrier Reef to ocean acidification.

The Great Barrier Reef (GBR) is founded on reef-building corals. Corals build their exoskeleton with aragonite, but ocean acidification is lowering the aragonite saturation state of seawater (Ωa). The downscaling of ocean acidification projections from global to GBR scales requires the set of regional drivers controlling Ωa to be resolved. Here we use a regional coupled circulation-biogeochemical model and observations to estimate the Ωa experienced by the 3,581 reefs of the GBR, and to apportion the contributions of the hydrological cycle, regional hydrodynamics and metabolism on Ωa variability. We find more detail, and a greater range (1.43), than previously compiled coarse maps of Ωa of the region (0.4), or in observations (1.0). Most of the variability in Ωa is due to processes upstream of the reef in question. As a result, future decline in Ωa is likely to be steeper on the GBR than currently projected by the IPCC assessment report.