Energy Impairments in Older Adults With Low Back Pain and Radiculopathy: A Matched Case-Control Study.
Peter C Coyle, Jenifer M Pugliese, J Megan Sions and 3 others
PMID 29698638WHAT IT FOUND
Older adults with chronic low back pain radiating to or below the knee used more oxygen per meter walking at their own pace and walked slower than matched pain-free peers.
Their peak walking oxygen was lower, but that result depended on removing an outlier.
Key findings
01While walking at their own pace, older adults with low back pain radiating to or below the knee used more oxygen per meter than matched pain-free controls (absolute mean difference .031 mL/kg/m, p=.009).
02At peak walking speed, they had lower peak walking oxygen than controls (absolute mean difference 2.39 mL/kg/min, p=.050) and walked slower (absolute mean difference .28 m/sec, p=.002).
03They had 2.04 greater odds of peak walking oxygen below 18 mL/kg/min, but this was not statistically significant (p=.308).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 38 participants were included. The sample was high-functioning: people who needed an assistive device for testing were excluded, so results may not apply to more disabled patients. People with significant comorbidities were excluded, so results may not apply to typical older adults with multiple health problems. The CLBPR group varied widely, with symptom duration from 3 months to 50 years and unilateral or bilateral leg symptoms. The peak walking oxygen result was sensitive to outliers: without removing one outlier from each group, the p value was .064; with removal, it was .050. Because this was a matched comparison, it cannot show that CLBPR caused the energy differences or that they predict future mobility decline.
Declared interests
The supplied text does not include a conflicts-of-interest declaration; the article is listed as supported by NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that chronic low back pain with leg symptoms causes energy impairment or future mobility decline, or that treating energy cost will prevent decline. This was a small matched comparison of current walking energy, and the authors state the design cannot support risk conclusions.