Identifying predictors for postoperative clinical outcome in lumbar spinal stenosis patients using smart-shoe technology.
Sunghoon I Lee, Andrew Campion, Alex Huang and 11 others
PMID 28720144WHAT IT FOUND
Preoperative smart-shoe walking measures were associated with postoperative disability and pain after surgery for lumbar spinal stenosis, while standard clinical variables were not.
This was a small pilot, so it does not yet guide surgical decisions.
Key findings
01A smart-shoe measure of foot-pressure timing variability, StdTime-P2P3-Max, was the best single predictor of postoperative ODI, with r = 0.61 and p = 0.016.
02Combining two smart-shoe measures, StdDevTime-P2P3-Max and SymIndex, predicted postoperative ODI with r = 0.78 and p < 5.32 × 10^-4.
03A smart-shoe measure of pressure consistency, AutoCorr-P2-Mean, was the best single predictor of postoperative VAS, with r = -0.70 and p = 0.0035; no clinical variable or preoperative outcome was significant.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The analysis used 15 patients with follow-up data, which is a very small sample for prediction. All patients were operated on by a single neurosurgeon, so the findings may not apply to other surgeons or surgical teams. The follow-up was at least three months, and the authors say pain can continue to change over longer periods. The study did not include factors such as depression or psychiatric illness, which the paper says have previously been linked to outcome. The supplied table labels a follow-up group as N = 17, while the text says 15 patients were reevaluated and the analysis used 15. The analysis tested many possible predictor combinations and selected the best result, but the paper does not report adjustment for multiple comparisons or external validation. The reported RMSE values are not translated into plain ODI or VAS points, so their clinical accuracy is unclear.
Declared interests
The paper names NIH/National Center for Advancing Translational Science (NCATS) as funder. No other conflicts of interest are given in the supplied text.
The easy way to misread this
Do not read these correlations as evidence that smart-shoe testing should be used in clinic. The paper analysed a small follow-up sample after surgery by a single neurosurgeon, tested many possible predictors, and did not validate the method in a larger population.