A tool to improve functional outcome assessment of a multimodal program for patients with chronic low back pain: A study on walk tests (at comfortable and fast speed)

Article type: Research Article

Authors: Trampe, Delphine^a | Gouteron, Anaïs^a | Naaim, Alexandre^b | Laroche, Davy^{b; c} | Grelat, Mickael^d | Casillas, Jean-Marie^{a; b; c; *}

Affiliations: [a] Department of Rehabilitation, University Hospital of Dijon, Dijon, France | [b] CIC INSERM 1432, Plateforme d’Investigation Technologique, University Hospital of Dijon, Dijon, France | [c] INSERM U1093, Dijon, France | [d] Department of Neurological Surgery, University Hospital of Dijon, Dijon, France

Correspondence: [*] Corresponding author: Jean-Marie Casillas, Department of Rehabilitation, University Hospital of Dijon, 23 Gaffarel Street, 21079 Dijon, France. Tel.: +33 380 293 814; E-mail: jean-marie.casillas@chu-dijon.fr.

Abstract: BACKGROUND: Tools for functional assessment of chronic low back pain (LBP) are lacking. OBJECTIVE: To determine the correlations and the responsiveness of the 400 m comfortable walk test (400 mCWT) and the 200 m fast-walk test (200 mFWT) in the functional assessment of a multimodal program. METHODS: One hundred and twenty-seven participants (68 females) with LBP and with or without radicular pain completed a Quebec Back Pain Disability Scale, a Sorensen test, a Shirado test, a 400 mCWT and a 200 mFWT, at baseline and at the end of the program. RESULTS: No significant side effect was reported during walk tests. Walking speed was significantly increased after the program (0.18 ± 0.15 m.s-1 for the 400 mCWT and 0.17 ± 0.17 m.s-1 for the 200 mFWT). Clinical parameters were also significantly improved (82.02 ± 83.1 seconds for the Shirado, 92.1 ± 100.1 seconds for the Sorensen, -14.0 ± 12.9 for the Quebec scale). A significant relationship was found between the increase in walking speed for the two walk tests and the improvement of the Quebec scale. The gait speed improvement was close to the minimal clinically important change (95% confidence interval: 0.14–0.22) determined from the Quebec scale threshold (minimum detectable change). CONCLUSIONS: Both 400 mCWT and 200 mFWT are correlated with functional parameters and are responsive for the functional assessment of LBP.

Keywords: Chronic low back pain, multimodal pain management, rehabilitation, walk speed, walk test

DOI: 10.3233/BMR-171019

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 33, no. 3, pp. 485-494, 2020