Evaluating the Reproducibility of the Walking Test for Intermittent Claudication Associated with Lumbar Spinal Stenosis

Study design: This is a multicenter, prospective study. Purpose: This study aimed to evaluate the reproducibility of the walking test for patients with lumbar spinal stenosis (LSS). Overview of literature: Walking test is one of the useful procedures to investigate cauda equina syndrome with lumbar spinal stenosis. One the other hands, there were few studies to investigate the reproducibility of this test. Methods: In this study, we prospectively examined 70 LSS patients with intermittent claudication symptoms at a multicenter outpatient clinic. A walking test was administered at baseline and week 4 to assess patients' walking distance and lower limb pain and numbness. Immediately after the walking test, patients were asked to use the Visual Analog Scale (VAS) to rate their pain and numbness in the front, back, outside, inside, and hip of the lower legs. The reproducibility of the walking test was evaluated using Cohen's kappa analysis and intraclass correlation coefficients (ICCs). Meanwhile, the Swiss Spinal Stenosis (SSS) Questionnaire was used to evaluate the severity of the stenosis. Results: The walking distance ICC at baseline and at week 4 remained unchanged at 0.7, with acceptable interobserver reliabilities for lower limb pain and numbness in both legs. The average VAS score for lower leg pain was 23.2 +/- 25.2 mm at baseline and 27.4 +/- 28.8 mm at week 4, while the corresponding average VAS score for numbness was 23.4 +/- 26.7 mm at baseline and 24.8 +/- 25.2 mm at week 4. The ICC score was 0.7 for leg pain and 0.7 for numbness. The mean SSS was 30.2 +/- 5.5 at baseline and 29.2 +/- 5.2 at week 4, and there was no significant difference in the severity. Conclusions: The walking test for LSS has acceptable reproducibility.