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European Journal of Physical and Rehabilitation Medicine 2020 Oct 28

DOI: 10.23736/S1973-9087.20.06189-4

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Development of a new patient-reported outcome measure assessing activities and participation in people with lumbar spinal stenosis: the cochin spinal stenosis 19-item questionnaire

Chiara MASI 1, 2 , Gaelle COURAUD 1, 3, Camille DASTE 1, 3, 4, Jennifer JOUFFRIAULT 1, Serge POIRAUDEAU 1, 3, 4, 5, Marie-Martine LEFEVRE-COLAU 1, 3, 4, 5, Francois RANNOU 1, 4, 6, Christelle NGUYEN 1, 4, 6

1 AP-HP.Centre-Université de Paris, Service de Rééducation et de Réadaptation de l’Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, Paris, France; 2 Physical Medicine and Rehabilitation Unit, Istituto Ortopedico Rizzoli, Bologna, Italy; 3 Université de Paris, Faculté de Santé, UFR de Médecine de l’Université de Paris, Paris, France; 4 INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique, Université de Paris, ECaMO Team, Paris, France; 5 Institut Fédératif de Recherche sur le Handicap, Paris, France; 6 INSERM UMR-S 1124, Laboratoire de Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des Prés, Paris, France



BACKGROUND: Lumbar spinal stenosis (LSS) is the leading cause of spinal surgery in people over 65-years old. In people with LSS, generic self-administered questionnaires are the most commonly used PROs to assess health-related quality of life, global activity limitation, and low back pain-located activity limitation.
AIM: To develop of a new patient-reported outcome measure assessing activities and participation in people with LSS.
DESIGN: Observation, prospective and qualitative study.
SETTING: For the qualitative study, enrolled in- and outpatients with LSS from 2 French tertiary care centers (Department of PRM of Cochin Hospital and Department of Rheumatology of Limoges Hospital). For the Internet E-survey, screened the electronic medical records of the Department of PRM of Cochin Hospital.
POPULATION: Enrolled from February to April 2018, patients older than 50-years and symptomatic LSS.
METHODS: We used a 2 step approach. In a first step, we conducted a qualitative study using in-depth semi-structured interviews in 20 patients with LSS to collect meaningful concepts and to develop a provisional questionnaire. In a second step, using the provisional questionnaire, we conducted an Internet E-survey in an independent sample of 200 patients with LSS.
RESULTS: Concepts collected from patients generated a 48-item provisional questionnaire. Overall, 63/200 (31.5%) patients completed the provisional questionnaire. Item reduction resulted in a 19-item questionnaire, the Cochin Spinal Stenosis 19-item (CSS-19) questionnaire. Principal component analysis extracted 3 factors. In confirmatory analysis, factor 1 influenced all items. We found convergent validity with low back pain, LSS-specific disability and divergent validity with mental health-related quality of life. Cronbach α coefficient (95% CI) was 0.96 (0.94;0.97). ICC was 0.90 (0.70;0.97). Bland and Altman analysis found no systematic trend for test-retest.
CONCLUSIONS: CSS-19 is a new patient-reported outcome measure assessing activities and participation in people with LSS. Its construction prioritized patients’ perspectives at all stages. Its content and construct validities are good.
CLINICAL REHABILITATION IMPACT: Instruments able to capture specific needs of people with LSS in terms of activities and participation are lacking.


KEY WORDS: Lumbar spinal stenosis; Activities; Participation; Disability; Patient-reported outcome measure

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