BACKGROUND: The 6-minute walking test (6WT) has previously shown to be reliable and valid outcome measure in patients undergoing surgery for degenerative lumbar disorders (DLD). A role of 6WT in conservatively treated patients undergoing epidural steroid injection (ESI) remains unclear. METHODS: About 50 patients with DLD, scheduled for ESI were assessed by the smartphone-based 6WT and common paper-based patient-reported outcome measures (PROMs), including the Core Outcome Measures Index [COMI] back, Oswestry Disability Index (ODI) and Short Form Survey (SF-12). Pearson correlation coefficient (PCC) was used to define the relationship between 6WT and PROMs. Reliability of the 6WT was determined by intraclass correlation coefficient (ICC). Age- and sex-adjusted objective functional impairment (OFI) z-scores were calculated for each patient. RESULTS: A total of 50 patients (mean age 52 years, SD 13; 25% female), including 35 patients (70%) with lumbar disc herniation and 15 patients (30%) with lumbar spinal stenosis were included. The mean 6-minute walking distance (6WD) was 454.1 m (SD 89.1); the age- and sex-adjusted mean OFI z-score was -2.1 (SD 4.0). A total of 17 (34%) patients had mild, 8 (16%) moderate, and 4 (8%) severe OFI, while 21 (42%) had 6WT results within the normal population range (no OFI). The PCCs between the 6WD and VAS back pain were r=-0.30, ODI r=-0.43, COMI back r=-0.36, and PCS-12 r=0.51 (all p<.05). The ICC of the 6WT was β=0.92. CONCLUSIONS: This external validation in a patient cohort with DLD, which was managed conservatively, confirms the reliability and content validity of the 6WT with similar PCCs with PROMs compared to the original surgical cohort. The results confirm the 6WT as a valid and useful tool for assessing OFI in patients with DLD and a broad range of functional restrictions in an outpatient setting.
- Publikační typ
- časopisecké články MeSH
BACKGROUND CONTEXT: The 6-minute walking test (6WT) has been previously shown to be a reliable and valid outcome measure. It is unclear if the 6WT may further help to detect differences in well performing patients that reach a ceiling effect in PROMs after surgery. PURPOSE: To evaluate changes and timing of change in objective functional impairment (OFI) as measured with the smartphone-based 6WT in relation to patient-reported outcome measures (PROMs) after surgery for degenerative lumbar disorders (DLD). STUDY DESIGN: Prospective observational cohort study. PATIENT SAMPLE: Fifty consecutive patients undergoing surgery for DLD. OUTCOME MEASURES: Patients self-determined their OFI using the 6WT application (6WT-app) and completed a set of paper-based PROMs before, 6 weeks and 3 months after surgery. METHODS: Fifty patients undergoing surgery for DLD were assessed preoperatively (baseline), 6 weeks (6W) and 3 months (3M) postoperatively. Paired sample t-tests were used to establish significant changes in raw 6-minute walking distance (6WD) and standardized Z-scores, as well as PROMs. Pearson correlation coefficient was used to define the relationship between 6WT and PROMs. Floor and ceiling effects were assessed for each PROM (visual analogue scale [VAS], core outcome measure index [COMI], Zurich claudication questionnaire [ZCQ]). RESULTS: Mean 6WT results improved from 377 m (standard deviation - SD 137; Z-score: 1.8, SD 1.8) to 490 m (SD 126; -0.7, SD 1.5) and 518 m (SD 112; -0.4, SD 1.41; all p<.05) at 6W and 3M follow-up. No significant improvement was observed between 6W and 3M for the ZCQ, VAS back and leg pain. While correlation between 6WT and all PROMs were weak at baseline, correlation coefficient increased to moderate at 3M. A considerable ceiling effect (best possible score) was observed, most notably for the ZCQ physical performance, VAS back and leg pain in 24%, 20%, and 16% of patient at 6W and in 30%, 24%, and 28% at 3M. CONCLUSIONS: Objective functional tests can describe the continued change in the physical recovery of a patient and may help to detect differences in well performing groups as well as in cases where patients' PROM results cannot further improve because of a ceiling effect.
- MeSH
- bederní obratle chirurgie MeSH
- bolest MeSH
- degenerace meziobratlové ploténky * chirurgie diagnóza MeSH
- hodnocení výsledků péče pacientem MeSH
- hodnocení výsledků zdravotní péče MeSH
- lidé MeSH
- prospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
Chitin/chitosan-glucan complex (ChCsGC) was isolated from Schizophyllum commune (S. commune) and dissolved for the first time in precooled (-15°C) 8wt.% urea/6wt.% NaOH aqueous solution. Novel nonwoven microfiber mats were fabricated by wet-dry-spinning technique and evaluated the mechanical of fabrics mats and surface morphology. Isolated and nonwoven mat were characterized employing FTIR-ATR, Optical microscope, TGA, DSC, H/C NMR, SEM and XRD techniques. According to the physical/chemical characterization measurements we can assumed that, the net and the novel dressing mats have the same chemical structure with slightly changes in the thermal stability for the dressing mats.The biological activity of the nonwoven ChCsGC fabric was tested against different types of bacteria exhibiting excellent antibacterial activity. Cell viability of the plain complex and nonwovens mats were evaluated utilizing mouse fibroblast cell line varying concentrations and treatment time. ChCsGC did not show any cytotoxicity against mouse fibroblast cells and the cell-fabrics interaction was also investigated using fluorescence microscope. The novel ChCsGC nonwovens exhibited excellent surgical wound healing ability when tested using rat models.
- MeSH
- antibakteriální látky aplikace a dávkování chemie MeSH
- buňky NIH 3T3 MeSH
- chitosan aplikace a dávkování chemie izolace a purifikace MeSH
- glukany aplikace a dávkování chemie izolace a purifikace MeSH
- hojení ran účinky léků MeSH
- krysa rodu rattus MeSH
- myši MeSH
- obvazy * MeSH
- proliferace buněk účinky léků MeSH
- Schizophyllum izolace a purifikace MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
