Physical and Psychological Factors Associated With Walking Capacity in Patients With Lumbar Spinal Stenosis With Neurogenic Claudication: A Systematic Scoping Review

Abstract

Objective: The purpose of this study was to evaluate the current state of scientific knowledge regarding physical and psychological factors associated with walking capacity in patients with lumbar spinal stenosis (LSS) with neurogenic claudication.Design: Systematic scoping review.Literature Search: We searched CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE, Cochrane, PsycINFO, and SPORTDiscus databases.Study Selection Criteria: Cohorts and cross-sectional studies reporting on associations between physical or psychological factors and impaired walking capacity in patients with symptomatic LSS were included.Data Synthesis: Data were synthetized to identify associations between physical or psychological factors and either walking capacity, gait pattern characteristics, or functional tasks.Results: Twenty-four studies were included. Walking capacity was significantly correlated with several pain outcomes, disability, estimated walking distance, and cross-sectional area of the lumbar spine. Gait pattern characteristics such as speed and stride were strongly and positively correlated with disability outcomes. Functional tasks were significantly correlated with lower back and upper limb disability, lower limb endurance strength, ranges of motion, and speed. Associations with psychological factors were mostly conflicting except for the Rasch-based Depression Screener and the Pain Anxiety Symptom Scale (PASS-20) questionnaire that were associated with a decreased performance in functional tasks.Conclusion: Physical and psychological factors that are associated with walking capacity in patients with symptomatic LSS were identified. However, many associations reported between physical or psychological factors and walking capacity were conflicting, even more so when correlated with walking capacity specifically.