title: Preliminary results of the use of a two-stage treadmill test as a clinical diagnostic tool in the differential diagnosis of lumbar spinal stenosis.
abstract: This study assesses the ability of a two-stage treadmill test to distinguish stenotic from nonstenotic subjects by capitalizing on the postural dependency of stenotic symptoms. Forty-five subjects (26 stenotic, 19 nonstenotic) participated. An earlier onset of symptoms with level walking (p = 0.0009), increased total walking time on an inclined treadmill (p = 0.014), and prolonged recovery time after level walking (p = 0.001) were significantly associated with stenosis. Only one of four self-reported postural variables were significantly associated with stenosis. Linear discriminant analysis performed using the treadmill variables resulted in the correct classification of 76.9 and 94.7% of stenotic and nonstenotic subjects, respectively. Likelihood ratios for all treadmill variables were > 2.50, and < 2.00 for all self-report variables. A two-stage treadmill test may be useful in the differential diagnosis of lumbar stenosis, and clinical measurement of the postural nature of symptoms seems to be superior to subjects' self-reports.
authors.affiliation: Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pennsylvania, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Fritz
authors.forename: R E
authors.initials: RE
authors.lastname: Erhard
authors.forename: A
authors.initials: A
authors.lastname: Delitto
authors.forename: W C
authors.initials: WC
authors.lastname: Welch
authors.forename: P E
authors.initials: PE
authors.lastname: Nowakowski
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013130:Spinal Stenosis / Q000175:diagnosis*; D016138:Walking