Association between frailty status and pain, balance, and quality of life in patients with lumbar spinal stenosis

TL;DR

Frail patients with lumbar spinal stenosis experience more pain, balance issues, and lower quality of life compared to non-frail patients.

Contribution

This study identifies specific associations between frailty and clinical outcomes in lumbar spinal stenosis patients.

Findings

Frail patients with LSS had higher pain intensity, disability, and fear of falling compared to non-frail patients.

Frailty was significantly associated with reduced mobility, lower physical activity, and decreased vitality in LSS patients.

Abstract

Frailty is a clinical syndrome that affects individuals physically and psychosocially. However, the association between lumbar spinal stenosis (LSS) and frailty remains unclear. This study aimed to compare pain, balance, disability, fear of falling, and quality of life between patients with LSS with and without frailty.

This cross-sectional study included 43 frail and 48 nonfrail patients with LSS according to the frailty criteria of Fried et al. Pain intensity (numeric rating scale [NRS]), static balance (single leg stance test [SLST]), dynamic balance (Timed Up and Go test [TUG]), disability (Oswestry Disability Index [ODI]), fear of falling (Falls Efficacy Scale–International [FES-I]), and quality of life (Short form-36 [SF-36]) were assessed.

Frailty was observed in 47.3% of patients, and baseline characteristics were similar between the groups (p > 0.05). NRS scores for low back and leg pain, ODI and FES-I scores, and TUG test durations were significantly higher in frail patients with LSS than in nonfrail patients (p < 0.05). SLST durations and SF-36 subscale scores were significantly lower in frail patients with LSS (p < 0.05). TUG duration (p = 0.001, OR = 1.482), physical activity level (p = 0.007, OR = 0.999), and the SF-36 vitality subscale (p = 0.031, OR = 0.968) were significantly associated with frailty in the logistic regression model (p < 0.001).

Frail patients with LSS experience greater pain intensity, balance disorders, disability, fear of falling, and poorer quality of life. Moreover, reduced mobility, lower physical activity levels, and decreased vitality are associated with a higher likelihood of frailty in patients with LSS. Therefore, early assessment of frailty in patients with LSS and the implementation of personalized rehabilitation approaches may help mitigate its negative impact.