Objective
Understanding mobility of patients with Cauda equina syndrome is important because it can predict the patient's functional outcome. If the level of mobility can be predicted early, appropriate individual rehabilitation treatment can be provided at the earliest possible time. To investigate the relationship between the lower extremity motor score (LEMS) and the mobility score of Korean Version of Spinal Cord Independence Measure (K-SCIM) to predict the patient's level of mobility.
Subjects & Methods
We retrospectively reviewed 42 patients with cauda equina syndrome who were admitted to our rehabilitation center from March 2015 to February 2019. For a diagnosis of cauda equina syndrome, one or more of the following must be present : (1) Neurologic deficit in the lower limb(motor/sensory loss, reflex change), (2) Bladder and/or bowel dysfunction, and (3) Reduced sensation in the saddle area. We excluded patients with any of the following: (1) a diagnosis of cerebral infarction or hemorrhage in the brain by CT or MRI, (2) complete or incomplete limb paralysis due to spinal cord injuries, (3) a history of traumatic brain damage or brain tumor, (4) presence of neuromuscular diseases (e.g., amyotrophic lateral sclerosis and myasthenia gravis), and (5) unstable medical condition. Demographic characteristics and clinical characteristics were analyzed to identify factors influencing the lower extremity motor scores. Patients were divided into three groups according to age, and the correlation between LEMS and K-SCIM was analyzed. The lower extremity motor score is a sum of assessed voluntary muscle strength of 5 key muscles (hip flexor, knee extensor, ankle dorsiflexor, long toe extensor, ankle plantarflexor). We classified the three groups according to age and the lower extremity motor scores and the mobility score of K-SCIM were analyzed to compare the relationship between strength of lower extremities and mobility of patients.
Results
Forty- two patients with cauda equine syndrome were analyzed for data (22 male and 20 female patients). Subject ages ranged from 21 to 85 years with a mean of 62.0±16.5 years. The mean
LEMS was 35.5±8.2 points on the basis of a total of 50 points. And, the mean LEMS-HE was 42.3±9.8 points on the basis of a total of 60 points. The mean mobility score of K-SCIM was 4.2±2.2 points on the basis of a total of 8 points (Table 1). The correlation between LEMS or LEMS-HE and mobility score of K-SCIM was evaluated, and LEMS was found to have a significant effect on mobility score of K-SCIM in all groups. Comparing LEMS and LEMS-HE, LEMS-HE had a higher coefficient of determination, which tended to increase with age (Table 2).
Conclusion
There was a significant correlation between LEMS or LEMS-HE and mobility score of K-SCIM in patients with cauda equina syndrome, especially LEMS-HE statistically significant and high coefficient of determination. In patients with cauda equina syndrome, the level of mobility of p |
