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Functional Improvements Utilizing the Short Physical Performance Battery (SPPB) in the Elderly after Epidural Steroid Injections

  • Other Pain (A. Kaye and N. Vadivelu, Section Editors)
  • Published:
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Abstract

Purpose of Review

The treatment of debilitating pain and loss of function secondary to lumbar stenosis is in high demand with the aging patient population. Options, including epidural steroid injections (ESIs) and medication therapy, are limited and it is unclear if they provide any functional improvements. In this prospective study, we evaluate functional outcomes in older adults with symptomatic lumbar stenosis treated with ESIs compared to those managed with medications by introducing the Short Physical Performance Battery (SPPB). Our study was IRB-approved and included 16 patients, 68 to 83 years old, with symptomatic back and radicular leg pain secondary to lumbar stenosis. Patients could elect to undergo a lumbar ESI (n = 11) or be treated via medication management (n = 5). Numeric pain score, SPPB score, and adverse events were measured and compared at baseline and a 1-month follow-up visit.

Recent Findings

Statistically significant improvements were observed from baseline compared to the 1-month follow-up for total SPPB score in the injection group. Similar improvements in the injection group were observed for pain scores and the SPPB subcomponents such as the 4-m walk test, chair stand time, and balance score. Comparatively, no statistically significant improvements were observed in the medication group.

Summary

Lumbar ESIs improved objective physical capacity parameters and pain scores in elderly patients with symptomatic lumbar stenosis compared to medication management. In addition, the SPPB is an easy-to-use tool to measure changes in physical function in older adults and could easily be integrated into an outpatient pain clinic.

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Funding

The authors wish to disclose and thank the sponsor of the study. The study was conducted by Dr. Rene Przkora and was sponsored by the National Institutes of Health-funded University of Texas Medical Branch (UTMB) Clinical and Translational Science Award (grant no. UL1TR001439) and by the UTMB Claude D. Pepper Older Americans Independence Center (grant no. P30 AG024832 to E.V.) Research Career Development Project (project no. RCD4 to R.P.). The sponsorship was limited to supplies and expenses. It had no influence or interference after the protocol was designed.

The financial sponsor of this work had no role in the design and conduct of the study or the collection, management, analysis, or interpretation of the data. The sponsor also did not have a role in the preparation or review of the manuscript or the decision to submit.

Author information

Authors and Affiliations

  1. Department of Anesthesiology, University of Florida College of Medicine, SW Archer Road, PO Box 100254, Gainesville, FL, 32610, USA

    Rene Przkora, Christopher Babl & Terrie Vasilopoulos

  2. Departments of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA

    Michael P. Kinsky

  3. Departments of Physical Therapy, University of Texas Medical Branch, Galveston, TX, USA

    Steve R. Fisher

  4. Department of Orthopaedic Surgery, University Hospital Leipzig, Leipzig, Germany

    Christoph E. Heyde

  5. Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, USA

    Alan D. Kaye

  6. Internal Medicine-Geriatrics, University of Texas Medical Branch, Galveston, TX, USA

    Elena Volpi

Authors
  1. Rene Przkora
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  2. Michael P. Kinsky
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  3. Steve R. Fisher
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  4. Christopher Babl
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  6. Terrie Vasilopoulos
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  7. Alan D. Kaye
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  8. Elena Volpi
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Corresponding author

Correspondence to Rene Przkora.

Ethics declarations

The present investigation was a prospective, Institutional Review Board-approved, observational study in adults > 65 years old. Informed written consent was obtained for every patient.

Conflict of Interest

Each author certifies that he or she, or a member of his or her immediate family, has no commercial association (i.e., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted manuscript. Rene Przkora, Michael P. Kinsky, Steve R. Fisher, Christopher Babl, Christoph E. Heyde, Terrie Vasilopoulos, Alan D. Kaye, and Elena Volpi declare no conflict of interest. Alan Kaye is on the speaker bureau for Merck and Depomed, Inc.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Przkora, R., Kinsky, M.P., Fisher, S.R. et al. Functional Improvements Utilizing the Short Physical Performance Battery (SPPB) in the Elderly after Epidural Steroid Injections. Curr Pain Headache Rep 23, 14 (2019). https://doi.org/10.1007/s11916-019-0748-2

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  • DOI: https://doi.org/10.1007/s11916-019-0748-2

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