1. Cone of economy classification: evolution, concept of stability, severity level, and correlation to patient-reported outcome scores
- Author
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Isador H. Lieberman, Ram Haddas, Varun Sambhariya, Andrew R. Block, and Thomas Kosztowski
- Subjects
Adult ,musculoskeletal diseases ,Functional balance ,Cohort Studies ,Correlation ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Patient Reported Outcome Measures ,Prospective Studies ,Prospective cohort study ,Postural Balance ,Balance (ability) ,030222 orthopedics ,business.industry ,Spine ,Sagittal plane ,medicine.anatomical_structure ,Economy ,Coronal plane ,Surgery ,Patient-reported outcome ,Severity level ,business ,human activities ,030217 neurology & neurosurgery - Abstract
A prospective cohort study To determine a classification system for cone of economy (CoE) measurements that defines clinically significant changes in altered balance and to assess if the CoE measurements directly impacts patients reported outcome measures (PROMs). Preoperative functional data is a crucial component of determining patient disability and prognosis. The CoE has been theorized to be the foundation of biomechanical changes that leads to increased energy expenditure and disability in spine patients. PROMs have been developed to quantify the level of debilitation in spine patients but have various limitations. A total of 423 symptomatic adult patients with spine pathology completed a series of PROMs preoperatively including VAS, ODI, Tampa Scale for Kinesiophobia (TSK), Fear and Avoidance Beliefs Questionnaire (FABQ), and Demoralization (DS). Functional balance was tested in this group using a full-body reflective marker set to measure head and center of mass (CoM) sway. PROMs scores were correlated with the magnitude of the CoE measurements. Patients were separated by the following proposed classification: CoM coronal sway > 1.5 cm, CoM sagittal sway > 3.0 cm, CoM total sway > 30.0 cm, head coronal sway > 3.0 cm, head sagittal sway > 6.0 cm, and head total sway > 60.0 cm. Significant differences were noted in the ODI (
- Published
- 2021