Evaluation of the effectiveness of spinal cord stimulation in patients with critical lower limb ischemia using the WIQ Questionnaire

Abstract

Aim. To evaluate various parameters of walking using the Walking Impairment Questionnaire (WIQ) in patients with critical lower limb ischemia (CLLI) before and one year after spinal cord stimulation (SCS). Methods. In 46 patients with CLLI aged 64.5 (54.9–72.6) years, the following parameters were assessed before and one year after SCS using the WIQ questionnaire: pain, distance, speed, stairs, where 100% no restrictions when walking. Results. In patients with CLLI, low WIQ values were initially identified for the scales of distance, speed, and stairs, less than 10%, and about 30% for the pain scale. One year after SCS, the values of pain, distance, and speed increased to 83.3% (68.4%–100%), 39.5% (17.9%–55.2%), and 24.4% (17.3%–35.8%), respectively, with significance at p < 0.001, p = 0.004, and p = 0.005, respectively. The lowest rates were on the scale of stairs: 6.2% (3.4%–7.3%), p = 0.06. Before the SCS, the factor adversely affecting the indicators of the distance scale was diabetes mellitus (β = –0.417; p = 0.002), and the age factor adversely affected the walking speed (β = –0.544; p = 0.005). After SCS, age exerted a negative effect on the walking speed (β = –0.497; p = 0.002). The scale for stairs was negatively affected by the presence of coronary heart disease (β = –0.421; p = 0.001) or diabetes mellitus (β = –0.325; p = 0.032). Conclusion. The use of SCS in patients with CLLI improves the parameters of walking in the long-term follow up after treatment, except for the ability to climb stairs. Age and the presence of diabetes mellitus or coronary heart disease are adverse factors that affect the walking parameters, both before and in the long-term period after SCS. Received 14 March 2019. Accepted 25 July 2019. Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest.