• Chiara Masi, Gaelle Couraud, Camille Daste, Jennifer Jouffriault, Serge Poiraudeau, Marie-Martine LefÈvre-Colau, Francois Rannou, and Christelle Nguyen.
• Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique-Hôpitaux de Paris (AP-HP), Cochin Hospital, Paris, France.
• Eur J Phys Rehabil Med. 2021 Feb 1; 57 (1): 92-100.

BackgroundLumbar spinal stenosis (LSS) is the leading cause of spinal surgery in people over 65-years old. In people with LSS, generic self-administered questionnaires are the most commonly used PROs to assess health-related quality of life, global activity limitation, and low back pain-located activity limitation.AimThe aim was to develop a new patient-reported outcome measure assessing activities and participation in people with LSS.DesignObservation, prospective and qualitative study.SettingFor the qualitative study, were enrolled in- and outpatients with LSS from 2 French tertiary care centers (Department of PRM of Cochin Hospital and Department of Rheumatology of Limoges Hospital). For the Internet E-survey, screened the electronic medical records of the Department of PRM of Cochin Hospital.PopulationFrom February to April 2018 were enrolled patients older than 50-years and symptomatic LSS.MethodsWe used a 2-step approach. In a first step, we conducted a qualitative study using in-depth semi-structured interviews in 20 patients with LSS to collect meaningful concepts and to develop a provisional questionnaire. In a second step, using the provisional questionnaire, we conducted an Internet E-survey in an independent sample of 200 patients with LSS.ResultsConcepts collected from patients generated a 48-item provisional questionnaire. Overall, 63/200 (31.5%) patients completed the provisional questionnaire. Item reduction resulted in a 19-item questionnaire, the Cochin Spinal Stenosis 19-item (CSS-19) questionnaire. Principal component analysis extracted 3 factors. In confirmatory analysis, factor 1 influenced all items. We found convergent validity with low back pain, LSS-specific disability and divergent validity with mental health-related quality of life. Cronbach α coefficient (95% CI) was 0.96 (0.94; 0.97). ICC was 0.90 (0.70; 0.97). Bland and Altman analysis found no systematic trend for test-retest.ConclusionsCSS-19 is a new patient-reported outcome measure assessing activities and participation in people with LSS. Its construction prioritized patients' perspectives at all stages. Its content and construct validities are good.Clinical Rehabilitation ImpactInstruments able to capture specific needs of people with LSS in terms of activities and participation are lacking.

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