Research ArticleOriginal Article
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Exploring physiotherapist’s ability to identify cauda equina syndrome early

Khalid F. Althobaiti, Joshua R. Zadro, Fahad A. Alzhrani and Hosam A. Alzahrani
Neurosciences Journal April 2025, 30 (2) 101-107; DOI: https://doi.org/10.17712/nsj.2025.2.20240035

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Tables

  • Table 1

    - Characteristics of participants.

      Ability to early identify and manage CES (%)P-valuea
    CharacteristicsAll participants (N=401)“Proficient ability” (N=52)“Good ability” (N=203)“Fair ability” (N=108)“Poor ability” (N=38) 
    Age, years (mean (SD))29.5 (5.5)29.9 (5.7)29.6 (5.9)29.3 (5.2)29.3 (4.6)0.945 b
    Gender (N (%))     0.243
    Male187 (46.6)36.5%46.3%48.1%57.9% 
    Female214 (53.4)63.5%53.7%51.9%42.1% 
    Highest Academic Education Qualification (N (%))   0.006
    Internship year7 (1.7)0.0%2.5%1.9%0.0% 
    Diploma degree13 (3.2)3.8%1.5%4.6%7.9% 
    Bachelor’s degree307 (76.6)63.5%75.9%79.6%89.5% 
    Master’s degree64 (16.0)30.8%18.2%9.3%2.6% 
    PhD degree10 (2.5)1.9%2.0%4.6%0.0% 
    Years of practice (N (%))     0.385
    Less than 1 year88 (21.9)23.125.115.721.1 
    From 1 to 5 years170 (42.4)42.337.951.939.5 
    From 6 to 10 years69 (17.2)11.519.715.715.8 
    More than 10 years74 (18.5)23.117.216.723.7 

    CES - cauda equina syndrome; N- number of participants; SD - standard deviation.

    • ↵a P-value was assessed using chi square, unless otherwise stated.

    • ↵b P-value was assessed using One-way ANOVA.

  • Table 2

    - Responses of physiotherapists to the cauda equina syndrome statements.

    Statements  
     Yes n (%)No n (%)
    Do you use toolkit/guidelines for early identification of cauda equina syndrome?102 (25.4)299 (74.6)
     Agree n (%)Disagree n (%)
    Full neurological examinations that include sensation when a patient has lower back pain is not important. (Reversed statement)88 (21.9)313 (78.1)
    Cauda equina syndrome does not have a ‘progression pattern’. (Reversed statement)69 (17.2)332 (82.8)
    Suspected cauda equina syndrome stage is when the patient has urinary difficulties of neurogenic origin.354 (88.3)47 (11.7)
     Yes n (%)No n (%)
    Do you suspect cauda equina syndrome when patients describe their pain by radicular pain of one side or both sides (Ipsilateral radiculopathy or Bilateral radiculopathy)? a343 (85.5)58 (14.5)
    Do you ask your patient when they have bilateral radiculopathy about any bowel/bladder dysfunctions in detail?226 (56.4)175 (43.6)
    Do you give your patient with suspected cauda equina syndrome warning signs card (‘Safety Netting Card’)?179 (44.6)222 (55.4)
    Do you warn and explain to the patient with suspected cauda equina syndrome the red flags symptoms?289 (72.1)112 (27.9)
    Do you document the patient’s signs and symptoms of cauda equina syndrome including duration, frequency and progression and the time and date of every contact immediately?289 (72.1)112 (27.9)
     Agree n (%)Disagree n (%)
    Communication and simple language are not important with patients with suspected cauda equina syndrome and could not be vital information from patients regarding early cauda equina syndrome symptoms. (Reversed statement)149 (37.2)252 (62.8)
     Correct n (%)Incorrect n (%)
    What is the appropriate management of patients with suspected cauda equina syndrome? b146 (36.4)255 (63.6)
     Agree n (%)Disagree n (%)
    The MRI request should state the extreme urgency of investigation and evaluation (or re-evaluation) of the patient with suspected cauda equina syndrome.353 (88.0)48 (12.0)

    • ↵a Bilateral radiculopathy=Yes; Ipsilateral radiculopathy=No,

    • ↵b Send the patient immediately to MRI and give the patient ‘Safety Netting Card’ or warn the patient=correct; any other answer=incorrect

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