Evidence-Based Normative Data in Lumbar Flexion Control Tests; a Pilot Study (original) (raw)
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Assessments of Lumbar Flexion Range of Motion
Spine, 2014
Objective. To compare intertester reliability and concurrent validity of 2 frequently used methods for assessing lumbar fl exion range of motion: the fi ngertip-to-fl oor distance (FFD) test and the modifi ed Schober (mSchober) test. Summary of Background Data. An assessment of lumbar fl exion range of motion is often incorporated in the clinical evaluation of patients with low back pain, as well as in clinical studies when examining the effects of different therapies on these patients. In both cases, the validity and reliability of assessment methods are important. Methods. The FFD test and the mSchober test were used in a heterogeneous study sample (n = 98) including patients with low back pain, pelvic girdle pain, and individuals without pain in either of these areas. Each participant was examined by 2 of 3 randomly selected assessors on the same day. Intraclass correlation coeffi cient 3,1 , together with the Bland and Altman plot, were used to examine intertester reliability. Absolute reliability was calculated by the smallest detectable change. The relationship between the 2 tests was measured using Pearson correlation coeffi cient (r), which was used as the measure of concurrent validity. Results. The FFD test and the mSchober test showed an intraclass correlation coeffi cient of 0.93 and 0.77, and a smallest detectable change of 9.8 and 1.8 cm, respectively. There was a medium negative correlation between the 2 tests; an increase in the mSchober test resulted in a decrease in the FFD test (r = − 0.47, P ≤ 0.001). Conclusion. In our heterogeneous study sample, the FFD and the mSchober test showed excellent intertester reliability but with a relatively large smallest detectable change. However, the medium correlation between these 2 tests to measure lumbar fl exion range of motion indicates that they do not fully assess the same phenomenon and hence should be used in combination when examining patients.
Reliability of movement control tests in the lumbar spine
BMC Musculoskeletal Disorders, 2007
Background: Movement control dysfunction [MCD] reduces active control of movements. Patients with MCD might form an important subgroup among patients with non specific low back pain. The diagnosis is based on the observation of active movements. Although widely used clinically, only a few studies have been performed to determine the test reliability. The aim of this study was to determine the inter-and intra-observer reliability of movement control dysfunction tests of the lumbar spine.
Objective Assessment with Establishment of Normal Values for Lumbar Spinal Range of Motion
Physical Therapy, 1983
The purpose of this article is to present an assessment method, in conjunction with age-related normal values, for lumbar spinal range of motion. Lumbar flexion, lumbar extension, and right and left lateral flexion were measured on 172 subjects by a combination of goniometry and spinal distraction techniques. Normal values are given for six age groups; each group had a range of 10 years. The results demonstrate that a significant decrease in lumbar spinal range of motion is expected with increasing age. The interobserver reliability based on 17 subjects was substantial for the four measurements taken; coefficients ranged from +.76 to +1.0. The information may prove useful to the clinician as an improved method for assessing the lumbar spine.
Development of kinematics tests for the evaluation of lumbar proprioception and equilibration
Clinical Biomechanics, 2003
Objective. This study aimed at developing lumbar repositioning and seated equilibration tests. Design. 3D-electrogoniometric study of trunk repositioning and equilibration in seated position. Background. Postural equilibrium and lumbar proprioception alterations have been shown in patients with low-back pain. Methods. In 21 healthy volunteers, pure flexion and flexion + rotation repositioning error was measured using 3D-electrogoniometry. Lumbar kinematics was analysed (time and frequency domain) during antero-posterior and lateral equilibration tests in seated position. Reproducibility and stability of the protocol were evaluated.
Multivariate Study of 42 Lumbar Spines Range of Motion of the Intact Lumbar Segment : A
2019
Background A thorough understanding of the biomechanical characteristics of the healthy human spine is critical in furthering the treatment of spinal pathology. The goal of this study was to investigate the motion of the intact lumbar spine segment as measured by range of motion (ROM), and to investigate the dependencies thereof on gender and intervertebral level. Materials and Methods Kinematic data was obtained for 42 human lumbar segments (L1-S1) in response to a pure-moment loading protocol in flexion extension (FE), lateral bending (LB) and axial torsion (AT). Data was obtained for 204 individual functional spinal units (91 female, 113 male). Multivariate analysis of variance was conducted to detect differences between genders and intervertebral levels in each mode of loading. Correlations between ROM and donor demographics, including height, weight, and age, were conducted. Results ROM was significantly greater for females than for males in FE, LB and AT (p<0.001). ROM tended to increase down the vertebral column in FE. L3-4 FE ROM was significantly greater than L1-2 (p=0.024), and L4-5 and L5-S1 FE ROM were significantly greater than for every other level (p<0.003). LB ROM tended to be greater toward the center of the segment with L2-3, L3-4 and L4-5 ROM being significantly greater than both L1-2 (p<0.001) and L5-S1 (p=0.006, p<0.001, p=0.043, respectively). A similar trend was found for AT, however only L1-2 was significantly less than all other levels (p=0.042, p<0.001, p<0.001, and p=0.034 for L2-3, L3-4, L4-5, and L5-S1 respectively). Conclusion The significant differences in lumbar ROM between male and female spine segments and between the intervertebral levels must be taken into account in study design in order to prevent biases in outcomes. The significant differences in ROM between levels may also have critical implications in the design of spinal implants, particularly those designed to maintain or restore healthy motion.
Reproducibility of postural control measurement during unstable sitting in low back pain patients
BMC Musculoskeletal Disorders, 2007
Background: Postural control tests like standing and sitting stabilometry are widely used to evaluate neuromuscular control related to trunk balance in low back pain patients. Chronic low back pain patients have lesser postural control compared to healthy subjects. Few studies have assessed the reproducibility of the centre of pressure deviations and to our knowledge no studies have investigated the reproducibility of three-dimensional kinematics of postural control tests in a low back pain population. Therefore the aim of this study was to assess the test-retest reproducibility of a seated postural control test in low back pain patients.
The reliability of the CODA motion analysis system for lumbar spine analysis: a pilot study
Physiotherapy Practice and Research, 2010
Background: Low bock pain (LBP)is 0 very common musculoskeletal disorder. Lumbar range of motion (ROM) and posture are parameters which are commonly assessed in LBP research. Reliable methods of measuring lumbar spine ROM and posture are needed. The CODA motion analysis system has several potential advantages over other motion analysis systems; however its reliability for lumbar spine analysis has not been examined. This study investigated the reliability of the CODA system for measuring lumbar spine sagittal plane ROM and posture. Methods: Twelve participants were tested by two investigators on two occasions. Ten trials of lumbar ROM and usual sitting posture were performed. The reliability of upper lumbar, lower lumbar, and pelvic sagittal plane motion was assessed using intra-closs correlation coefficients (ICC) and Blond and Altman methods, including evaluation of the mean diHerence and limits of agreement. Results: Levels of association were very good for ROM, for both intra-rater and inter-rater measurements (all ICC >0.7). However, agreement was more variable, with some lower lumbar and pelvic regions displaying large mean differences and wide limits of agreement. Overall, greater reliability was obtained for the upper lumbar region angles, and for intra-rater comparisons. Conclusion: Reliability of the CODA system varied from very good to fair, depending on the parameters assessed. While good association was found between most parameters, the level of agreement was only fair to moderate. Recommendations are mode to improve the protocol used to assess spinal motion, which may improve reliability.
Archives of Physical Medicine and Rehabilitation, 2008
Objective: To examine the interobserver reliability of the assessment of lumbar range of motion (ROM) and maximal isometric strength in patients with chronic low back pain (CLBP) using commercially available equipment. Design: A prospective repeated-measures design. Setting: Ambulatory care in a university hospital. Participants: Twelve patients (5 men, 7 women; age range, 20Ϫ52y) with CLBP, with a mean visual analog scale score of 31.5Ϯ25.8mm, volunteered for the study. The duration of their symptoms was 63Ϯ115 months and the mean Oswestry Disability Index score was 31%. Interventions: Not applicable. Main Outcome Measures: Movements of the lumbar spine were assessed with commercially available equipment. Both the range of motion (ROM) and the maximal isometric strength for flexion, extension, lateroflexion, and rotation of the lumbar spine were evaluated twice to analyze the interobserver reliability. The same test procedure was performed on 2 separate days by 2 investigators who were blinded to the outcome of the assessment of their colleague. The order of investigator was balanced, so that each investigator tested the same number of patients as first investigator. Results: The intraclass correlation coefficient varied between .91 and .98 for the measurements of the lumbar ROM and was between .93 and .97 for all the strength measurements. Post hoc power analysis confirmed previous power analysis, that is, despite the small sample size, an excellent power was found for the observed interobserver reliability coefficients (power range, 0.93Ϫ1.00). No learning effect was found when comparing the results of the second measurement with the first measurement (PϾ.05). Conclusions: The interobserver reliability is excellent for the measurement of the ROM of the lumbar spine and for the maximal isometric strength using specific devices in patients with CLBP.
Parallel Reliability of Lumbar-Flexion Measurements
Journal of Sport Rehabilitation, 2004
Context:Research and clinical recordings of lumbar flexion demand practicable and precise methodology for quantifying variations.Objective:To describe and evaluate the parallel reliability of 2 methods of measuring lumbar fexion—perpendicular stick markers (SM) and the distanciometer (DM)—using an electrogoniometer (EGM) as reference.Design:Parallel measurement for reliability.Setting:Laboratory.Participants:25 healthy men.Intervention:Simultaneous measure of lumbar flexion at preestablished positions (0°, 15°, 30°, and 45°).Outcome Measures:Data from SM and DM, recorded simultaneously.Results:High parallel reliability was found when comparing the EGM data with the SM (r = .997; measurement error: 0.6° ± 0.7°; no differences: t-test P = .260) and with the DM (r = .962; measurement error: 2.8° ± 1.9°; no differences: t-test P = .973).Conclusions:Considering the reliability, practicability, and low cost of the described methods, they can be regarded as applicable and useful.