Background Low back pain (LBP) is one of the most common musculoskeletal disorders, causing significant personal and social burden. Current research is focused on the processes of the central nervous system (particularly the sensorimotor system) and body perception, with a view to developing new and more efficient ways to treat chronic low back pain (CLBP). Several clinical tests have been suggested that might have the ability to detect alterations in the sensorimotor system. These include back-photo assessment (BPA), two-point discrimination (TPD), and the movement control tests (MCT). The aim of this study was to determine whether the simple clinical tests of BPA, TPD or MCT are able to discriminate between nonspecific CLBP subjects with altered body perception and healthy controls. Methods A cross-sectional study was conducted. At one point in time, 30 subjects with CLBP and 30 healthy controls were investigated through using BPA, TPD and MCT on the lower back. Correlations among the main covariates and odds ratios for group differences were calculated. Results MCT showed an odds ratio for the presence of CLBP of 1.92, with a statistically significant p-value (0.049) and 95%CI. The TPD and BPA tests were unable to determine significant differences between the groups. Conclusions Of the three tests investigated, MCT was found to be the only suitable assessment to discriminate between nonspecific CLBP subjects and healthy controls. The MCT can be recommended as a simple clinical tool to detect alterations in the sensorimotor system of nonspecific CLBP subjects. This could facilitate the development of tailored management strategies for this challenging LBP subgroup. However, further research is necessary to elucidate the potential of all the tests to detect alterations in the sensorimotor system of CLBP subjects. Trial registration No trial registration was needed as the study contains no intervention. The study was approved by the Swiss Ethics Commission of Northwest and Central Switzerland (EKNZ) reference number 2015–243.
Background: Low back pain is one of the most common musculoskeletal disorders. It leads to major costs in health care systems and causes significant personal and social burdens. Current research focuses on the processes of the central nervous system such as cortical changes in pain perception to discover new and more efficient ways to treat chronic low back pain (CLBP). Several clinical tests have been suggested that might correlate with altered cortical representation. These include back-photo assessment (BPA), movement control tests (MCI) and two-point discrimination thresholds (TPD).Objective: The aim of this study was to determine whether BPA, MCI and TPD tests can discriminate between CLBP patients with altered body perception and healthy controls.Design: A case-control study matched by gender and age.Methods: Using MCI, BPA and TPD tests on the lower back, thirty patients with CLBP and thirty healthy controls were investigated at one point in time. Participants were also required to complete three questionnaires: the ‘Fear Avoidance Belief Questionnaire’, the ‘Hospital Anxiety and Depression Scale’ and the ‘Fremantle Back Awareness Questionnaire’. Correlations among the main covariates and odds ratios for group differences were calculated.Results: The MCI showed a statistically significant odds ratio for the presence of CLBP of 0.65 (p< 0.05), whereas TPD and BPA did not determine differences between the groups.Conclusion: The movement control test was found to be the only suitable test to discriminate CLBP patients from healthy controls.Trial registration: The study was approved by the Swiss Ethical Commission Northwest and Central Switzerland (EKNZ) and registered at 21.8.2015, reference number 2015-243.
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