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ECK DISORDERS REMAIN A common problem in modern, industrialized countries. Neck pain has been the most common chief complaint among working-aged women visiting their physicians. 1,2 In a Canadian study, 3 54% of the general population had experienced neck pain during the past 6 months, and approximately 5% were highly disabled by neck pain. The prevalence of chronic neck pain has been reported to be 7% in women and 5% in men in Finland. 4 Patients with chronic neck pain used health care services twice as much as the population on average. 2 Sick leave, therapy, and specialist care form the major part of the costs incurred by neck pain, whereas investigations at the primary health care level play a minor role. 5 The origin and exact pathophysiologic mechanisms of chronic neck pain often remain obscure because trauma or severe degenerative conditions at working age are found only in Author Affiliations are listed at the end of this article.

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BackgroundMovement 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.MethodsWe videoed patients performing a standardized test battery consisting of 10 active movement tests for motor control in 27 patients with non specific low back pain and 13 patients with other diagnoses but without back pain. Four physiotherapists independently rated test performances as correct or incorrect per observation, blinded to all other patient information and to each other. The study was conducted in a private physiotherapy outpatient practice in Reinach, Switzerland. Kappa coefficients, percentage agreements and confidence intervals for inter- and intra-rater results were calculated.ResultsThe kappa values for inter-tester reliability ranged between 0.24 – 0.71. Six tests out of ten showed a substantial reliability [k > 0.6]. Intra-tester reliability was between 0.51 – 0.96, all tests but one showed substantial reliability [k > 0.6].ConclusionPhysiotherapists were able to reliably rate most of the tests in this series of motor control tasks as being performed correctly or not, by viewing films of patients with and without back pain performing the task.

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Depression, cardiovascular comorbidity, disorder influencing walking ability, and scoliosis predicted poorer subjective outcome. Better walking ability, self-rated health, higher income, less overall comorbidity, and pronounced central stenosis predicted better subjective outcome. Male gender and younger age predicted better postoperative walking ability. The predictive value may be outcome specific; thus, the use of all relevant outcome measures is recommended when studying predictors of LSS.

The results suggest that clear myelographic stenosis and no prior surgical intervention, no comorbidity of diabetes, no hip joint arthrosis, and no preoperative fracture of the lumbar spine are factors associated with a good outcome in surgical management of lumbar spinal stenosis.

Background: To determine whether there is a difference between patients with low back pain and healthy controls in a test battery score for movement control of the lumbar spine.