A Screening Tool for Patients With Lumbar Instability: A Content Validity and Rater Reliability of Thai Version

Chatprem, Thiwaphon; Puntumetakul, Rungthip; Yodchaisarn, Wantanee; Siritaratiwat, Wantana; Boucaut, Rose; Sae-Jung, Surachai

doi:10.1016/j.jmpt.2019.04.010

Cited by 9 publications

(32 citation statements)

References 25 publications

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“…For translation measurement (Figure 2), lines were drawn to bisect the endplate angle. The difference between the two distances from (A) and (B) defined the amount of translation (mm) [49]. The process of lumbar segmental motion measurement was assessed by a radiologist (Researcher JK), using flexion-extension radiographs according to criteria proposed by Panjabi in 2003 [4].…”

Section: Lumbar Segmental Motionmentioning

confidence: 99%

The Effects of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique versus General Strengthening Exercise on Lumbar Segmental Motion in Patients with Clinical Lumbar Instability: A Randomized Controlled Trial with 12-Month Follow-Up

Puntumetakul

Saiklang

Tapanya

et al. 2021

IJERPH

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Trunk stability exercises that focus on either deep or superficial muscles might produce different effects on lumbar segmental motion. This study compared outcomes in 34 lumbar instability patients in two exercises at 10 weeks and 12 months follow up. Participants were divided into either Core stabilization (deep) exercise, incorporating abdominal drawing-in maneuver technique (CSE with ADIM), or General strengthening (superficial) exercise (STE). Outcome measures were pain, muscle activation, and lumbar segmental motion. Participants in CSE with ADIM had significantly less pain than those in STE at 10 weeks. They showed significantly more improvement of abdominal muscle activity ratio than participants in STE at 10 weeks and 12 months follow-up. Participants in CSE with ADIM had significantly reduced sagittal translation at L4-L5 and L5-S1 compared with STE at 10 weeks. Participants in CSE with ADIM had significantly reduced sagittal translations at L4-L5 and L5-S1 compared with participants in STE at 10 weeks, whereas STE demonstrated significantly increased sagittal rotation at L4-L5. However, at 12 months follow-up, levels of lumbar sagittal translation were increased in both groups. CSE with ADIM which focuses on increasing deep trunk muscle activity can reduce lumbar segmental translation and should be recommended for lumbar instability.

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Section: Lumbar Segmental Motionmentioning

confidence: 99%

The Effects of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique versus General Strengthening Exercise on Lumbar Segmental Motion in Patients with Clinical Lumbar Instability: A Randomized Controlled Trial with 12-Month Follow-Up

Puntumetakul

Saiklang

Tapanya

et al. 2021

IJERPH

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“…The selection of participants was undertaken using a convenience sampling approach. The exclusion criteria included the following; contraindication to X-ray assessment (e.g., pregnancy), previous lumbar surgery, serious spinal pathology (e.g., cauda equina syndrome, malignancy, vertebral fracture and infection), scoliosis, neurological deficit and spondylolisthesis [ 12 , 29 ].…”

Section: Methodsmentioning

confidence: 99%

“…All X-ray images for each participant were read by a trained observer who was blinded to the clinical test results. Imaging-related findings have been previously used to confirm the presence of lumbar instability [ 7 , 12 , 21 – 24 ]. The amount of sagittal plane translation and rotation occurring at individual spinal motion segments between L 1-2 and L 5 -S 1 was calculated from the X-ray films (Fig.…”

Section: Methodsmentioning

confidence: 99%

“…The amount of sagittal plane translation and rotation occurring at individual spinal motion segments between L 1-2 and L 5 -S 1 was calculated from the X-ray films (Fig. 1 ) [ 12 ].

Fig.…”

Section: Methodsmentioning

confidence: 99%

“…The incidence rate of clinical lumbar instability in patients with CLBP is 13-46% [ 8 , 9 ]. Lumbar instability can lead to pain, functional limitations and reduced quality of life [ 10 – 12 ], as well as further develop into spondylolisthesis in certain cases, which may require surgical treatment [ 1 , 13 ]. Therefore, the prompt detection of lumbar instability is crucial to preventing disease progression or inhibiting adverse effects.…”

Section: Introductionmentioning

confidence: 99%

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A diagnostic tool for people with lumbar instability: a criterion-related validity study

Chatprem

Puntumetakul

Kanpittaya

et al. 2021

BMC Musculoskelet Disord

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Background Several clinical tests used to identify patients with lumbar instability have reported diagnostic accuracy in separate studies with conflicting results. To augment the diagnostic process, tests that are better able to identify lumbar instability suitable for use in the clinical setting are required. The aim of this study was to identify the probability to diagnose patients with lumbar instability, using x-ray imaging as the reference standard. Methods This study was a cross-sectional, diagnostic validity study. One hundred forty participants with chronic low back pain underwent an x-ray assessment and 14 clinical examinations. Data were analysed using multivariate regression methods to determine which clinical tests were most diagnostic for lumbar instability when they were applied together. Results Eighteen (12.85%) participants had radiological lumbar instability. Three clinical tests i) interspinous gap change during flexion-extension, ii) passive accessory intervertebral movement tests, iii) posterior shear test demonstrated an ability to diagnose lumbar instability of 67% when they were all positive. At this probability threshold, sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (−LR) were 5.56, 99.18%, 6.78, and 0.95. Conclusions These 3 clinical tests could be useful in identifying patients with lumbar instability in the general community. These three tests are simple to perform by physical therapists, reliable to use in a clinical setting, and safe for patients. We recommend physical therapists use these three tests to assess patients who are suspected of having lumbar instability, in the absence of an x-ray assessment, to receive appropriate targeted intervention or referral for further investigation. Trial registration Thai Clinial Trial Registry (TCTR 20180820001; 19th August 2018).

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