Relationship between pain and vertebral motion in chronic low-back pain subjects

Dickey, James P.; Pierrynowski, M.R.; Bednar, Drew A.; Yang, Simon X.

doi:10.1016/s0268-0033(02)00032-3

Cited by 66 publications

(40 citation statements)

References 25 publications

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“…The more practical, non-invasive and low cost tests, such as the modified Schober, are widely used in medical examinations and have received a large amount of scientific attention. Studies with more sophisticated (due to technical equipment) expensive or invasive measuring devices have provided detailed information about the lumbar ROM in chronic low back pain patients [9,26], but have few participants and are hardly applicable to everyday clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Do MRI findings correlate with mobility tests? An explorative analysis of the test validity with regard to structure

Quack

Schenk²,

Laeubli³

et al. 2006

Eur Spine J

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To find out whether segmental magnetic resonance imaging (MRI) findings such as intervertebral disc degeneration (DD) and facet joint osteoarthritis (FJO) are associated with motion deficiencies as seen in common mobility tests and observed range of motion (ROM). A total of 112 female subjects, nurses and office workers, with and without low back pain, were examined by clinical experts, and lumbar mobility was measured including modified Schober, fingertip-to-floor distance (FTFD) and ZEBRIS motion analysis. An MRI of the lumbar spine was made. Mobility findings were correlated with segmental morphologic changes as seen on MRI at the levels of L1-2 through L5-S1. Only a few statistically significant correlations between MRI findings and the results of the mobility tests could be found. Lateral bending was weakly and negatively correlated to DD and FJO but only on the level of L5-S1. The FTFD showed a weak positive correlation to endplate changes on the level of L4-5. When ROM is observed by clinical experts, there are several significant relationships between MRI findings and the observed motion. There is a highly significant segmental correlation between DD and disc form alteration as seen on MRI on the level of single motion segments. Pain history and current pain level did not moderate any association between MRI and mobility. There is no clear relationship between the structural changes represented by MRI and the measured mobility tests used in this study. Our findings suggest that close observation of spinal motion may provide at least equal information about the influence of spinal structures on motion than the commonly used measured mobility tests do.

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Section: Introductionmentioning

confidence: 99%

Do MRI findings correlate with mobility tests? An explorative analysis of the test validity with regard to structure

Quack

Schenk²,

Laeubli³

et al. 2006

Eur Spine J

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“…9 -11 Therefore, several invasive methods emerged with different reliability, technical difficulties, and, especially, clinical feasibility. For example, invasive methods include conventional lateral radiographs, 3-dimensional lumbar motion analyses by biplanar radiography, 12 videofluoroscopic or cineradiographic analyses, [13][14][15][16] the use of percutaneous transpedicular-external fixation pins 17,18 or Kirschner wires inserted into the spinous process, 19 and the use of open interventional magnetic resonance imaging. 20 Because the specific apparatus required and invasive nature of the aforementioned methods, to date, their use has been limited to scientific studies with small patient series investigated, except for conventional lateral radiographs.…”

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confidence: 99%

“…Because the postulated main advantage compared to fusion operation is the preservation of mobility, the quantification of movement will be of special clinical interest in future studies dealing with these techniques. Although the demonstration of coupled spinal motion is not possible and the methods are not as precise as other more invasive or technical demanding methods, 12,15,17,19 radiographs obtained in maximum flexion and extension will most likely be used more frequently to calculate the ROM of lumbar spine because of its clinical feasibility. 14,22,24 -28 Different radiologic methods have been described for the analysis of conventional flexion-extension radiographs to calculate the segmental ROM.…”

mentioning

confidence: 99%

Evaluation of Lumbar Spine Motion With Dynamic X-ray–A Reliability Analysis

Cakir

Richter

Käfer

et al. 2006

Spine

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Study Design. Radiologic evaluation of lumbar range of motion (ROM) with dynamic radiograph.Objectives. To calculate 95% confidence intervals (CIs) for the measurement error accompanying different methods, different observers, and different levels of training when measuring sagittal plane segmental ROM in lumbar spine. In addition, to compare the 95% CI with frequently common statistical methods of reliability analysis.Summary of Background Data. Dynamic radiographs are commonly used for ROM calculation of the lumbar spine. Yet, the reliability of different measurement methods still remains unclear.Methods. In 24 patients, levels L4 -L5 and L5-S1 were measured with the Cobb and superimposition methods on flexion-extension radiographs. There were 2 experienced and 1 inexperienced observer that performed the measurements. The 95% CIs were compared with the corresponding Pearson correlation coefficient and P value (t test).Results. The 95% CI of the superimposition method was Ϯ4.0°for the experienced and Ϯ4.7°for the inexperienced observer. The corresponding values for the Cobb method was Ϯ4.2°for the experienced and Ϯ6.8°for the inexperienced observer. The 95% CI for the measurement error became even worse when different methods or observers were compared, whereas a method constancy revealed superior reliability than observer constancy in experienced observers.Conclusions. For lumbar ROM measurement with dynamic radiograph, the superimposition method seems to be more reliable than the Cobb method. Study protocols dealing with ROM measurement have to calculate the 95% CI of the measurement method used because clinically valid conclusions can only be drawn with respect to these intervals.

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“…4 Some studies have found that people with low back pain (LBP) have impaired joint movement of the spine. [6][7][8] Passias and colleagues, 6 whose study was aimed at better understanding the mechanical dysfunctions of vertebrae in people with discogenic LBP, reported a decrease in mobility in this population relative to people without LBP symptoms. Palpatory tests are frequently used to assess asymmetrical vertebral position and rotational movement through palpation of the transverse processes and to aid in diagnosis when pain and function are altered.…”

Section: Ré Sumémentioning

confidence: 94%

Inter- and Intra-observer Agreement of the Motion Palpation Test for Lumbar Vertebral Rotational Asymmetry

Bracht

Nunes

Celestino

et al. 2015

Physiotherapy Canada

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Purpose: To investigate inter-and intra-observer agreement in the assessment of lumbar vertebral rotational (VR) asymmetry by a motion palpation test. Methods: For this prospective and descriptive test-retest study, 51 asymptomatic participants (40 women, 11 men; mean age 23.3 [SD 5.6] years) were recruited from the community. Each participant was assessed in two sessions by the same three observers, who assessed VR by means of a palpatory test for movement asymmetry. This test is performed by applying posteroanterior pressure in an alternating manner to the left and right transverse processes of a vertebra to determine motion asymmetry in the transverse plane and thus the vertebral position. Observers classified the vertebral position as neutral, rotation to the right, and rotation to the left; they were blinded to which participant was being assessed and to any previous results. Results: Intra-and inter-observer agreement was verified by the kappa coefficient (k) and the weighted kappa coefficient (k w ). Values of k and k w varied from 0.07 (95% CI, À0.10 to 0.245) to 0.37 (95% CI, 0.11-0.63) for intra-observer agreement and from 0.12 (95% CI, À0.06 to 0.29) to 0.30 (95% CI, 0.08-0.52) for inter-observer agreement. Conclusion: The motion palpation test used to assess VR asymmetry has low agreement levels; therefore, its clinical significance for measuring vertebral position is questionable.Key Words: lumbar vertebrae; motion palpation test; reproducibility of results; spine. RÉ SUMÉObjet: Analyser la convergence interobservateurs et intra-observateur dans l'é valuation de l'asymé trie de la rotation des vertè bres (RV) lombaires par palpation du mouvement. Mé thodes: Pour cette é tude test-retest prospective et descriptive, on a recruté dans la communauté 51 participants asymptomatiques (40 femmes, 11 hommes; â ge moyen de 23,3 [ET de 5,6] ans). Les trois mê mes observateurs ont é valué chaque participant au cours de deux sé ances et dé terminé la RV par palpation afin de dé terminer l'asymé trie du mouvement. On pratique ce test en appliquant une pression anté rieure en alternance sur les apophyses transverses gauche et droite d'une vertè bre afin de dé terminer l'asymé trie du mouvement dans le plan transversal et, par consé quent, la position de la vertè bre. Les observateurs ont classé la position de la vertè bre comme neutre, en rotation vers la droite et en rotation vers la gauche. Ils ne savaient pas quel participant é tait é valué et ne connaissaient pas les ré sultats anté rieurs. Ré sultats: On a vé rifié la convergence interobservateurs et intra-observateur au moyen du coefficient kappa (k) et du coefficient kappa pondé ré (k p ). Les valeurs de k et k p ont varié de 0,07 (IC à 95% de 0,10 à 0,245) à 0,37 (IC à 95% de 0,11 à 0,63) dans le cas de la convergence intra-observateur et de 0,12 (IC à 95% de À0,06 à 0,29) à 0,30 (IC à 95% de 0,08 à 0,52) dans celui de la convergence interobservateurs. Conclusion: La palpation du mouvement utilisé e pour é valuer l'asymé trie de la RV produit de fa...

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Relationship between pain and vertebral motion in chronic low-back pain subjects

Cited by 66 publications

References 25 publications

Do MRI findings correlate with mobility tests? An explorative analysis of the test validity with regard to structure

Do MRI findings correlate with mobility tests? An explorative analysis of the test validity with regard to structure

Evaluation of Lumbar Spine Motion With Dynamic X-ray–A Reliability Analysis

Inter- and Intra-observer Agreement of the Motion Palpation Test for Lumbar Vertebral Rotational Asymmetry

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