Reliability of Physical Examination Items Used for Classification of Patients With Low Back Pain

Dillen, Linda R. Van; Sahrmann, Shirley A.; Norton, Barbara J.; Caldwell, Cheryl; Fleming, Deborah A; McDonnell, Mary Kate; Woolsey, Nancy B

doi:10.1093/ptj/78.9.979

Cited by 182 publications

(199 citation statements)

References 11 publications

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“…34 For each test, a judgment is made by the clinician about the presence or absence of a specific movement impairment. Because one of the main assumptions of Sahrmann's model is that early movement of the lumbopelvic region during everyday movements contributes to LBP, 25 a primary judgment made is whether the patient moves his or her lumbopelvic region early in the range of the test movement.…”

Section: Discussionmentioning

confidence: 99%

“…34 The current study focused specifically on a subset of active movement tests. The tests consisted of trunk, limb, and combined trunk and limb movements.…”

Section: Examination Itemsmentioning

confidence: 99%

“…34 People were recruited from outpatient physical therapy clinics, through advertisements on posters and in local newspapers, and from family members and friends of patients who had already participated in the study. People between 18 and 75 years of age who had LBP symptoms in the region of the lower back, proximal lower extremity, or distal lower extremity 29 were eligible for inclusion in the study.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Gender-Related Differences in Prevalence of Lumbopelvic Region Movement Impairments in People With Low Back Pain

Scholtes¹,

Dillen²

2007

J Orthop Sports Phys Ther

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Section: Discussionmentioning

confidence: 99%

“…34 The current study focused specifically on a subset of active movement tests. The tests consisted of trunk, limb, and combined trunk and limb movements.…”

Section: Examination Itemsmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Gender-Related Differences in Prevalence of Lumbopelvic Region Movement Impairments in People With Low Back Pain

Scholtes¹,

Dillen²

2007

J Orthop Sports Phys Ther

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“…For this report we used information on lumbar curvature, pain on active movement, a graded lumbar pain provocation test [21], lumbar pain threshold [5,6], neuromuscular control [15,32] as judged by the therapist, and a test of the ability to activate the lumbar multifidus muscles [29]. An overview of the variables is given in Table 2.…”

Section: Data Collection and Research Variablesmentioning

confidence: 99%

“…Inability to control lumbar movement (y/n) Patients were categorised as being able to control lumbar movement or not based on the therapist's interpretation of the performance of six exercises [32] 85 (21) Activation of multifidus muscles (can/cannot) Inability to voluntarily activate lumbar multifidus muscles (LMM) based on palpation of contraction after therapist's instruction [29] 210 ( Heavy smokers were almost twice as common in group 1 as in both groups 2 and 3. The mean of BMI was almost equal in the three groups.…”

Section: (29) Amentioning

confidence: 99%

Modic changes and their associations with clinical findings

et al. 2006

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It is believed that disc degeneration (DD) is, in general, only mildly associated with low back pain (LBP). MRI-identified Modic changes (MC), probably a late stage of DD, are relatively strongly associated with LBP but it is not known if people with MC also have a specific clinical profile. The purpose of this study was to investigate if the clinical findings differ in people with Modic changes (MC) as compared to those with only degenerative disc findings or none at all. In a population-based sample of 412 40-year-old Danes, information was collected independently with MRI, questionnaires and clinical examination. Three subgroups of people were created: those with both DD and MC, those with only DD, and those with neither DD nor MC. The clinical pattern was investigated for each subgroup in order to test the assumption that the clinical picture differs in the three groups. It was expected that people with both DD and MC would have a more pronounced clinical profile than those with only DD who, in turn, would differ from those with neither of these two MRI findings. Our findings were generally in concordance with our expectations. MC constitutes the crucial element in the degenerative process around the disc in relation to LBP, history, and clinical findings. People with DD and no MC only vaguely differ from those without. People with LBP and MC may deserve to be diagnosed as having specific LBP.

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Effect of Motor Skill Training in Functional Activities vs Strength and Flexibility Exercise on Function in People With Chronic Low Back Pain

et al. 2021

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IMPORTANCE Chronic low back pain (LBP) is the most prevalent chronic pain in adults, and there is no optimal nonpharmacologic management. Exercise is recommended, but no specific exercise-based treatment has been found to be most effective.OBJECTIVE To determine whether an exercise-based treatment of person-specific motor skill training (MST) in performance of functional activities is more effective in improving function than strength and flexibility exercise (SFE) immediately, 6 months, and 12 months following treatment. The effect of booster treatments 6 months following treatment also was examined. DESIGN, SETTING, AND PARTICIPANTSIn this single-blind, randomized clinical trial of people with chronic, nonspecific LBP with 12-month follow-up, recruitment spanned December 2013 to August 2016 (final follow-up, November 2017), and testing and treatment were performed at an academic medical center. Recruitment was conducted by way of flyers, physician and physical therapy offices, advertisements, and media interviews at Washington University in St Louis, Missouri. Of 1595 adults screened for eligibility, 1301 did not meet the inclusion criteria and 140 could not be scheduled for the first visit. A total of 154 people with at least 12 months of chronic, nonspecific LBP, aged 18 to 60 years, with modified Oswestry Disability Questionnaire (MODQ) score of at least 20% were randomized to either MST or SFE. Data were analyzed between December 1, 2017, and October 6, 2020.INTERVENTIONS Participants received 6 weekly 1-hour sessions of MST in functional activity performance or SFE of the trunk and lower limbs. Half of the participants in each group received up to 3 booster treatments 6 months following treatment. MAIN OUTCOMES AND MEASURESThe primary outcome was the modified Oswestry Disability Questionnaire (MODQ) score (0%-100%) evaluated immediately, 6 months, and 12 months following treatment.RESULTS A total of 149 participants (91 women; mean [SD] age, 42.5 [11.7] years) received some treatment and were included in the intention-to-treat analysis. Following treatment, MODQ scores were lower for MST than SFE by 7.9 (95% CI, 4.7 to 11.0; P < .001). During the follow-up phase, the MST group maintained lower MODQ scores than the SFE group, 5.6 lower at 6 months (95% CI, 2.1 to 9.1) and 5.7 lower at 12 months (95% CI, 2.2 to 9.1). Booster sessions did not change MODQ scores in either treatment.CONCLUSIONS AND RELEVANCE People with chronic LBP who received MST had greater short-term and long-term improvements in function than those who received SFE. Person-specific MST in functional activities limited owing to LBP should be considered in the treatment of people with chronic LBP.

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Reliability of Physical Examination Items Used for Classification of Patients With Low Back Pain

Cited by 182 publications

References 11 publications

Gender-Related Differences in Prevalence of Lumbopelvic Region Movement Impairments in People With Low Back Pain

Gender-Related Differences in Prevalence of Lumbopelvic Region Movement Impairments in People With Low Back Pain

Modic changes and their associations with clinical findings

Effect of Motor Skill Training in Functional Activities vs Strength and Flexibility Exercise on Function in People With Chronic Low Back Pain

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