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Trunk extension effort in patients with chronic low back dysfunction.

Zeevi Dvir1, Jennifer L Keating

  • 1Department of Physical Therapy, Tel Aviv University, Ramat Aviv, Israel. zdvir@post.tau.ac.il

Spine
|April 3, 2003
PubMed
Summary

This study found that most patients with chronic low back dysfunction exert maximal effort during trunk extension tests. The DEC parameter effectively assessed effort, indicating high patient engagement in rehabilitation.

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Area of Science:

  • Biomechanics
  • Rehabilitation Medicine
  • Clinical Assessment

Background:

  • The DEC parameter reliably distinguishes maximal effort from feigned weakness in healthy individuals.
  • Its utility in patients with chronic low back dysfunction remains unexplored.

Purpose of the Study:

  • To measure trunk extension strength and assess effort in patients with chronic low back dysfunction.
  • To evaluate the applicability of the DEC parameter in this patient population using a novel protocol.

Main Methods:

  • Isokinetic trunk extension strength was measured in 44 patients with chronic low back dysfunction.
  • Tests were performed at specific angular velocities (10 and 40 degrees/second) and range of motion (20 degrees).
  • The DEC score was calculated based on eccentric and concentric strength ratios.

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Main Results:

  • Trunk extension strength scores were significantly reduced compared to healthy subjects.
  • 89% of patients had DEC scores below the cutoff for maximal effort at 99% confidence.
  • Reduced concentric strength at 40 degrees/second was noted in false-positive cases.

Conclusions:

  • The study protocol indicates that the majority of patients with chronic low back dysfunction perform at maximal effort levels.
  • The DEC parameter is applicable for assessing effort in this population.