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Methods for assessment of trunk stabilization, a systematic review
E Maaswinkel1, M Griffioen2, R S G M Perez3
1MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands.
Summary
Assessing trunk stabilization in low back pain (LBP) requires methods that simultaneously measure intrinsic stiffness and reflexes. Current methods often lack construct validity, potentially leading to inaccurate results for LBP patients.
Area of Science:
- Biomechanics
- Neurology
- Rehabilitation Science
Background:
- Trunk stabilization differs between low back pain (LBP) patients and healthy individuals.
- Existing assessment methods for trunk stabilization may not capture intrinsic stiffness and reflex contributions concurrently, impacting study validity.
- A critical review of current methods is needed to evaluate their construct validity and clinimetric properties for LBP research.
Purpose of the Study:
- To critically review methods for studying trunk stabilization in low back pain (LBP).
- To assess the construct validity of existing methods by defining criteria for simultaneously measuring intrinsic stiffness and reflexes.
- To evaluate the clinimetric properties, including reliability and measurement error, of trunk stabilization assessment techniques.
Main Methods:
- A systematic literature search identified 133 relevant articles on trunk stabilization assessment.
- Methods were categorized into upper limb (un)loading, moving platform, unloading, and loading techniques.
- A theoretical framework with methodological criteria was applied to evaluate construct validity.
Main Results:
- Fifty of 133 articles met the criteria for simultaneously assessing intrinsic stiffness and reflexes.
- Only four articles reported reliability or measurement error data for trunk stabilization methods.
- Test-retest reliability in the evaluated studies ranged from poor (ICC 0) to moderate (ICC 0.72).
Conclusions:
- Many current methods for assessing trunk stabilization in LBP lack sufficient construct validity.
- There is a significant need for reliable and valid methods that can simultaneously measure intrinsic stiffness and reflexes.
- A proposed perturbation method using system identification is recommended for more accurate trunk stabilization assessment in LBP.
