Diagnostic value of trunk flexion-extension testing in old chronic low back pain patients
Thomas Kienbacher1, Elisabeth Fehrmann2, Richard Habenicht2
1Karl-Landsteiner-Institute for outpatient rehabilitation Research, Vienna, Austria. kienbacher@rehabzentrum.at.
Purpose:
Dynamic trunk flexion-extension testing has been proven to objectively diagnose low back pain in persons under the age of 60 years but older persons have difficulty complying with standardized movement velocity.
Methods:
190 patients and 71 matched healthy volunteers (18-90 years of age) performed modified testing by holding static positions at standing, half, and full trunk flexion.
Results:
Lumbar extensor muscle activity in isometric positions was significantly higher in patients with higher activity in the oldest (60-90 years) and the middle-aged (40-59 years) but not in the youngest (18-39 years) subgroups compared to normal. There were no differences in gross trunk range of motion, half flexion relaxation ratio, proprioception, muscle activity differences between positions, and fear-avoidance behavior. The diagnostic accuracy as expressed by the area under the curve was fair (0.74).
Conclusions:
Lumbar extensor muscle activity demonstrated moderate to good diagnostic value in old patients.
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