Visual and instrumental diagnostics using chromokinegraphics: Reliability and validity for low back pain...

Area of Science:

• Biomechanics and Movement Analysis
• Spinal Kinematics
• Pain Assessment

Background:

• Dysfunctional spinal movement patterns are suspected in low back pain (LBP) patients.
• A need exists for reliable clinical tools to distinguish normal from pathological spinal movement.

Purpose of the Study:

• To assess if ultrasound-based kinematic parameters and chromokinegraphical angle-time matrices (CATMAs) can differentiate movement in non-specific chronic LBP (CLBP), specific LBP (SLBP), and control groups.
• To evaluate the diagnostic value of CATMAs for identifying pathological spinal movement.

Main Methods:

• Assessed thoracic and lumbar spine range of motion (ROM), angular velocity (V), and side-to-side differences during lateral flexion in 17 healthy, 16 CLBP, and 11 SLBP individuals.
• Utilized CATMAs, dichotomizing movement as physiological or non-physiological based on investigator ratings.
• Estimated intrarater and interrater reliability using kappa statistics and Cronbach's Alpha; employed t-tests and ROC analysis for group separation and cut-off determination.

Main Results:

• CATMA ratings showed moderate to good discriminant validity for CLBP vs. controls (rater B) but insufficient validity for rater A, resulting in poor inter-rater reliability.
• Intrarater reliability for CATMAs was moderate to good, except for SLBP vs. controls (rater A).
• No significant group differences in absolute ROM or V were found; however, relative side comparisons revealed significant differences between CLBP and controls (p<0.05), with optimal cut-offs identified via ROC analysis.

Conclusions:

• Relative side asymmetries in spinal angular velocity (V) and range of motion (ROM) can distinguish individuals with CLBP from controls.
• CATMAs demonstrated limited diagnostic utility for identifying pathological spinal movement patterns.