[Function-based tests to determine the return-to-activity state in patients with non-specific low back pain]
Alina Hanke1, Wolfgang Schoch2,3, Matthias Keller3
1Hochschule Furtwangen, Germany.
Summary
Functional tests for non-specific low back pain can assess return-to-activity status. However, patient-specific biopsychosocial factors are crucial for predicting pain recurrence and chronicity.
Area of Science:
- Rehabilitation Medicine
- Physical Therapy
- Pain Management
Background:
- Non-specific low back pain (NLBP) is common, with high recurrence rates.
- Functional tests are increasingly used to assess patient status and guide return-to-activity (RTA).
- Evaluating functional tests is crucial for managing recurrent and chronic pain.
Purpose of the Study:
- To evaluate the evidence for functional tests in NLBP patients.
- To assess the validity of these tests for predicting return-to-activity (RTA) status.
- To provide recommendations for activity resumption and risk assessment for chronification and recurrence.
Main Methods:
- PubMed literature search.
- Narrative review of studies from the past ten years.
- Inclusion of twelve studies analyzing functional tests for NLBP.
Main Results:
- Thirty-three functional tests showed reliability, validity, and relevance for RTA assessment in NLBP.
- Tests assessing walking, lifting, carrying, motor control, strength, and mobility are particularly relevant.
- These tests can identify 'yellow and blue flags' indicating psychosocial risk factors.
Conclusions:
- RTA status determination in NLBP should be patient-specific, integrating biopsychosocial factors beyond just movement tests.
- Functional tests alone cannot definitively predict safe return to activities without increased risk of recurrence or chronicity.
- Movement-based tests remain valuable for evaluating daily activities, designing therapies, and building patient confidence.
