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Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
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A novel physical functioning test to complement subjective questionnaires in chronic low back pain assessments.
Dhananjaya Sutanto1, Yi-Jian Yang1, Stephen Heung-Sang Wong1
1Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, Hong Kong.
The Spine Journal : Official Journal of the North American Spine Society
|December 19, 2022
Summary
The new Lift and Place (LAP) test shows higher reliability and better correlation with disability scores in chronic low back pain (CLBP) patients compared to the loaded forward reach (LFR) test.
Area of Science:
- Biomedical Engineering
- Rehabilitation Science
- Clinical Biomechanics
Background:
- Lifting disability is a common issue for patients with chronic low back pain (CLBP).
- Existing physical assessment tests, like the loaded forward reach (LFR) test, may not accurately reflect lifting disability in CLBP patients.
- There is a need for reliable and valid assessment tools to measure lifting disability in CLBP.
Purpose of the Study:
- To introduce and evaluate the Lift and Place (LAP) test for assessing lifting disability in CLBP.
- To compare the LAP test's performance against established physical assessments, including the LFR test.
- To determine the correlation between the LAP test and self-reported disability measures.
Main Methods:
- A cross-sectional study involving 83 CLBP patients and 82 asymptomatic individuals (aged 18-55).
- Participants completed self-reported disability questionnaires (Oswestry disability index, Roland-Morris disability questionnaire) and underwent physical assessments (LAP test, LFR test, etc.).
- Statistical analyses included group comparisons, correlation analyses, Receiver Operating Characteristic (ROC) curve analysis, and test-retest/inter-rater reliability (Intraclass Correlation Coefficient - ICC).
Main Results:
- CLBP patients exhibited slower performance on the LAP test (21.6s vs 18.6s) and reduced reach on the LFR test (33.6cm vs 36.3cm) compared to asymptomatic individuals.
- The LAP test showed significant correlations with Oswestry disability index (r=0.418) and Roland-Morris disability questionnaire (r=0.390), unlike the LFR test.
- The LAP test demonstrated good reliability (test-retest ICC=0.913, inter-rater ICC=0.997) and a higher area under the curve (AUC=0.685) in ROC analysis compared to the LFR test (AUC=0.379).
Conclusions:
- The Lift and Place (LAP) test is a reliable and valid tool for assessing lifting disability in patients with chronic low back pain.
- The LAP test demonstrates a stronger correlation with patient-reported disability than the loaded forward reach (LFR) test.
- The LAP test holds potential for use in rapid screening of lifting disability in CLBP populations, warranting further investigation.
