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Reliability of movement control tests in the lumbar spine.

Luomajoki H, Kool J, de Bruin ED, Airaksinen O - BMC Musculoskelet Disord (2007)

Bottom Line: Movement control dysfunction [MCD] reduces active control of movements.Kappa coefficients, percentage agreements and confidence intervals for inter- and intra-rater results were calculated.Intra-tester reliability was between 0.51 - 0.96, all tests but one showed substantial reliability [k > 0.6].

View Article: PubMed Central - HTML - PubMed

Affiliation: Physiotherapie Reinach, 5734 Reinach, Switzerland. hannu@physios.ch

ABSTRACT

Background: Movement control dysfunction [MCD] reduces active control of movements. Patients with MCD might form an important subgroup among patients with non specific low back pain. The diagnosis is based on the observation of active movements. Although widely used clinically, only a few studies have been performed to determine the test reliability. The aim of this study was to determine the inter- and intra-observer reliability of movement control dysfunction tests of the lumbar spine.

Methods: We videoed patients performing a standardized test battery consisting of 10 active movement tests for motor control in 27 patients with non specific low back pain and 13 patients with other diagnoses but without back pain. Four physiotherapists independently rated test performances as correct or incorrect per observation, blinded to all other patient information and to each other. The study was conducted in a private physiotherapy outpatient practice in Reinach, Switzerland. Kappa coefficients, percentage agreements and confidence intervals for inter- and intra-rater results were calculated.

Results: The kappa values for inter-tester reliability ranged between 0.24 - 0.71. Six tests out of ten showed a substantial reliability [k > 0.6]. Intra-tester reliability was between 0.51 - 0.96, all tests but one showed substantial reliability [k > 0.6].

Conclusion: Physiotherapists were able to reliably rate most of the tests in this series of motor control tasks as being performed correctly or not, by viewing films of patients with and without back pain performing the task.

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Test protocol -Prone lying active knee Flexion. A. Correct – Active knee flexion at least 90° without extension movement of the low back and pelvis. B Not correct By the knee flexion low back does not stay neutral maintained but moves in Ext. Rating protocol: As patients did not know the tests, only clear movement dysfunction was rated as "not correct". If the movement control improved by instruction and correction, it was considered that it did not infer a relevant movement dysfunction.
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Figure 5: Test protocol -Prone lying active knee Flexion. A. Correct – Active knee flexion at least 90° without extension movement of the low back and pelvis. B Not correct By the knee flexion low back does not stay neutral maintained but moves in Ext. Rating protocol: As patients did not know the tests, only clear movement dysfunction was rated as "not correct". If the movement control improved by instruction and correction, it was considered that it did not infer a relevant movement dysfunction.

Mentions: We used ten active movement tests based on descriptions by Sahrmann [7] and O'Sullivan [9] [Figure 1, 2, 3, 4, 56, 7, 8, 9]. The test battery consisted of three tests for flexion and extension control and four tests for rotational control. To perform all of the tests, a patient needed approximately 10 minutes. The videos were all recorded within two weeks. The criteria for correct and incorrect performance are presented in Table 2.


Reliability of movement control tests in the lumbar spine.

Luomajoki H, Kool J, de Bruin ED, Airaksinen O - BMC Musculoskelet Disord (2007)

Test protocol -Prone lying active knee Flexion. A. Correct – Active knee flexion at least 90° without extension movement of the low back and pelvis. B Not correct By the knee flexion low back does not stay neutral maintained but moves in Ext. Rating protocol: As patients did not know the tests, only clear movement dysfunction was rated as "not correct". If the movement control improved by instruction and correction, it was considered that it did not infer a relevant movement dysfunction.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2164955&req=5

Figure 5: Test protocol -Prone lying active knee Flexion. A. Correct – Active knee flexion at least 90° without extension movement of the low back and pelvis. B Not correct By the knee flexion low back does not stay neutral maintained but moves in Ext. Rating protocol: As patients did not know the tests, only clear movement dysfunction was rated as "not correct". If the movement control improved by instruction and correction, it was considered that it did not infer a relevant movement dysfunction.
Mentions: We used ten active movement tests based on descriptions by Sahrmann [7] and O'Sullivan [9] [Figure 1, 2, 3, 4, 56, 7, 8, 9]. The test battery consisted of three tests for flexion and extension control and four tests for rotational control. To perform all of the tests, a patient needed approximately 10 minutes. The videos were all recorded within two weeks. The criteria for correct and incorrect performance are presented in Table 2.

Bottom Line: Movement control dysfunction [MCD] reduces active control of movements.Kappa coefficients, percentage agreements and confidence intervals for inter- and intra-rater results were calculated.Intra-tester reliability was between 0.51 - 0.96, all tests but one showed substantial reliability [k > 0.6].

View Article: PubMed Central - HTML - PubMed

Affiliation: Physiotherapie Reinach, 5734 Reinach, Switzerland. hannu@physios.ch

ABSTRACT

Background: Movement control dysfunction [MCD] reduces active control of movements. Patients with MCD might form an important subgroup among patients with non specific low back pain. The diagnosis is based on the observation of active movements. Although widely used clinically, only a few studies have been performed to determine the test reliability. The aim of this study was to determine the inter- and intra-observer reliability of movement control dysfunction tests of the lumbar spine.

Methods: We videoed patients performing a standardized test battery consisting of 10 active movement tests for motor control in 27 patients with non specific low back pain and 13 patients with other diagnoses but without back pain. Four physiotherapists independently rated test performances as correct or incorrect per observation, blinded to all other patient information and to each other. The study was conducted in a private physiotherapy outpatient practice in Reinach, Switzerland. Kappa coefficients, percentage agreements and confidence intervals for inter- and intra-rater results were calculated.

Results: The kappa values for inter-tester reliability ranged between 0.24 - 0.71. Six tests out of ten showed a substantial reliability [k > 0.6]. Intra-tester reliability was between 0.51 - 0.96, all tests but one showed substantial reliability [k > 0.6].

Conclusion: Physiotherapists were able to reliably rate most of the tests in this series of motor control tasks as being performed correctly or not, by viewing films of patients with and without back pain performing the task.

Show MeSH
Related in: MedlinePlus