Objective: To describe the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of five clinical tests used to measure trunk muscle endurance in low back pain.
Design: A cross-sectional non-experimental design.
Setting: Orthopaedic and physical therapy departments of four hospitals and outpatient physical therapy clinics, Tehran, Iran.
Subjects: Convenience sample of 200 subjects participated in this study. Subjects were categorized into four groups: men without low back pain (N = 50, mean (SD) age = 38 (12) years), women without low back pain (N = 50, mean (SD) age = 43 (11) years), men with low back pain (N = 50, mean (SD) age = 39 (12) years) and women with low back pain (N = 50, mean (SD) age = 43 (12) years).
Main measures: Five clinical static endurance tests of trunk muscles such as: Sorensen test, prone isometric chest raise test, prone double straight-leg raise test, supine isometric chest raise test and supine double straight-leg raise test were measured in each group.
Results: The result of receiver operating characteristics (ROC) curve analysis revealed that in a separate analysis of data for men and women, among all tests, the prone double straight-leg raise test had the highest sensitivity, specificity and predictive value in low back pain compared with other performed tests.
Conclusions: It seems that the prone double straight-leg raise test has more sensitivity, specificity and predictive value in low back pain than other tests and could be used as a useful clinical method for testing the spinal muscle endurance to predict the probability of the occurrence of low back pain.
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References
1.
Svensson H., Andersson Gbj, Johansson S., Wilhemsson C., Vedin A.A retrospective study of low back pain in 38-to-64 year old women: frequency of occurence and impact on medical services. Spine1988; 13: 548—52.
2.
Ehrlich GELow back pain. Bull World Health Organ2003 ; 81: 671—72.
3.
Woolf AD, Pfleger B.Burden of major musculoskeletal condition. Bull World Health Organ2003; 81: 646—56.
4.
Leclere H., Beaulieu MD, Bordage G., Sindon A., Couillard M.Why are clinical problems difficult? General practitioners' opinion concerning 24 clinical problems. CMAJ1990; 143: 1305—15.
5.
Clare HA, Adams R., Maher CGA systemic review of efficacy of McKenzie therapy for spinal pain. Aust J Physiother2004; 50: 209—16.
6.
Calliet R.Low back pain syndrome, third edition. FA Davis, 1981.
7.
Hultman G., Nordin M., Saraste H., Ohlsen H.Body composition, endurance, strength, cross-sectional area and density of erector spine in men with and without low back pain. J Spinal Disord1993; 6: 114—23.
8.
Jorgensen K. , Nicholaisen T.Trunk extensor endurance: determination and relation to low back trouble. Ergonomics1987 ; 30: 259—67.
9.
Roy SH, Deluca CJ, Casavant DALumbar muscle fatigue and chronic low back pain. Spine1989; 14: 992—1001.
10.
Ashmen KJ, Swanik CB, Lephart SMStrength and flexibility characteristics of athletes with chronic low back pain. J Sport Rehabil1996; 5: 275—86.
11.
O'Sullivan PB , Mitchell T., Bulich P., Waller R., Holte J.The relationship between posture and back muscle endurance in industrial workers with flexion-related low back pain . Man Ther2006; 11: 264—71.
12.
Biering-Sorensen F.Physical measurements as risk indicators for low back trouble over a one year period. Spine1984; 9: 106—19.
13.
Luoto S., Heliovaara M., Hurri H., Alaranta H.Static back endurance and the risk of low-back pain. Clin Biomech (Bristol, Avon) 1995; 10: 323—24.
14.
Kujala UM, Taimela S., Viljanen T. et al. Physical loading and performance as predictors of back pain in healthy adults. A 5-year prospective study. Eur J Appl Physiol Occup Physiol1996; 73: 452—58.
15.
Payne N., Gledhill N., Katzmarzyk PT, Jamnik V.Health-related fitness, physical activity and history of back pain. Can J Appl Physiol2000; 25: 236—49.
16.
Nourbakhsh MR, Arab AMRelationship between mechanical factors and incidence of low back pain. J Orthop Sports Phys Ther2002; 32: 447—60.
17.
Tsuboi T., Satou T., Egawa K., IzumiY, Miyazaki M. Spectral analysis of electromyogram in lumbar muscles: fatigue induced endurance contraction. Eur J Appl Physiol Occup Physiol1994; 69: 361—66.
18.
Mayer TG, Kondraske G., Mooney V., Carmichael TW, Butsch R.Lumbar myoelectric spectral analysis for endurance assessment. A comparison of normals with deconditioned patients. Spine1989; 14: 986—91.
19.
Roy SH, Deluca CJ, Emley M., Buijs RJSpectral electromyographic assessment of back muscles in patients with low back pain undergoing rehabilitation. Spine1995; 20: 38—48.
20.
Ito T., Shirado O., Suzuki H., Takahashi M.Lumbar trunk muscle endurance testing: an inexpensive alternative to a machine for evaluation. Arch Phys Med Rehabil1996 ; 77: 75—79.
21.
Moffroid MTEndurance of trunk muscles in persons with chronic low back pain: assessment, performance, training. J Rehabil Res Dev1997; 34: 440—47.
22.
Malliou P., Gioftsidou A., Beneka A., Godolias G.Measurements and evaluations in low back pain patients. Scand J Med Sci Sports2006; 16: 219—30.
23.
Corin G., Strutton PH, McGregor AHEstablishment of a protocol to test fatigue of the trunk muscles. Br J Sports Med2005; 39: 731—35.
24.
Foster DN, Fulton MNBack pain and the exercise prescription. Clin Sports Med1991; 10: 187—209.
25.
Parnianpour M., Nordin M., Kahanovitz N., Frankel V.The triaxial coupling of torque generation of trunk muscles during isometric exertion and the effect of fatiguing isoinertial movements on the motor output and movement patterns. Spine1988; 13: 982—92.
26.
Moreau CE, Green BN, Johnson CD, Moreau SRIsometric back extension endurance tests: a review of the literature. J Manip Physiol Ther2001; 24: 110—22.
27.
McIntosh G. , Wilson L., Affieck M., Hall H.Trunk and lower extremity muscle endurance: normative data for adults. J Rehabil Outcome Meas1998; 2: 20—39.
28.
Demoulin C. , Vanderthommen M., Duysens C., Crielaard JMSpinal muscle evaluation using the Sorensen test: a critical appraisal of the literature. Joint BoneSpine2006; 73: 43—50.
29.
Debeliso M. , O'Shea JP, Harris C., Adamski KJ, Climstein M.The relation between trunk strength measures and lumbar disc deformation during stoop type lifting. J Exerc Physiol2004; 7: 16—26.
30.
Schenk P., Klipstein A., Spillmann S., Strøyer J., Laubli T.The role of back muscle endurance, maximum force, balance and trunk rotation control regarding lifting capacity. Eur J Appl Physiol2006; 96: 146—56.
31.
Kroll PG, Machado L., Happy C., Leong S., Chen B.The relationship between five measures of trunk strength. J Back Musculoskeletal Rehabil2000; 14: 89—97.
32.
Nicolaisen T., Jorgensen K.Trunk strength, back muscle endurance and low back trouble. Scand J Rehabil Med1985 ; 17: 121—27.
33.
Kankaanpaa M., Taimela S., Laaksonen D., Hanninen O., Airaksinen O.Back and hip extensor fatigability in chronic low back pain patients and control. Arch Phys Med Rehabil1998; 79: 412—17.
34.
Shrout PE, Fleiss JLIntraclass correlation: use in assessing rater reliability. Psychol Bull1979; 86: 420—28.
35.
Portney LG, Watkins MPFoundations of clinical research — applications to practice, second edition. Prentice-Hall, 2000: 96—101.
36.
Thorstensen A., Carlson H.Fiber types in human lumbar back muscles. Acta Phys Scand1987; 131: 185—202.
37.
Armstrong RBMechanism of exercise-induced delayed onset muscular soreness: a brief review. Med Sci Sports Exerc1984; 6: 529—38.
38.
Roy SH, Oddsson Lie.Classification of paraspinal muscle impairments by surface electromyography . Phys Ther1998; 78: 838—51.
39.
Cooper RG, St Clair Forbes W, Jayson MIV. Radiographic demonstration of paraspinal muscle wasting in patients with chronic low back pain. Br J Rheumatol1992; 31: 389—94.
40.
Hides JA, Stokes MJ, Saide M., Jull GA, Cooper DHEvidence of llumnar multifidus wasting ipsilateral to symptom in patients with acute/subacute low back pain. Spine1994 ; 19: 165—72.
41.
Moffroid M., Reid S., Henry SM, Haugh LD, Ricamato A.Some endurance measures in persons with chronic low back pain. J Orthop Sports Phys Ther1994; 20: 81—87.
42.
Plamondon A., Trimble K., Larivière C., Desjardins P.Back muscle fatigue during intermittent prone back extension exercise. Scand J Med Sci Sports2004; 14: 221—30.
43.
Arokoski JP , Kankaapaa M.,Valta T. et al. Back and hip extensor muscle function during therapeutic exercises. Arch Phys Med Rehabil1999; 80: 842—50.
44.
Latikka P., Battie MC, Videman T., Gibbsons LECorrelation of isokinetic and psychological back lift and static back extensor endurance tests in men. Clin Biomech1995; 10: 325—30.
