Gondhalekar Gauri A, Kumar Senthil P, Eapen Charu, Mahale Ajit
Junior Executive, Department of Physiotherapy, Breach Candy Hospital Trust , Mumbai, India .
Professor, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation (MMIPR), Maharishi Markandeshwar University (MMU) , Mullana-Ambala, Haryana, India .
J Clin Diagn Res. 2016 Jan;10(1):KC07-11. doi: 10.7860/JCDR/2016/14987.7142. Epub 2016 Jan 1.
Low back pain is a chronic health problem with high socioeconomic impact. Specific diagnosis or treatment approach has not yet effectively established to treat chronic low back pain. Standing Back Extension Test is one of the clinical measures to detect the passive extension subgroup of Motor Control Impairment (MCI); which could have an impact on spinal stability leading to recurrent chronic low back pain. Reliability and validity of this test is not fully established.
To determine the intra-rater and inter-rater reliability and concurrent validity of the Standing Back Extension Test for detecting MCI of the lumbar spine.
A total of 50 subjects were included in the study, 25 patients with Non Specific Low Back Pain (NSLBP) (12 men, 13 women) and 25 healthy controls (12 men, 13 women) were recruited into the study. All subjects performed the test movement. Two raters blinded to the subjects rated the test performance as either 'Positive' or 'Negative' based on the predetermined rating protocol. The thickness of Transverse Abdominis (TrA) muscle was assessed using Rehabilitative Ultrasound Imaging (RUSI).
For reliability, the kappa coefficient with percent agreement was calculated and for assessing the validity Receiver Operator Characteristic (ROC) curves and Area under the Curve (AUC) were constructed.
The standing back extension test showed very good intra-rater (k=0.87 with an agreement of 96%) and good inter-rater (k=0.78 with an agreement of 94%) reliability and high AUC for TrA muscle.
The standing back extension test was found to be a reliable and a valid measure to detect passive extension subgroup for MCI in subjects with low back pain.
腰痛是一个具有高度社会经济影响的慢性健康问题。尚未有效确立针对慢性腰痛的具体诊断或治疗方法。站立后伸试验是检测运动控制障碍（MCI）被动伸展亚组的临床措施之一；这可能会对脊柱稳定性产生影响，导致复发性慢性腰痛。该试验的可靠性和有效性尚未完全确立。
确定站立后伸试验在检测腰椎MCI方面的评分者内和评分者间可靠性以及同时效度。
本研究共纳入50名受试者，招募了25例非特异性腰痛（NSLBP）患者（12名男性，13名女性）和25名健康对照者（12名男性，13名女性）。所有受试者均进行测试动作。两名对受试者情况不知情的评分者根据预先确定的评分方案将测试表现评定为“阳性”或“阴性”。使用康复超声成像（RUSI）评估腹横肌（TrA）的厚度。
为评估可靠性，计算了一致性百分比的kappa系数；为评估效度，构建了受试者工作特征（ROC）曲线和曲线下面积（AUC）。
站立后伸试验显示出非常好的评分者内可靠性（k = 0.87，一致性为96%）和良好的评分者间可靠性（k = 0.78，一致性为94%），并且TrA肌肉的AUC较高。
发现站立后伸试验是检测腰痛受试者中MCI被动伸展亚组的可靠且有效的措施。
