Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, 17100 Savona, Italiy.
Medicina (Kaunas). 2019 Aug 29;55(9):548. doi: 10.3390/medicina55090548.
Low back pain is one of the most common health problems. In 85% of cases, it is not possible to identify a specific cause, and it is therefore called Non-Specific Low Back Pain (NSLBP). Among the various attempted classifications, the subgroup of patients with impairment of motor control of the lower back (MCI) is between the most studied. The objective of this systematic review is to summarize the results from trials about validity and reliability of clinical tests aimed to identify MCI in the NSLBP population. The MEDLINE, Cochrane Library, and MedNar databases have been searched until May 2018. The criteria for inclusion were clinical trials about evaluation methods that are affordable and applicable in a usual clinical setting and conducted on populations aged > 18 years. A single author summarized data in synoptic tables relating to the clinical property; a second reviewer intervened in case of doubts about the relevance of the studies. 13 primary studies met the inclusion criteria: 10 investigated inter-rater reliability, 4 investigated intra-rater reliability, and 6 investigated validity for a total of 23 tests (including one cluster of tests). Inter-rater reliability is widely studied, and there are tests with good, consistent, and substantial values (waiter's bow, prone hip extension, sitting knee extension, and one leg stance). Intra-rater reliability has been less investigated, and no test have been studied for more than one author. The results of the few studies about validity aim to discriminate only the presence or absence of LBP in the samples. At the state of the art, results related to reliability support the clinical use of the identified tests. No conclusions can be drawn about validity.
下背痛是最常见的健康问题之一。在 85%的情况下，无法确定特定的原因，因此称为非特异性下背痛（NSLBP）。在各种尝试的分类中，下背部运动控制受损（MCI）患者亚组是研究最多的。本系统评价的目的是总结关于旨在识别 NSLBP 人群中 MCI 的临床测试的有效性和可靠性的试验结果。 已经对 MEDLINE、Cochrane 图书馆和 MedNar 数据库进行了搜索，直到 2018 年 5 月。纳入标准为关于在负担得起且适用于常规临床环境的评估方法的临床试验，并且在年龄> 18 岁的人群中进行。一位作者总结了与临床特性相关的摘要数据表中的数据；如果对研究的相关性有疑问，第二位审阅者会介入。 13 项主要研究符合纳入标准：10 项研究了评价者间可靠性，4 项研究了评价者内可靠性，共有 6 项研究了总共 23 项测试（包括一组测试）的有效性。评价者间可靠性得到了广泛研究，并且有一些测试具有良好、一致和实质性的价值（服务员弓、俯卧髋伸展、坐姿膝伸展和单腿站立）。评价者内可靠性研究较少，没有一项测试被一位以上的作者研究过。关于有效性的少数研究的结果旨在仅区分样本中是否存在或不存在 LBP。 在目前的技术水平下，与可靠性相关的结果支持已识别测试的临床使用。关于有效性，无法得出结论。
