Research Center of Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Department of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand.
Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Int J Environ Res Public Health. 2021 Nov 19;18(22):12151. doi: 10.3390/ijerph182212151.
Lumbar instability (LI) comprises one subgroup of those with chronic low back pain (CLBP); it indicates the impairment of at least one of the spinal stabilizing systems, and radiographic criteria of translation and rotation are used for its diagnosis. Previous studies have developed and tested a screening tool for LI where patients with sub-threshold lumbar instability (STLI) were detected in the initial stage of lumbar pathology using radiographs as a gold standard for diagnosis. The radiographic measurement in STLI lies between the range of translation and rotation of the LI and asymptomatic lumbar motion. However, there are no studies indicating the validity and cut-off points of the screening tool for STLI. The current study aimed to determine the validity of an LI screening tool to support the diagnostic process in patients with STLI. This study design was cross-sectional in nature. A total of 135 participants with CLBP, aged between 20 and 60 years, who had undergone flexion and extension radiographs, answered a screening tool with 14 questions. The cut-off score for identifying STLI using the screening tool was at least 6/14 positive responses to the LI questions. The findings suggested that the LI screening tool we tested is effective for the detection of STLI. The tool can be used in outpatient settings.
腰椎不稳定（LI）是慢性下腰痛（CLBP）的一个亚组；它表明至少有一个脊柱稳定系统受损，并且使用平移和旋转的放射学标准进行其诊断。先前的研究已经开发并测试了一种 LI 的筛查工具，该工具可在腰椎病理学的初始阶段使用 X 光片作为 LI 和无症状腰椎运动的诊断金标准来检测亚阈值腰椎不稳定（STLI）患者。STLI 的放射学测量值介于 LI 的平移和旋转范围以及无症状腰椎运动之间。然而，目前尚无研究表明 STLI 筛查工具的有效性和截断值。本研究旨在确定 LI 筛查工具的有效性，以支持 STLI 患者的诊断过程。本研究设计为横断面研究。共有 135 名年龄在 20 至 60 岁之间的慢性下腰痛患者接受了屈伸位 X 光片检查，他们回答了一个包含 14 个问题的筛查工具。使用筛查工具确定 STLI 的截断分数为至少 6/14 个 LI 问题呈阳性反应。研究结果表明，我们测试的 LI 筛查工具对 STLI 的检测是有效的。该工具可用于门诊环境。
