ABSTRACT: Study Design: Descriptive pilot study.
Objectives: To develop evidence-based ‘normative’ data for range of movement (ROM) at the hip, knee and lumbar spine during four clinical tests for lumbar flexion control.
Summary of background data: Recently several studies have highlighted movement control dysfunction of the lumbar region as a potential diagnostic area. However, evidence-based ‘normative’ ROM data for a ‘normal’ population has yet to be uncovered, making lumbar control assessments difficult. This is the first study to utilize a biomechanical device to evaluate the ROM during lumbar flexion control tests.
Methods: 20 people without LBP performed 4 clinical tests involving the control of lumbar flexion. ROM during the tests was evaluated using electrogoniometry at the hip, knee and lumbar spine. The lumbar spine electrode monitored flexion control and 5 degrees of lumbar flexion was classed as a loss of control. Each participant was recorded performing the tests 3 times after being taught the tests by the researcher.
Results: Average ROM values were shown to be 10-15° less than the previously reported values. The intra-measure and inter-rater agreement results demonstrated that the majority of the ROM variables had moderate or above (>0.4) correlation. However, several of the results showed poor (<0.2) to fair (>0.2 – 0.4) intra-measure agreement and inter-rater agreement. Bland-Altman Plots showed that the majority of the ROM differences were within 1°-10°, however there were outliers of up to 30° difference. Therefore, there were large variations in the ROM measurements between test attempts due to the limitations of the data collection procedures.
Conclusions: This study was not able to provide accurate ‘normative’ ROM values due to the limitations of the methodology. However, the conclusion of this pilot study was that the lumbar flexion control testing methodology is feasible but requires modifications. Further study is required on the validity of the utilised motor control tests.
10/2012, Degree: MSc Physiotherapy (pre-registration), Supervisor: Gerard Hargreaves