No abstract

No abstract

IntroductionOne set of clinical prediction rules (CPR) can be used clinically to identify patients with low back pain who are likely to benefit from motor control exercise. Individuals with a history of recurrent low back pain during remission (rLBP) still have persisting impaired trunk neuromuscular control. Accordingly, CPR should detect these individuals with rLBP. This study aimed to determine the predictive validity of CPR to identify individuals with rLBP.MethodsOverall, 30 subjects aged less than 40 years (22 subjects with rLBP and 8 subjects without a history of low back pain) were recruited. We used the following criteria as CPR: (1) presence of aberrant movement during active forward bend and (2) passive straight leg raising result greater than 91°. Kappa statistics and the chi-square test were used to determine predictive validity. Diagnostic accuracy was also calculated.ResultsKappa demonstrated substantial agreement (kappa = 0.73), while the chi-square test showed significant association (χ² = 16.28; <i>p</i> < 0.001) between positive CPR and rLBP. Diagnostic accuracy demonstrated positive likelihood ratio of 3.82, while accuracy equalled 90%.ConclusionsOur findings indicated the predictive validity of CPR to identify individuals with rLBP. The result from this study would help identify those predisposed to recurrent episodes of low back pain who would likely have a positive response to motor control exercise.

Purpose Morphology studies demonstrated that patients with chronic low back pain (CLBP) have bilateral multifidus muscle (LM) atrophy. This atrophy should result in LM contractility deficit bilaterally. Additionally, a recent study showed the effect of sex on LM thickness. Researchers proposed percentage LM contractility (LM CONT ) as standardization to enable the comparison across participants. This study aimed to determine side-to-side difference in LM CONT and to determine the difference in LM CONT between males and females. Patients and Methods Twenty-five healthy individuals (NoLBP group; 10 males and 15 females) and 35 with CLBP (CLBP group; 16 males and 19 females; 23 unilateral pain and 12 bilateral pain) were recruited. Ultrasound imaging was used to measure LM thickness at rest, during maximum voluntary isometric contraction, and during combined maximum voluntary isometric contraction with electrical stimulation. These data were used to calculate LM CONT . For unilateral CLBP, right and left LM CON were renamed to painful and non-painful sides. Results Data demonstrated no significant difference ( p > 0.05) between right (87.3 ± 13.7%) and left (87.2 ± 14.0%) in NoLBP, right (71.2 ± 15.7%) and left (76.5 ± 19.7%) in bilateral CLBP, and painful (70.3 ± 17.5%) and non-painful (77.7 ± 18.4%) in unilateral CLBP. No difference ( p > 0.05) was found between males and females in both NoLBP (male 84.8 ± 6.5%, female 88.9 ± 15.4%) and CLBP groups (male 76.3 ± 15.5%, female 71.9 ± 14.0%). Conclusion The findings suggested that LM contractility deficit in CLBP is not specific to painful side. No effect was found of sex on LM contractility. Therefore, we can use averaged LM activation across painful and non-painful sides and across males and females to compare between NoLBP and CLBP groups.

No abstract