Movement control tests for the lumbopelvic complex. Are these tests reliable and valid?

Abstract

This study evaluated inter- and intra-observer reliability and discriminative validity of three movement control tests: 1) standing knee-lift test; 2) static lunge test; and 3) dynamic lunge test. Thirty-eight subjects, 21 with low-back pain and 17 healthy, were video-recorded while performing the tests. Four physical therapists scored the tests according to a standardized protocol and calculated a composite score for each test based on the number of incorrect test components. Inter-observer reliability for the composite scores ranged between 0.68 and 0.80 (ICC 2,k) and intra-observer reliability between 0.54 and0.82 (ICC 2,1). The separate test components ranged between 0.32 and 0.91 (κ) for inter-observer reliability and 0.42 and1.00 for intra-observer reliability. Test components showing the highest values were: back extension; arm lowering; and shoulders moving backwards. Components hip hitch, trunk lateral flexion, knee not lifted straight up and hips moving backwards did not reach accepted thresholds. Discriminative validity ranged between 0.47 and 0.56 (AUC). As our results showed an overall good agreement for the composite, scores and for the majority of the included test components the tests can be considered reliable enough. As the tests' discriminative ability was close to "none", they should, however, not be used for diagnostic purposes but should be further evaluated toward predicted validity.

Test-retest reliability of a smartphone app for measuring core stability for two dynamic exercises

“…Several studies have demonstrated a link between musculoskeletal disorders, pain and the ability to adequately control movements and muscular activation in clinical tests (Hodges & Richardson, 1996; Luomajoki et al, 2008; Moseley & Hodges, 2006). Dynamic movement tests are gaining popularity as components of musculoskeletal screening with the goal of identifying increased injury risk (Granstrom, Ang & Rasmussen-Barr, 2017). According to Barbado et al (2016) perturbations of trunk movement can vary in amplitude and can range from self-imposed and predictable to externally imposed and unpredictable.…”

Movement Control Impairment and Low Back Pain: State of the Art of Diagnostic Framing

“…The steps related to the selection of articles are outlined in the flow-diagram below (Figure 1). Of the 13 studies included, 10 investigated inter-rater reliability [28,29,30,31,32,33,34,35,36,37], 4 investigated intra-rater reliability [31,32,33,38], and only 6 studies analyzed validity [28,29,31,32,39,40]. Overall, the tests showed reliability ranging from fair to excellent ( K value between 0.32 and 1.00) for the inter-rater and from moderate to excellent for the intra-rater ( K value from 0.42 to 1.00).…”

“…Seventeen tests were investigated by a single author [28,30,31,32,33,36,37]. In the remaining 6 evaluated by multiple studies, only 4 (waiter’s bow, one leg stance, sitting knee extension, and prone hip extension) showed agreement between reliability values [29,33,34,36], while for the other 2 (bent knee fall out and active straight leg raising), this did not happen [29,30,33,35,36,37].…”

“…Excellent reliability has been identified for joint position sense [30], sitting forward lean [30], and leg lowering [30]. Substantial reliability was identified for pelvic tilt [33], rocking pelvis forwards [33], standing back extension test [31], static lunge test [32], and dynamic lunge test [32]. Moderate reliability was identified for knee lift abdominal test [36], rocking pelvis backwards [33], prone active knee flexion [33], and standing knee-lift test [32].…”

“…Substantial reliability was identified for pelvic tilt [33], rocking pelvis forwards [33], standing back extension test [31], static lunge test [32], and dynamic lunge test [32]. Moderate reliability was identified for knee lift abdominal test [36], rocking pelvis backwards [33], prone active knee flexion [33], and standing knee-lift test [32]. The unilateral pelvic lift showed moderate reliability for the left side ( K = 0.47) and substantial for the right side ( K = 0.61) [37].…”