The Comprehensive Muscular Activity Profile (CMAP): Its High Sensitivity, Specificity and Overall Classification Rate for Detecting Submaximal Effort on Functional Capacity Testing

Abstract

Introduction. A traditional problem faced by clinicians attempting to objectively measure

The Comprehensive Muscular Activity Profile (CMAP): Its Clinical Utility in Objectively Differentiating Between Low Back Pain Patients and Normals1

“…Together with the earlier reviewed investigations by Gatchel and colleagues (Gatchel, Ricard, Choski, et al., 2009 and Gatchel and Theodore 2009), these results further attest to the clinical utility of the CMAP, which is a safe, non‐invasive, and objective measure of muscle functioning/impairment, as well as subject effort during the measurement process. Such findings have significant clinical implications for physical impairment evaluations.…”

“…Indeed, in the earlier study by Gatchel et al. (Gatchel, Ricard, Choski, et al., 2009), it was found that effort could be affected by “secondary gain‐type” instructions.…”

“…(2005) subsequently concluded that the results were indeed quite mixed and called for more clinical research to determine what measure(s) are “reliable, valid and discriminate with a high degree of accuracy between healthy persons and those with LBP” (p. 711). Their call stimulated the earlier published study by Gatchel and colleagues (Gatchel, Ricard, Choski, et al., 2009), which demonstrated the utility and validity of the CMAP, as well as a subsequent study by Gatchel and Theodore (2009) that reported some preliminary findings revealing the CMAP's clinical utility for patients with musculoskeletal pain claims. Building upon these two studies, the present investigation was designed to evaluate the ability of the CMAP to reliably differentiate between healthy individuals and those with LBP.…”

“…Unfortunately, although physical impairment (i.e., the alteration of an individual's usual health status, because of anatomic or pathologic abnormalities) needs to be evaluated, there is currently still no universal agreement about what measures should be used in impairment evaluation because of concerns about the objectivity/validity of such measures (Gatchel, Ricard, Choski, et al., 2009). In the past, one such potentially objective measure that has received a great deal of attention for musculoskeletal disorders has been surface electromyographic (sEMG) recordings during purposeful muscular activity and resting states.…”

Malingering and Pain: is this a Major Problem in the Medicolegal Setting?

“…A recent randomized controlled study was conducted to assess the ability of the CMAP to accurately determine whether maximal effort was put forth by individuals (Gatchel et al 2008). Within this study, participants undergoing rangeof-motion and lifting capacity assessments were asked to either give maximal effort or submaximal effort on each task.…”