Multiplanar lumbopelvic control in patients with low back pain: is multiplanar assessment better than single plane assessment in discriminating between patients and healthy controls?
Multiplanar lumbopelvic control in patients with low back pain: is multiplanar assessment better than single plane assessment in discriminating between patients and healthy controls?
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DOI：
10.1179/2042618614y.0000000078
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发表时间：
2016-01-01
影响因子：
2
通讯作者：
Davis, A. M.
中科院分区：
文献类型：
--
作者：
Nelson-Wong, E.;Gallant, P.;Davis, A. M.
目的：下腰痛（LBP）患者通常有腰盆控制缺陷。矢状运动期间的腰椎骨盆评估被纳入基于治疗的分类的常用临床检查算法中。本研究的目的是调查是否在矢状面和额状面运动的腰盆控制联合评估区分与不LBP的人比单平面assessmentals.Methods：19例LBP患者和18名健康对照自愿参加这项研究。主动直腿抬高（ASLR）和主动髋关节外展（AHAbd）测试分别用于评估矢状面和额状面运动期间的腰骨盆控制。使用公布的评分标准将测试评分为阳性或阴性。为每个单独的测试和组合测试创建列联表（均为阳性/均为阴性），以存在/不存在LBP作为参考标准，以计算灵敏度（sn）、特异性（sp）、可能性（+LR和-LR）和诊断优势比（OR）。主动直腿抬高和AHAbd单独试验的sn分别为0.63、0.74，sp分别为0.61、0.50，OR分别为2.7、2.8。组合检验的sn=0.89，sp=0.60，OR=12.0。40%的LBP患者在两个平面的motion.Discussion的控制缺陷：AHAbd和ALSR测试似乎有更大的诊断歧视时，联合使用时，比单独使用。有一定比例的LBP患者在两个平面都有控制缺陷，而其他患者仅表现出单平面缺陷。这些发现强调了LBP患者多平面评估的重要性。
Objectives: Patients with low back pain (LBP) commonly have lumbopelvic control deficits. Lumbopelvic assessment during sagittal motion is incorporated into commonly used clinical examination algorithms for Treatment Based Classification. The purpose of this study was to investigate whether combined assessment of lumbopelvic control during sagittal and frontal plane motion discriminates between people with and without LBP better than single plane assessment alone.Methods: Nineteen patients with LBP and 18 healthy control participants volunteered for this study. The active straight leg raise (ASLR) and active hip abduction (AHAbd) tests were used to assess lumbopelvic control during sagittal and frontal plane motion, respectively. The tests were scored as positive or negative using published scoring criteria. Contingency tables were created for each test alone and for the combined tests (both positive/both negative) with presence/absence of LBP as the reference standard to calculate accuracy statistics of sensitivity (sn), specificity (sp), likelihood (+LR and -LR), and diagnostic odds ratios (OR).Results: Active straight leg raise and AHAbd tests alone had sn of 0.63, 0.74, respectively, sp of 0.61, 0.50, respectively, and OR of 2.7, 2.8, respectively. The combined tests had sn=0.89, sp=0.60, and OR=12.0. Forty percent of patients with LBP had control deficits in both planes of motion.Discussion: The AHAbd and ALSR tests appear to have greater diagnostic discrimination when used in combination than when used independently. A percentage of patients with LBP had control deficits in both planes, while others demonstrated uniplanar deficits only. These findings highlight the importance of multiplanar assessment in patients with LBP.