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Predictors of dysfunction in the flexion pattern subgroup of patients with chronic lower-back pai

Not Applicable
Completed
Conditions
Diseases of the musculo-skeletal system and connective tissue
Registration Number
KCT0002736
Lead Sponsor
Yonsei University
Brief Summary

In this study, 13 variables were measured: the visual analog scale (VAS), the Oswestry Disability Index (ODI), the Short Form-36 (SF-36), the Beck Depression Inventory (BDI), hip internal rotation range of motion, hip flexion range of motion, knee extension range of motion, knee extension with dorsiflexion range of motion, ratio of forward flexion, knee extension strength, hip extension strength, hip flexion strength, and lumbopelvic stability in 108 subjects in the flexion pattern subgroup of CLBP. Participants did not show back pain or adverse reactions during measurement. The models for predictors of lower-back pain in the CLBP flexion pattern subgroup included knee extension and the BDI as predictor variables that accounted for 8.1% of the variance in the VAS (p < 0.05); predictors for disability included the BDI, age, and hip flexion strength, which accounted for 21.2% of the variance in the ODI (p < 0.05); predictors for health-related quality of life included the BDI, sex, knee extension with dorsiflexion range of motion, and age, which accounted for 38.8% of the variance in the SF-36 (p < 0.05) in multiple regression models with a stepwise selection procedure. The current results suggest that knee extension, the BDI, age, hip flexion strength, knee extension with dorsiflexion, and sex should be considered when determining appropriate prediction, prevention, and intervention in the flexion pattern subgroup of patients with CLBP.

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
108
Inclusion Criteria

The inclusion criteria were: Participants with mechanical lower back pain persisting for more than 3 months and pain in the flexion direction of movement (forward bending, sitting, and driving).And screening based on classification of the movement impairment syndrome by Sahrmann was used to confirm flexion pattern subgroup (lumbar flexion syndrome). If this test fails to classify the subgroup, it is excluded from the participants in this study.
This classification was checked through primary and secondary tests. The primary test involved determining whether the symptoms increased as the lumbar spine moved in the flexed direction. The secondary test assessed whether the symptoms disappeared or diminished when the movement in that direction was reduced or limited. The test was considered positive if: 1) lumbar spine alignment tended to flex toward neutral and 2) the lumbar spine moved in the direction of flexion with movement of the extremities. The secondary test was performed when symptoms or pain appeared or increased during the primary test. The test included forward bending, quadruped alignment, rocking backwards in a quadruped position, alignment in a sitting position, knee extension in a sitting position, and hip and knee flexion in a supine position.

Exclusion Criteria

The exclusion criteria were: spinal canal stenosis; spondylolisthesis; spondylitis; large herniated disc sciatica; radiating pain below the knee; previous back surgery; history of known spinal fractures; malignancy; known muscle, nerve, skin, or joint diseases; and pregnancy.

Study & Design

Study Type
Observational Study
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
hip internal rotation range of motion;hip flexion range of motion;knee extension range of motion;knee extension with dorsiflexion range of motion;ratio of forward flexion;knee extension strength;hip extension strength;hip flexion strength;lumbopelvic stability
Secondary Outcome Measures
NameTimeMethod
Visual analog scale, ,;Oswestry disability index;Short Form-36 (quality of life)
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