Abstract
Objective
To analyze the ability to discriminate between healthy individuals and individuals
with chronic nonspecific low back pain (CNLBP) by measuring the relation between patient-reported
outcomes and objective clinical outcome measures of the erector spinae (ES) muscles
using an ultrasound during maximal isometric lumbar extension.
Design
Cross-sectional study with screening and diagnostic tests with no blinded comparison.
Setting
University laboratory.
Participants
Healthy individuals (n=33) and individuals with CNLBP (n=33).
Interventions
Each subject performed an isometric lumbar extension. With the variables measured,
a discriminate analysis was performed using a value ≥6 in the Roland and Morris disability
questionnaire (RMDQ) as the grouping variable. Then, a logistic regression with the
functional and architectural variables was performed. A new index was obtained from
each subject value input in the discriminate multivariate analysis.
Main Outcome Measures
Morphologic muscle variables of the ES muscle were measured through ultrasound images.
The reliability of the measures was calculated through intraclass correlation coefficients
(ICCs). The relation between patient-reported outcomes and objective clinical outcome
measures was analyzed using a discriminate function from standardized values of the
variables and an analysis of the reliability of the ultrasound measurement.
Results
The reliability tests show an ICC value >.95 for morphologic and functional variables.
The independent variables included in the analysis explained 42% (P=.003) of the dependent variable variance.
Conclusions
The relation between objective variables (electromyography, thickness, pennation angle)
and a subjective variable (RMDQ ≥6) and the capacity of this relation to identify
CNLBP within a group of healthy subjects is moderate. These results should be considered
by clinicians when treating this type of patient in clinical practice.
Keywords
List of abbreviations:
CI (confidence interval), CNLBP (chronic nonspecific low back pain), ES (erector spinae), MVC (maximal voluntary contraction), OMPQ (Orebro Musculoskeletal Pain Questionnaire), PRO (patient reported outcome), RMDQ (Roland and Morris disability questionnaire)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 19, 2014
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
