Conclusions For most clinical tests in LBP there is not consistent evidence for an association with outcome .
Central ization and non-organic signs are exceptions from that .
Background There is a strong tradition of performing a clinical examination of low back pain ( LBP ) patients and this is generally recommended in guidelines .
However , establishing a pathoanatomic diagnosis does not seem possible in most LBP patients and clinical tests may potentially be more relevant as prognostic factors .
The aim of this review of the literature was to systematic ally assess the association between low-tech clinical tests commonly used in adult patients with acute , recurrent or chronic LBP and short- and long-term outcome .
Lumbar spine segmental mobility assessment: an examination of validity for determining intervention strategies in patients with low back pain.
OBJECTIVE To examine the predictive validity of posterior-anterior ( PA ) mobility testing in a group of patients with low back pain ( LBP ) . DESIGN R and omized controlled trial . SETTING Outpatient physical therapy clinics . PARTICIPANTS Patients with LBP ( N=131 ; mean age + /- st and ard deviation , 33.9+/-10.9 y ; range , 19 - 59 y ) , and a median symptom duration of 27 days ( range , 1 - 5941 d ) . Patients completed a baseline examination , including PA mobility testing , and were categorized with respect to both hypomobility and hypermobility ( present or absent ) , and treated for 4 weeks . INTERVENTION Seventy patients were r and omized to an intervention involving manipulation and 61 to a stabilization exercise intervention . MAIN OUTCOME MEASURES Oswestry Disability Question naire ( ODQ ) scores were collected at baseline and after 4 weeks . Three-way repeated measures analyses of variance ( ANOVAs ) were performed to assess the effect of mobility categorization and intervention group on the change on the ODQ with time . Number-needed-to-treat ( NNT ) statistics were calculated . RESULTS Ninety-three ( 71.0 % ) patients were judged to have hypomobility present and 15 ( 11.5 % ) were judged with hypermobility present . The ANOVAs result ed in significant interaction effects . Pairwise comparisons showed greater improvements among patients receiving manipulation categorized with hypomobility present versus absent ( mean difference , 23.7 % ; 95 % confidence interval [ CI ] , 5.1%-42.4 % ) , and among patients receiving stabilization categorized with hypermobility present versus absent ( mean difference , 36.4 % ; 95 % CI , 10.3%-69.3 % ) . For patients with hypomobility , failure rates were 26 % with manipulation and 74.4 % with stabilization ( NNT=2.1 ; 95 % CI , 1.6 - 3.5 ) . For patients with hypermobility , failure rates were 83.3 % and 22.2 % for manipulation and stabilization , respectively ( NNT=1.6 ; 95 % CI , 1.2 - 10.2 ) . CONCLUSIONS Patients with LBP judged to have lumbar hypomobility experienced greater benefit from an intervention including manipulation ; those judged to have hypermobility were more likely to benefit from a stabilization exercise program
Conclusions For most clinical tests in LBP there is not consistent evidence for an association with outcome .
Central ization and non-organic signs are exceptions from that .
Background There is a strong tradition of performing a clinical examination of low back pain ( LBP ) patients and this is generally recommended in guidelines .
However , establishing a pathoanatomic diagnosis does not seem possible in most LBP patients and clinical tests may potentially be more relevant as prognostic factors .
The aim of this review of the literature was to systematic ally assess the association between low-tech clinical tests commonly used in adult patients with acute , recurrent or chronic LBP and short- and long-term outcome .