Disability measurement in persons with back pain: a validity study of spinal range of motion and velocity. Development and Initial Validation of the Back Pain Functional Scale Predicting Response to Motor Control Exercises and Graded Activity for Patients With Low Back Pain: Preplanned Secondary Analysis of a Randomized Controlled Trial Concurrent Comparison of Responsiveness in Pain and Functional Status Measurements Used for Patients With Low Back Pain Is Work Status of Low Back Pain Patients Best Described by an Automated Device or by a Questionnaire? Responsiveness of functional status in low back pain: a comparison of different instruments Assessing change over time in patients with low back pain. Reliability and Validity of a New Objective Tool for Low Back Pain Functional Assessment Responsiveness of common outcome measures for patients with low back pain. Level of Distress in a Recurrent Low Back Pain Population Referred for Physical Therapy Randomised controlled trial of exercise for low back pain: clinical outcomes, costs, and preferences Evaluation of a randomized controlled trial in the management of chronic lower back pain in a French automotive industry: an observational study. [Feasability of a back school assessment programme]. Outcome measures in chronic low back pain Function and the patient with chronic low back pain. Randomised controlled trial for evaluation of fitness programme for patients with chronic low back pain. Early Identification of Patients at Risk of Developing a Persistent Back Problem: The Predictive Validity of The Örebro Musculoskeletal Pain Questionnaire
OBJECTIVE To evaluate the criterion validity and responsiveness to change of spine kinematic variables to assess disability in patients with low back pain . DESIGN Blinded comparison between spine kinematic variables , Oswestry disability question naire scores , and work status . SETTING Multidisciplinary occupational rehabilitation clinic of a university hospital . PATIENTS Population -based cohort of 111 patients with subacute work-related back pain who were absent from regular work for more than 4 weeks because of back pain . INTERVENTIONS This study was part of a population -based r and omized clinical trial . Patients were r and omized to 4 different methods of management : usual care , rehabilitation , ergonomics , or rehabilitation and ergonomics . MAIN OUTCOME MEASURES Oswestry disability question naire , kinematic analysis of the spine during flexion and extension of the trunk , and work status were collected at weeks 4 , 12 , 24 , and 52 after the back accident . RESULTS Kinematic variables were poorly to moderately related to work status and Oswestry question naire scores . Kinematic variables were also unresponsive to change in work status and Oswestry question naire scores over time . CONCLUSION Spine kinematics during flexion and extension of the trunk do not appear to be a valid measure of disability in patients with subacute and chronic back pain Study Design . A prospect i ve repeated- measures design was applied . Objectives . To examine the measurement properties of the Back Pain Functional Scale ( BPFS ) and the Rol and –Morris Question naire ( RMQ )  and to formulate hypotheses and sample size estimates for a subsequent comparison study . Summary of Background Data . Although there are numerous functional status measures for patients with low back pain , most have been conceived of and vali date d with a group rather than an individual patient as the unit of interest . Also , little has been done to formally compare — this includes the generation of a priori hypotheses , followed by statistical hypotheses testing — the many competing measures . Methods . Subjects were 77 patients with low back pain who were referred by physicians to 10 outpatient physical therapy clinics located in Canada and the United States . The question naires were administered at patients ’ initial visits , within 48 hours of the initial visit , and at 1- , 2- , and 3-week follow-up visits . Reliability , cross-sectional validity , and longitudinal validity ( sensitivity to change ) coefficients were calculated . Results . Test – retest reliability estimates of 0.81 and 0.88 were obtained for the RMQ and BPFS , respectively . The measures demonstrated similar levels of cross-sectional validity . Correlations of 0.56 and 0.65 were noted between a prognostic rating of change and the RMQ and BPFS , respectively . The RMQ demonstrated a ceiling effect .  Approximately 180 patients are needed for a subsequent head-to-head comparison study of the measures . Conclusions . The BPFS appears to have sound measurement properties , and a formal head-to-head comparison study with the RMQ is warranted Background Current treatments for low back pain have small effects . A research priority is to identify patient characteristics associated with larger effects for specific interventions . Objective The aim of this study was to identify simple clinical characteristics of patients with chronic low back pain who would benefit more from either motor control exercises or grade d activity .  Design This study was a secondary analysis of the results of a r and omized controlled trial . Methods One hundred seventy-two patients with chronic low back pain were enrolled in the trial , which was conducted in Australian physical therapy clinics . The treatment consisted of 12 initial exercise sessions over an 8-week period and booster sessions at 4 and 10 months following r and omization . The putative effect modifiers ( psychosocial features , physical activity level , walking tolerance , and self-reported signs of clinical instability ) were measured at baseline . Measures of pain and function ( both measured on a 0–10 scale ) were taken at baseline and at 2 , 6 , and 12 months by a blinded assessor . Results Self-reported clinical instability was a statistically significant and clinical ly important modifier of treatment response for 12-month function ( interaction : 2.72 ; 95 % confidence interval=1.39 to 4.06 ) . Participants with high scores on the clinical instability question naire ( ≥9 ) did 0.76 points better with motor control exercises , whereas those who had low scores ( < 9 ) did 1.93 points better with grade d activity . Most other effect modifiers investigated did not appear to be useful in identifying preferential response to exercise type . Limitations The psychometric properties of the instability question naire have not been fully tested . Conclusions A simple 15-item question naire of features considered indicative of clinical instability can identify patients who respond best to either motor control exercises or grade d activity Study Design . Prospect i ve study of two sample s of patients with acute and chronic low back pain , respectively . Objectives . To compare the responsiveness of four functional status question naires , Rol and Morris Disability Question naire ( RMDQ ) ,  Oswestry Disability Index ( ODI ) ,  Disability Rating Index ( DRI ) , and  Physical Functioning scale of the SF-36 ( PFSF-36 ) , and two  pain scales , a  Numerical Pain Rating Scale ( NRS ) and  Visual Analogue Scale ( VAS ) .  Summary of Background Data . Concurrent comparisons of different outcome measurements in back patients have been requested . Methods .  Norwegian versions of the scales and question naires  were completed by 54 patients with acute ( < 3weeks ) and 50 patients with chronic low back pain ( > 3 months ) . Clinical change was estimated on a global change index . An alternative external criterion was the expected clinical course in the two cohorts . Mean changes , st and ardized response mean ( SRM ) , and area under the receiver operating characteristic ( ROC ) curves with cutoff point for highest sensitivity and specificity were calculated . Results . At the follow-up , 63 % of the acute and 41 % of the chronic sample reported improvement on the global change index . Large SRMs ( 1.3–2.0 ) and areas under the ROC curves ( 0.84–0.93 ) were found for the measurements in the acute sample . In the chronic sample , the SRMs ( 0.4–1.1 ) and areas under the ROC curves ( 0.65–0.83 ) were lower , in particular for the PFSF-36 and the VAS . There was no statistically significant difference between the responsiveness in the measurements , except for higher responsiveness in the NRS compared with the VAS when using expected clinical course as the external criterion for change . Conclusion . The results suggest that all the outcome measures were appropriate for measuring changes in functional status and pain in patients with acute low back pain , whereas among chronic patients the RMDQ , ODI , DRI , and NRS were most appropriate Study Design . A prospect i ve cohort study of patients with subacute occupational back pain . Objectives . To study the relation between a marketed opto‐electric device measuring trunk kinematics , a widely used specific functional capacity question naire , and work status in back pain patients , and to assess the responsiveness to change in work status of the opto‐electric device and the question naire . Summary of Background Data . Several instruments have been developed to evaluate the functional capacities of patients with back pain , but the relation between these instruments and work status has rarely been studied . Methods . The relation between the opto‐electric device , the question naire , and work status in patients with back pain was evaluated . The study population was a prospect i ve cohort of patients with subacute back pain who were absent from regular work for more than 4 weeks . All data were compiled blindly on the same day , at study entry ( 4 weeks after work accident ) , and at 12 , 24 , and 52 weeks after the work accident . The validity of the question naire and opto‐electric device scores was assessed with partial correlation analyses , st and ardized response mean , logistic regression analyses , and receiver operating characteristics curves . Results . The correlation between the question naire and opto‐electric device scores was low . The question naire scores were significantly related to work status , but the opto‐electric device scores were not . The question naire was responsive to change in work status , whereas the opto‐electric device was not . Conclusions . The opto‐electric device scores were not related to either functional capacity scores ( question naire ) or work status in patients with low back pain , and the opto‐electric device was not responsive to change in work status . Conversely , the question naire was related to work status and was responsive to change in work status & NA ; This study compares the responsiveness of three instruments of functional status : two disease‐specific question naires ( Oswestry and Rol and Disability Question naires ) , and a patient‐specific method ( severity of the main complaint ) . We compared changes over time of functional status instruments with pain rated on a visual analog scale . Two strategies for evaluating the responsiveness in terms of sensitivity to change and specificity to change were used : effect size statistics and receiver‐operating characteristic method . We chose global perceived effect as external criterion . A cohort of 81 patients with non‐specific low back pain for at least 6 weeks assessed these measures before and after 5 weeks of treatment . According to the external criterion 38 patients improved . The results of both strategies were the same . All instruments were able to discriminate between improvement and non‐improvement . The effect size statistics of the instruments were higher in the improved group than in the non‐improved group . For each instrument the receiver‐operating characteristic curves showed some discriminative ability . The curves for the Rol and Question naire and pain were closer to the upper left than the curves for the other instruments . The sensitivity to change of the rating of Oswestry Question naire was lower than that of the other instruments . The main complaint was not very specific to change . The two strategies for evaluating the responsiveness were very useful and appeared to complement each other BACKGROUND AND PURPOSE This study compared the ability of the Rol and -Morris ( RM ) , Oswestry ( OSW ) , and Jan van Breemen Institute ( JVB ) pain and function question naires to detect change over time . SUBJECTS The sample consisted of 88 patients with mechanical low back pain who were referred by physicians to the outpatient physical therapy department of a teaching hospital . METHODS Question naires were completed by the subjects at their initial visit and 4 to 6 weeks later . Clinical ly important change was estimated by having the subject and the clinician independently complete two rating scales . Sensitivity to change was assessed using receiver operating characteristic ( ROC ) curve analysis . RESULTS The ROC curve areas for the RM ( 0.79 ) , OSW ( 0.78 ) , and JVB pain ( 0.79 ) question naires were significantly greater than for the JVB function question naire ( 0.66 ) . Blank and multiple responses per item were present on approximately 20 % of the OSW question naires and 14 % of the JVB question naires . Words rather than checks were evident on 3 % of the RM question naires . CONCLUSION AND DISCUSSION Based on the latter finding , we believe the RM question naire may be the preferred instrument for assessing change over time in patients with low back pain Study Design . Classification and functional assessment model for nonspecific low back pain ( LBP ) patients and controls on the basis of kinematic analysis parameters . Objective . Develop a logistic regression model using kinematic analysis variables to ( 1 ) discriminate between LBP patients and controls and ( 2 ) obtain objective parameters for LBP functional assessment . Summary of Background Data . Functional assessment of spinal disorders has been carried out traditionally by means of subjective scales . Objective functional techniques have been developed , which usually involve the application of external loads or the analysis of highly st and ardized trunk flexion-extension maneuvers . Few studies have used everyday activities such as sit-to-st and or lifting an object from the ground . They have shown that the motion patterns of LBP patients differ from those of healthy subjects . Nevertheless , very few studies have tried to correlate objective findings to the results of subjective scales , and no previous study has developed a LBP classification and functional assessment model on the basis of kinematic analysis of everyday activities . Methods . Sixteen controls and 39 LBP patients performed a sit-to-st and task , and lifted three different weights from a st and ing position . The vertical forces exerted and the relative positions of the lower limb and the cervical , thoracic , lumbar , and sacroiliac regions were recorded . Reliability was determined from repetitions of the tests performed by the control group . Binary logistic regression analyses were computed . The results of the selected regression equation were correlated to the Oswestry Disability Index scale results , to check the validity of the procedure for the measurement of functional disability . Results . Reliability of the parameters was good . The selected regression model used two variables , and correctly classified 97.3 % of the patients . High correlations were found between the results of this regression equation and the Oswestry Disability Index scale . Conclusion . It is possible to distinguish LBP patients from healthy subjects by means of the biomechanical analysis of everyday tasks . This kind of analysis can produce objective and reliable indexes about the patients ' degree of functional impairment STUDY DESIGN A prospect i ve cohort study assessing the responsiveness of two disease-specific question naires and a generic health question naire for patients with low back pain and sciatica . OBJECTIVES To compare the responsiveness of the eight scales and two summery scales of the SF-36 question naire with that of the Oswestry Disability Index and Low Back Outcome Score question naires . SUMMARY OF BACKGROUND DATA Evaluation of treatment outcome is being determined more frequently from a patient 's perspective , particularly the impact treatment has on current health status . METHODS Patients were recruited from two orthopedic back pain clinics in a tertiary hospital . Patients completed the pretreatment question naire 1 month before treatment and follow-up question naires a minimum of 2 - 6 months after treatment . Patients undergoing surgery were also observed for a minimum of 2 years . RESULTS Overall , the Oswestry Disability Index was most responsive ; however , individual scales from the SF-36 question naire showed equal or greater sensitivity to change than the Oswestry Disability Index in each of the patient subgroups . The SF-36 Role Physical scale was prone to floor effects ( a high percentage of respondents score zero ) , and the change scores from the SF-36 Role Emotional scale varied by 100 points in either direction in each of the patient subgroups . CONCLUSION Responsiveness varied according to which method was used in its calculation . The responsiveness of the SF-36 question naire shows that it can be a useful adjunct in the assessment of patients with low back pain when combined with disease-specific question naires Study Design . Recruitment phase of a r and omized clinical trial . Objectives . To review the published literature on the use of the  distress risk assessment method in different back pain population s and healthcare setting s and compare results with those obtained from the current trial . Summary of Background . Psychological distress in low back pain is commonplace , and distress increases the relative risk of poor outcome with physical treatment alone . The  Distress and Risk Assessment Method  is a tool for use in the clinical setting to assist in the identification of distress and clinical decision-making . Methods . The  Distress Risk Assessment Method and Rol and Morris Disability Question naire were used to assess eligibility of patients with recurrent low back pain for recruitment into a r and omized clinical trial examining different physical therapy approaches . Results . In total , 221 patients were assessed , result ing in 212 correctly complete question naires . Of those 212 , 71 ( 33 % ) showed evidence of marked distress ( 41 depressed and 30 somatic ) . Functional disability , measured using the Rol and Morris Disability Question naire , was higher for the distressed group ( mean 14.1 , SD 4.8 , range 3–23 ) than the nondistressed group ( mean 8.0 , SD 5.1 , range 0–21 ) . Distress and anxiety measured using the distress risk assessment method were correlated to self-reported back-related functional disability . Conclusions . Distress associated with low back pain is common with one third of patients referred for physical therapy at the units studied exhibiting a level of distress that increased their relative risk of poor outcome by 3 to 4 times . Clinical ly , screening this group of patients may help indicate when liaison with other professionals is appropriate and possibly identify those patients who may be too distressed to respond to physical therapy intervention alone Abstract Objective : To evaluate effectiveness of an exercise programme in a community setting for patients with low back pain to encourage a return to normal activities . Design : R and omised controlled trial of progressive exercise programme compared with usual primary care management . Patients ' preferences for type of management were elicited independently of r and omisation . Participants : 187 patients aged 18 - 60 years with mechanical low back pain of 4 weeks to 6 months ' duration . Interventions : Exercise classes led by a physiotherapist that included strengthening exercises for all main muscle groups , stretching exercises , relaxation session , and brief education on back care . A cognitive-behavioural approach was used . Main outcome measures : Assessment s of debilitating effects of back pain before and after intervention and at 6 months and 1 year later . Measures included Rol and disability question naire , Aberdeen back pain scale , pain diaries , and use of healthcare services . Results : At 6 weeks after r and omisation , the intervention group improved marginally more than the control group on the disability question naire and reported less distressing pain . At 6 months and 1 year , the intervention group showed significantly greater improvement in the disability question naire score ( mean difference in changes 1.35 , 95 % confidence interval 0.13 to 2.57 ) . At 1 year , the intervention group also showed significantly greater improvement in the Aberdeen back pain scale ( 4.44 , 1.01 to 7.87 ) and reported only 378 days off work compared with 607 in the control group . The intervention group used fewer healthcare re sources . Outcome was not influenced by patients ' preferences . Conclusions : The exercise class was more clinical ly effective than traditional general practitioner management , regardless of patient preference , and was cost effective . Key messages Patients with back pain need to return to normal activities as soon as possible but are often afraid that movement or activity may be harmful An exercise programme led by a physiotherapist in the community and based on cognitive-behavioural principles helped patients to cope better with their pain and function better even one year later Patients ' preferences for type of management did not affect outcome Patients in the intervention group tended to use fewer healthcare re sources and took fewer days off work This type of exercise programme should be more widely OBJECTIVE To evaluate a specific workplace intervention for the management of  chronic lower back pain among employees working in assembly positions in the automotive industry . DESIGN R and omized controlled trial . SETTING On site at the workplace of a French automotive manufacturer . PARTICIPANTS Subjects ( N=75 volunteers ) were recruited on site and r and omly assigned to either an experimental group ( n=37 ) or a control group ( n=38 ) . INTERVENTION The experimental group followed a supervised 60-minute session , 3 times per week , of muscle strengthening , flexibility , and endurance training during 2 months . The control group received no direct intervention . Evaluation took place at baseline , 2 months , and 6 months . MAIN OUTCOME MEASURES Pain related parameters were evaluated using vali date d question naires and scales translated into French ( Quebec Back Pain Disability Scale , Rolan Morris Disability Question naire , Dallas Pain Question naire , and the Tampa Scale for Kinesiophobia ) . Perceived pain intensity was evaluated using the numerical rating scale , and physical outcome measures were evaluated using specific indicators ( flexibility , Biering-Sorensen Test , Shirado test ) . The multivariate analysis of variance , t test , and Wilcoxon signed-rank test were used for statistical analysis . RESULTS We observed a significant beneficial effect ( P<.025 ) for the experimental group at 2 and 6 months in pain parameters , specific flexibility , and in back functions , and a significant improvement at 6 months in the control group for the perceived pain intensity , anterior flexion , flexibility of quadriceps , and Dallas Pain Question naire 's work recreational score . An increase in the practice of physical activity outside the workplace was noted in both groups at 2 months but persisted at 6 months for the experimental group . CONCLUSIONS This study reinforces the multiple health benefits of physical activity and physical therapy modalities in the workplace by assisting individuals at risk who have chronic LBP OBJECTIVES Testing the feasability of a back school assessment programme in two population s of people suffering with chronic low back pain . MATERIAL Twenty-nine patients were r and omly included in a chronic low back pain assessment programme ( 15 patients waiting for back school and 14 patients after back school ) . METHODS The programme was made of the measure of the age , the sex , the body mass index , the pain ( VAS , St Antoine Hospitals Pain Question naire - SAPQ ) , the anxiety , the depression , the RIII nociceptive reflex , the fingertip-floor distance , the strength of the flexors and of the extensors of the lumbar spine ( CybexR 6000 isocinetic dynamometer ) , the lumbar function ( EIFEL , Dougados ) , the Dallas self- question naire . The Back School Education programme was made of five sessions ( information , ergonomics , extension exercises ) . RESULTS Comparing the two population s we did not observe significant differences concerning the age , the body mass index , the anxiety and depression levels , the pain ( VAS , SAPA , RIII nociceptive reflex ) , the lumbar stiffness , the lumbar disability , the quality of life ; the patients who had achieved back school had a peak torque of the flexors and a ratio flexors/extensors significantly lower . Comparing men and women we observed significant differences in the SAPQ and the muscles strength . The SAPQ was correlated with the depression and anxiety levels , the lumbar disability , the peak torque of the flexors . The VAS was correlated with the age , the lumbar stiffness , the depression level , the peak torque of the flexors . The RIII nociceptive reflex was correlated with the ratio flexors/extensors . CONCLUSION This study present some biases but this objective assessment of chronic low back pain appeared as feasible . The pain must be investigated in term of intensity , expression , alleviation . The impairment of the flexors muscles in women and after back school has to be confirmed . The different tests are relevant to determinate the efficiency of the back school programmes The purpose of this prospect i ve , single site cohort quasi-experimental study was to determine the responsiveness of the numerical rating scale ( NRS ) , Rol and –Morris disability question naire ( RMDQ ) , Oswestry disability index ( ODI ) , pain self-efficacy question naire ( PSEQ ) and the patient-specific functional scale ( PSFS ) in order to determine which would best measure clinical ly meaningful change in a chronic low back pain ( LBP ) population . Several patient-based outcome instruments are currently used to measure treatment effect in the chronic LBP population . However , there is a lack of consensus on what constitutes a “ successful ” outcome , how an important improvement/deterioration has been defined and which outcome measure(s ) best captures the effectiveness of therapeutic interventions for the chronic LBP population . Sixty-three consecutive patients with chronic LBP referred to a back exercise and education class participated in this study ; 48 of the 63 patients had complete data . Five question naires were administered initially and after the 5-week back class intervention . Also at 5 weeks , patients completed a global impression of change as a reflection of meaningful change in patient status . Score changes in the five different question naires were subjected to both distribution- and anchor-based methods : st and ard error of measurement ( SEM ) and receiver operating characteristic ( ROC ) curves to define clinical improvement . From these methods , the minimal clinical ly important difference ( MCID ) defined as the smallest difference that patients and clinicians perceive to be worthwhile is presented for each instrument . Based on the SEM , a point score change of 2.4 in the NRS , 5 in the RMDQ , 17 in the ODI , 11 on the PSEQ , and 1.4 on the PSFS corresponded to the MCID . Based on ROC curve analysis , a point score change of 4 points for both the NRS and RMDQ , 8 points for the ODI , 9 points for the PSEQ and 2 points for the PSFS corresponded to the MCID . The ROC analysis demonstrated that both the PSEQ and PSFS are responsive to clinical ly important change over time . The NRS was found to be least responsive . The exact value of the MCID is not a fixed value and is dependent on the assessment method used to calculate the score change . Based on ROC curve analysis the PSFS and PSEQ were more responsive than the other scales in measuring change in patients with chronic LBP following participation in a back class programme . However , due to the small sample size , the lack of observed worsening of symptoms over time , the single centre and intervention studied these results which need to be interpreted with caution OBJECTIVE To undertake a comparative examination of the reliability and validity of two frequently used self-report measures of functional disability , the Pain Disability Index  ( PDI ) and the Oswestry Low Back Pain Disability Question naire  ( OLBPDQ ) . DESIGN A descriptive ex-post facto design was used in the study . SETTING Pain clinics and neurosurgical units at three metropolitan hospitals . SUBJECTS One hundred patients with chronic low back pain of noncancer origin were administered the two question naires as part of a larger question naire battery . RESULTS Acceptable internal consistency values of 0.76 for the PDI and 0.71 for the OLBPDQ were obtained . A correlation of r = 0.63 was found between the PDI and the OLBPDQ , supporting the concurrent validity of the two scales . Both the scales were found to be correlated to the Beck Depression Inventory scores ( PDI , r = 0.42 ; OLBPDQ , r = 0.39 ) , with higher disability associated with greater depression . Only the total PDI score was found to be sensitive to functional status differences within the patient sample . CONCLUSIONS These findings support other recent work in favor of the PDI . The PDI had a slightly higher internal consistency and was more sensitive than the OLBPDQ OBJECTIVE To evaluate a progressive fitness programme for patients with chronic low back pain . DESIGN Single blind r and omised controlled trial . Assessment s were carried out before and after treatment by an observer blinded to the study and included a battery of vali date d measures . All patients were followed up by postal question naire six months after treatment . SETTING Physiotherapy department of orthopaedic hospital . SUBJECTS 81 patients with chronic low back pain referred from orthopaedic consultants for physiotherapy . The patients were r and omly allocated to a fitness programme or control group . INTERVENTION Both groups were taught specific exercises to carry out at home and referred to a back-school for education in back care . Patients allocated to the fitness class attended eight exercise classes over four weeks in addition to the home programme and backschool . RESULTS Significant differences between the groups were shown in the changes before and after treatment in scores on the Oswestry low back pain disability index ( P < 0.005 ) , pain reports ( sensory P < 0.05 and affective P < 0.005 ) , self efficacy reports ( P < 0.05 ) , and walking distance ( P < 0.005 ) . No significant differences between the groups were found by the general health question naire or question naire on pain locus of control . A benefit of about 6 percentage points on the disability index was maintained by patients in the fitness group at six months . CONCLUSION There is a role for supervised fitness programmes in the management of moderately disabled patients with chronic low back pain . Further clinical trials , however , need to be established in other centres to confirm these findings Objective To test the predictive utility of the Örebro Musculoskeletal Pain Screening Question naire in identifying patients at risk for developing persistent back pain problems . Design Prospect i ve , where participants completed the question naire and their cases were followed for 6 months to assess outcome with regard to pain , function , and absenteeism due to sickness . Participants One hundred seven patients , recruited from seven primary care units . Results Discriminant analyses showed that the items on the question naire were significantly related to future problems . For absenteeism due to sickness , 68 % of the patients were correctly classified into one of three groups , whereas an even distribution would have produced 33 % . The analyses for function correctly classified 81 % , and for pain 71 % , into one of two groups , compared with a chance level of 50 % . A total score analysis demonstrated that a cutoff score of 90 points had a sensitivity of 89 % and a specificity of 65 % for absenteeism due to sickness , and a sensitivity of 74 % and a specificity of 79 % for functional ability . Conclusions The results underscore that psychological variables are related to outcome 6 months later , and they replicate and extend earlier findings indicating that the Örebro Screening Question naire is a clinical ly reliable and valid instrument . The total score was a relatively good predictor of future absenteeism due to sickness as well as function , but not of pain . The results suggest that the instrument could be of value in isolating patients in need of early interventions and may promote the use of appropriate interventions for patients with psychological risk factors
The most commonly reported outcome was range of motion .
Interpretation : The literature to date offers limited and inconsistent evidence of kinematic/kinetic measures in low back pain patients that could be used clinical ly .
HighlightsCurrent low back pain assessment relies on subjective measures .Use of objective measures ( kinematics/kinetics ) is encouraged in low back pain assessment .This review highlights the heterogeneity of studies with low back pain and healthy subjects .
Background : Currently , there is a widespread reliance on self‐reported question naires to assess low back pain patients .
However , it has been suggested that objective measures of low back pain patients ' functional status should be used to aid clinical assessment .
The aim of this study is to systematic ally review which kinematic /kinetic parameters have been used to assess low back pain patients against healthy controls and to propose clinical kinematic/kinetic measures .