Construct validity of prognostic factors related to individuals with low back pain who may improve with spinal stabilization exercises
Hebert, J.J., Koppenhaver, S.L., Fritz, J. and Magel, J. (2009) Construct validity of prognostic factors related to individuals with low back pain who may improve with spinal stabilization exercises. In: ACC-RAC 2009 Conference, 12 - 14 March 2009, Las Vegas, NV.
INTRODUCTION: Prognostic factors have been identified which predict the clinical response to spinal stabilization exercise among individuals with low back pain (LBP). Deficits of the lumbar multifidus (LM) and transversus abdominus (TrA) muscles have also been observed in individuals with LBP, however the relationship between these deficits and the prognostic factors has not been explored. The purpose of this study was to examine the construct validity of prognostic factors purported to predict a favorable clinical outcome with stabilization exercise by evaluating the relationship between these factors and the degree of TrA and LM muscle activation.
METHODS: Forty-five volunteers with LBP were evaluated for the presence of prognostic factors (positive prone instability test (PIT), age less than 40 years, aberrant movements, straight leg raise greater than 91, and the presence of lumbar hypermobility) and degree of TrA and LM muscle activation during submaximal tasks using rehabilitative ultrasound imaging. We examined the relationship between the prognostic factors, individually and as a group, and LM and TrA muscle activation using point-biserial or Pearson correlation coefficients.
RESULTS: Significant relationships were identified between LM muscle activation and the number of prognostic factors identified; r D _0.45, p < 0.01, as well as the individual factors of segmental hypermobility; r D 0.34, p D 0.01, and a positive PIT; r D 0.29, p D 0.03. No significant correlations were observed for any factor or combination of factors and TrA muscle activation.
CONCLUSIONS: Patients demonstrating lumbar hypermobility, a positive PIT, or who met a greater number of stabilization criteria were more likely to have lower LM activation when compared to subjects without these characteristics. There were no significant correlations relating any of the factors to TrA activation. These findings support the construct validity of the stabilization CPR as being related to activation of the LM, but not the TrA. (This is an abstract from a conference presentation only and does not represent a full work that has been peer-reviewed and accepted for publication.)
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