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Functional movement analysis in patients with chronic nonspecific low back pain: a reliability and validity study.

ABSTRACT: BACKGROUND:Individuals afflicted with nonspecific chronic low back pain (CLBP) exhibit altered fundamental movement patterns. However, there is a lack of validated analysis tools. The present study aimed to elucidate the measurement properties of a functional movement analysis (FMA) in patients with CLBP. METHODS:In this validation (cross-sectional) study, patients with CLPB completed the FMA. The FMA consists of 11 standardised motor tasks mimicking activities of daily living. Four investigators (two experts and two novices) evaluated each item using an ordinal scale (0-5 points, one live and three video ratings). Interrater reliability was computed for the total score (maximum 55 points) using intra class correlation and for the individual items using Cohen's weighted Kappa and free-marginal Kappa. Validity was estimated by calculating Spearman's Rho correlations to compare the results of the movement analysis and the participants' self-reported disability, and fear of movement. RESULTS:Twenty-one participants (12 females, 9 males; 42.7?±?14.3?years) were included. The reliability analysis for the sum score yielded ICC values between .92 and.94 (p??.05). The study population showed comparably low pain levels, low scores of kinesiophobia and disability. CONCLUSION:The functional movement analysis displays excellent reliability for both, live and video rating. Due to the low levels of disability and pain in the present sample, further research is necessary to conclusively judge validity.

SUBMITTER: Vogel J

PROVIDER: S-EPMC6717644 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Functional movement analysis in patients with chronic nonspecific low back pain: a reliability and validity study.

Vogel Johanna J Wilke Jan J Krause Frieder F Vogt Lutz L Niederer Daniel D Banzer Winfried W

BMC musculoskeletal disorders 20190831 1

<h4>Background</h4>Individuals afflicted with nonspecific chronic low back pain (CLBP) exhibit altered fundamental movement patterns. However, there is a lack of validated analysis tools. The present study aimed to elucidate the measurement properties of a functional movement analysis (FMA) in patients with CLBP.<h4>Methods</h4>In this validation (cross-sectional) study, patients with CLPB completed the FMA. The FMA consists of 11 standardised motor tasks mimicking activities of daily living. Fo ...[more]

PMID: 31472693

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Project description:BackgroundThe Observable Movement Quality scale for patients with low back pain (OMQ-LBP) is a newly developed measurement instrument for use in primary care settings of physical and exercise therapists to assess movement quality (MQ) of patients with low back pain (LBP).ObjectiveThis study aims to determine validity, reliability and feasibility of the OMQ-LBP. The OMQ-LBP consists of a standardized movement circuit (performed twice) consisting of five daily activities problematic for LBP patients, which are scored with an 11-item observation list.MethodsConstruct validity was determined by testing seven hypotheses on associations between constructs (n = 85 patients with LBP) and four hypotheses on known group differences (n = 85 patients with LBP and n = 63 healthy controls; n = 35 matched participant-patients having VAS-pain ≥ 20 mm during and/or after both circuits and healthy controls). Internal consistency was analyzed with Cronbach's alpha (n = 85 patients with LBP). For inter- and intra-rater reliability Intraclass Correlation Coefficient (ICC) values were examined (n = 14 therapists: seven primary care physical therapists and seven exercise therapists). Additionally, content validity and feasibility were determined using thematic analysis of a brief interview with participants, patients (n = 38) and therapists (n = 14).ResultsAfter Bonferroni correction 2/7 associations between constructs and 2/4 significant group differences were confirmed. Cronbach's alpha was 0,79. The ICC-values of interrater reliability of the OMQ-LBP total score and the duration score were 0.56 and 0.99 and intra-rater reliability 0.82 and 0,93, respectively. Thematic analysis revealed five themes. Three themes elucidate that both patients and therapists perceived the content of the OMQ-LBP as valid. The fourth theme exhibits that OMQ-LBP provides a clear and unambiguous language for MQ in patients with LBP. Theme 5 depicts that the OMQ-LBP seems feasible, but video recording is time-consuming.ConclusionsThe OMQ-LBP is a promising standardized observational assessment of MQ during the five most problematic daily activities in patients with LBP. It is expected that uniform and objective description and evaluation of MQ add value to clinical reasoning and facilitate uniform communication with patients and colleagues.

Project description:BackgroundHead-eye movement control deficit is an identified problem in patients with chronic neck pain, particularly in cases of whiplash associated disorders (WAD). To date, there is no evidence concerning the reliability and validity of visually assessed active head-eye movement control tests. Therefore, the objectives of the present cross-sectional study were, a) to develop a test battery; and b) to investigate inter-observer reliability and discriminative validity in patients with chronic neck pain compared to healthy controls.MethodsThe study was conducted at two physiotherapy clinics in Switzerland. Ethics Committee approval was obtained. Ten active head-eye coordination tests, on 23 patients with chronic neck pain and associated symptoms and 19 healthy controls, were videotaped. The tests included eye movements in the neutral head position and 45° relative neck rotation, gaze stability and sequential head-eye movements. All tests were performed in the sitting and standing positions. Two blinded physiotherapists independently rated the randomized videos. Performance was rated as "negative", "moderately positive" or "clearly positive". Weighted kappa (wK) and 95% confidence intervals (CI) were calculated to investigate inter-observer reliability. Good reliability was defined as wK >0.5 with a lower boundary of 95% CI >0.2. Odds ratios (to define cut-off points) and the distribution of the classificator, numbers of positive tests, were calculated.ResultsThree out of ten tests showed "excellent" (wK 0.82 to 0.86), five out of ten tests showed "substantial" (wK 0.69 to 0.79) and two out of ten tests showed "moderate" (wK 0.54 to 0.59) reliability. Results were comparable in the sitting and standing positions. On average, three out of five tests were rated positive in patients and one out of five tests was rated positive in healthy controls. An odds ratio of 13.3 to 18.6 was obtained using ?2/5 tests as a cut-off point.ConclusionVisual assessment by physiotherapists of head-eye movement control tests is reliable. The test battery is able to discriminate between patients with chronic neck pain and healthy controls. There were no differences in performance between the sitting and standing positions. The test battery can therefore be reduced to five tests. Further research is needed to identify the test-retest stability and responsiveness.

Project description:Background This study aimed to compare the effects of cognitive functional therapy (CFT) and movement system impairment (MSI)-based treatment on pain intensity, disability, Kinesiophobia, and gait kinetics in patients with chronic non-specific low back pain (CNSLBP). Methods In a single-blind randomized clinical trial, we randomly assigned 91 patients with CNSLBP into CFT (n = 45) and MSI-based treatment (n = 46) groups. An 8-week training intervention was given to both groups. The researchers measured the primary outcome, which was pain intensity (Numeric rating scale), and the secondary outcomes, including disability (Oswestry disability index), Kinesiophobia (Tampa Kinesiophobia Scale), and vertical ground reaction force (VGRF) parameters at self-selected and faster speed (Force distributor treadmill). We evaluated patients at baseline, at the end of the 8-week intervention (post-treatment), and six months after the first treatment. We used mixed-model ANOVA to evaluate the effects of the interaction between time (baseline vs. post-treatment vs. six-month follow-up) and group (CFT vs. MSI-based treatment) on each measure. Results CFT showed superiority over MSI-based treatment in reducing pain intensity (P < 0.001, Effect size (ES) = 2.41), ODI (P < 0.001, ES = 2.15), and Kinesiophobia (P < 0.001, ES = 2.47) at eight weeks. The CFT also produced greater improvement in VGRF parameters, at both self-selected (FPF[P < 0.001, ES = 3], SPF[P < 0.001, ES = 0.5], MSF[P < 0.001, ES = 0.67], WAR[P < 0.001, ES = 1.53], POR[P < 0.001, ES = 0.8]), and faster speed, FPF(P < 0.001, ES = 1.33, MSF(P < 0.001, ES = 0.57), WAR(P < 0.001, ES = 0.67), POR(P < 0.001, ES = 2.91)] than the MSI, except SPF(P < 0.001, ES = 0.0) at eight weeks. Conclusion This study suggests that the CFT is associated with better results in clinical and cognitive characteristics than the MSI-based treatment for CNSLBP, and the researchers maintained the treatment effects at six-month follow-up. Also, This study achieved better improvements in gait kinetics in CFT. CTF seems to be an appropriate and applicable treatment in clinical setting. Trial registration The researchers retrospectively registered the trial 10/11/2022, at https://www.umin.ac.jp/ with identifier number (UMIN000047455). Supplementary Information The online version contains supplementary material available at 10.1186/s12891-023-06815-x.

Dataset Information

Functional movement analysis in patients with chronic nonspecific low back pain: a reliability and validity study.

Publications

Functional movement analysis in patients with chronic nonspecific low back pain: a reliability and validity study.

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