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Reliability of two functional clinical tests to evaluate trunk and lumbopelvic neuromuscular control and proprioception in a healthy population.

ABSTRACT: OBJECTIVES:The need to accurately assess trunk and lumbopelvic proprioception and neuromuscular control is widely accepted. However, based on current literature, there is a lack of reliable clinical tests to evaluate these aspects in clinical practice. The objective of this study is to investigate intra- and inter-tester reliability of the lateral step down test and the lumbopelvic position-reposition test in a healthy population. METHODS:Protocol and scoring methods were developed for the lateral step down test and lumbopelvic position-reposition test, used to assess trunk and lumbopelvic neuromuscular control and proprioception respectively. Each test was performed once by thirty participants and video analysis for test scoring was performed. Three items on the lateral step down test were scored to evaluate neuromuscular control and, four items on the lumbopelvic position-reposition test were scored to evaluate proprioception. Aggregate scores for each test were calculated based on the separate item scores. Intraclass correlation coefficients and linear weighted kappa coefficients were determined for intra- and inter-tester reliability. RESULTS:Based on the aggregate score, excellent intra- and inter-tester reliability (ICC (2,1)=0.73-0.88) was found for both tests. Moderate/almost perfect intra-and inter-tester agreement (K=0.62-0.91) was found for the separate items of the lateral step down test and fair/substantial agreement (K=0.25-0.76) for the items of the lumbopelvic position-reposition test. CONCLUSION:Current testing protocol and scoring method for the lateral step down test is reliable. Adjustments for the scoring method of the lumbopelvic position-reposition test are warranted to improve reliability.

SUBMITTER: De Blaiser C

PROVIDER: S-EPMC6849080 | biostudies-literature | 2019 Nov - Dec

REPOSITORIES: biostudies-literature

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Reliability of two functional clinical tests to evaluate trunk and lumbopelvic neuromuscular control and proprioception in a healthy population.

De Blaiser Cedric C De Ridder Roel R Willems Tine T Danneels Lieven L Roosen Philip P

Brazilian journal of physical therapy 20181110 6

<h4>Objectives</h4>The need to accurately assess trunk and lumbopelvic proprioception and neuromuscular control is widely accepted. However, based on current literature, there is a lack of reliable clinical tests to evaluate these aspects in clinical practice. The objective of this study is to investigate intra- and inter-tester reliability of the lateral step down test and the lumbopelvic position-reposition test in a healthy population.<h4>Methods</h4>Protocol and scoring methods were develope ...[more]

PMID: 30470667

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Project description:BackgroundAdequate trunk muscle endurance is considered to be an important indicator of good low back stability; therefore, its assessment is needed when determining an individual's risk for back pain. Optimal tests to assess each trunk muscle group separately are difficult to find. The objective of this study was to verify if two groups of trunk muscle endurance tests (standard and alternative) show comparable results in terms of muscle endurance ratios, holding times and rated perceived effort to perform each test.MethodsThe study was designed as a quasi-experimental repeated-measures design. There was a single group of participants who took part in two different trunk muscle endurance testing. Sixty-eight healthy adult volunteers, aged 20-45 years (31.9 ± 7.2 years), without recent musculoskeletal injury or disorder participated in the study. All participants finished the study. Trunk muscle endurance tests as tested on the Roman chair (B tests) were compared with standard tests as suggested by McGill (A tests). Each group of tests consisted of an endurance test for trunk extensors, trunk flexors, and lateral trunk muscles for left and right side. The order of tests' performances was randomly assigned to each participant, whereby a participant did perform A and B tests in the same order. In each test of A and B the holding time was recorded and a perceived effort in each test performance was also assessed by participants. Post testing performance the four ratios of trunk muscles endurance comparison were calculated for each group of tests to determine if there is a good or poor ratio between muscles. Results of each participant were compared for trunk muscle endurance ratio calculations, holding times and rated perceived effort for A and B tests.ResultsResults showed comparable trunk muscle endurance ratios in the three ratios observed, except for the flexors:extensors ratio (AFL:EX: 1.2 (IQR: 0.7-1.6) vs. BFL:EX: 0.6 (IQR: 0.3-0.8); p < 0.001). As compared to A tests, holding times were significantly longer in B tests for the extensors (AEX: 125.5 s (IQR: 104.8-182.8 s) vs. BEX: 284.0 s (IQR: 213.0-342.3 s); p < 0.001) and lateral trunk muscles (AL-LM: 61.0 s (IQR: 48.3-80.8 s) vs. BL-LM: 131.5 s (IQR: 95.5-158.5 s); AR-LM: 63.5 s (IQR: 45.8-77.3 s) vs. BR-LM: 113.0 s (IQR: 86.3-148.8 s); p < 0.001), both were also rated as slightly easier to perform in the extensors (ARPE-EX: 13 (IQR: 12.0-14.0) vs BRPE-EX: 11 (IQR: 10.0-13.0); pRPE-EX < 0.001) and lateral muscles testing (ARPE-LM: 14.0 (IQR: 12.3-15.8) vs. BRPE-LM: 13.0 (IQR: 12.0-15.0); pRPE-LM = 0.001).ConclusionsA and B tests are comparable in three of four trunk muscle endurance ratios, while longer holding times and lower perceived effort to perform were observed in most of the B tests. The Roman chair tests could be used as an alternative to standard tests.

Project description:BackgroundMusculoskeletal disorders particularly in the back and lower extremities are common among marines. Here, movement-control tests are considered clinically useful for screening and follow-up evaluation. However, few studies have addressed the reliability of clinical tests, and no such published data exists for marines. The present aim was therefore to determine the inter- and intra-observer reliability of clinically convenient tests emphasizing movement control of the back and hip among marines. A secondary aim was to investigate the sensitivity and specificity of these clinical tests for discriminating musculoskeletal pain disorders in this group of military personnel.MethodsThis inter- and intra-observer reliability study used a test-retest approach with six standardized clinical tests focusing on movement control for back and hip. Thirty-three marines (age 28.7 yrs, SD 5.9) on active duty volunteered and were recruited. They followed an in-vivo observation test procedure that covered both low- and high-load (threshold) tasks relevant for marines on operational duty. Two independent observers simultaneously rated performance as "correct" or "incorrect" following a standardized assessment protocol. Re-testing followed 7-10 days thereafter. Reliability was analysed using kappa (κ) coefficients, while discriminative power of the best-fitting tests for back- and lower-extremity pain was assessed using a multiple-variable regression model.ResultsInter-observer reliability for the six tests was moderate to almost perfect with κ-coefficients ranging between 0.56-0.95. Three tests reached almost perfect inter-observer reliability with mean κ-coefficients > 0.81. However, intra-observer reliability was fair-to-moderate with mean κ-coefficients between 0.22-0.58. Three tests achieved moderate intra-observer reliability with κ-coefficients > 0.41. Combinations of one low- and one high-threshold test best discriminated prior back pain, but results were inconsistent for lower-extremity pain.ConclusionsOur results suggest that clinical tests of movement control of back and hip are reliable for use in screening protocols using several observers with marines. However, test-retest reproducibility was less accurate, which should be considered in follow-up evaluations. The results also indicate that combinations of low- and high-threshold tests have discriminative validity for prior back pain, but were inconclusive for lower-extremity pain.

Project description:BackgroundThe root mean square surface electromyographic activity of lumbar extensor muscles during dynamic trunk flexion and extension from a standing position and task specific spine ranges of motion objectively assess muscle function in healthy young and middle age individuals. However, literature on neuromuscular activation and associated spine and hip kinematics in older individuals is sparse. This cross sectional study sought to examine the sex and age (<40 versus >60 years) related differences in the neuromuscular activation profiles of the lumbar extensors and the related spine and hip kinematics from healthy individuals during a standardized trunk flexion-extension task.MethodsTwenty five older (13 females, 60-90 years) and 24 younger (12 females, 18-40 years) healthy individuals performed trunk flexion-extension testing by holding static positions at half-flexion way and full range of motion between standing and maximum trunk flexion. The associated lumbar extensor muscle activity was derived from measurements at standing, half, and maximum flexion positions. The range of motion at the hip and lumbar spine was recorded using 3d accelerometers attached to the skin overlying the multifidus and semispinalis thoracis muscles lateral to the L5 and T4 spinous processes, respectively. Statistical calculations were performed using a permutation ANOVA with bootstrap confidence intervals.ResultsThe muscle activity in the half related to the maximum flexion position (half flexion relaxation ratio) was significantly smaller in older males when compared with younger males. Moreover, measurements revealed smaller activity changes from standing to the half and from half to the maximum flexion position in older compared to younger individuals. Older males displayed smaller gross trunk range of motion from standing to maximum flexion than any other group.ConclusionsGender and normal aging significantly affect both the activation patterns of the lumbar extensor muscles and the kinematics of the trunk during a standardized trunk flexion-extension task. Measurement results from healthy young and middle age individuals should not be used for the assessment of individuals older than 60 years of age.

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Reliability of two functional clinical tests to evaluate trunk and lumbopelvic neuromuscular control and proprioception in a healthy population.

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Reliability of two functional clinical tests to evaluate trunk and lumbopelvic neuromuscular control and proprioception in a healthy population.

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