Measures of low back function: a review of reproducibility studies.

OBJECTIVE The objective of the present study was to make a systematic literature review with preset quality criteria concerning reproducibility of the tests of the low back regarding strength, endurance and range of motion. DESIGN Literature in Medline and local databases was reviewed for articles concerning the reproducibility of strength, endurance, and range of motion measurements. BACKGROUND Measures of low back function are widely used, and are important for both clinical and research purposes in relation to low back problems. A review of the reproducibility of these tests has not previously been made. METHODS After extensive discussion among all the authors, general evaluation parameters were defined for the quality assessment. Every study was graded from 0 to 2 for each parameter. Parameters evaluated were: number of subjects, subject description, method description, test/retest interval, description of results, and statistics. RESULTS The literature search revealed a total of 79 studies. Most studies suffered from methodological weaknesses and only eleven studies received ten or more quality points (maximum 14). The results from the highest graded studies are highlighted. CONCLUSIONS It may be concluded that there is a considerable lack of information about the reproducibility of functional measures for the low back, and therefore a recommendation for consensus is difficult. However, most tests performed in the sagittal plane are reliable for use on groups. RELEVANCE Measures of low back function are thought to be of great importance for clinicians, and low back researchers in general. A review of reproducibility will be helpful both as a survey of tests, and to provide information on the usefulness in relation to the level of reproducibility.

[1]  T. Mayer,et al.  Reliability Problems Associated with the Modified Schöber Technique for True Lumbar Flexion Measurement , 1992, Spine.

[2]  P. Disler,et al.  Reliability of the American Medical Association guides' model for measuring spinal range of motion. Its implication for whole-person impairment rating. , 1999, Spine.

[3]  T. Mayer,et al.  Trunk Muscle Endurance Measurement: Isometric Contrasted to Isokinetic Testing in Normal Subjects , 1995, Spine.

[4]  P. Dolan,et al.  The use of surface EMG power spectral analysis in the evaluation of back muscle function. , 1997, Journal of rehabilitation research and development.

[5]  J. Graves,et al.  Reliability of lumbar isometric torque in patients with chronic low back pain. , 1992, Physical therapy.

[6]  P D O'Connor,et al.  Intrasubject reliability of spinal range of motion and velocity determined by video motion analysis. , 1993, Physical therapy.

[7]  M. Haas,et al.  Interexaminer Reliability and Discriminant Validity of Inclinometric Measurement of Lumbar Rotation in Chronic Low-Back Pain Patients and Subjects Without Low-Back Pain , 1992, Spine.

[8]  T Reilly,et al.  Sources of variation in back and leg dynamometry. , 1994, Ergonomics.

[9]  L. Snyder-Mackler,et al.  Comparison of spinal mobility and isometric trunk extensor forces with electromyographic spectral analysis in identifying low back pain. , 1991, Physical therapy.

[10]  G. Waddell,et al.  Trunk strength testing with iso-machines. Part 2: Experimental evaluation of the Cybex II Back Testing System in normal subjects and patients with chronic low back pain. , 1993, Spine.

[11]  K M Tillotson,et al.  Noninvasive Measurement of Lumbar Sagittal Mobility: An Assessment of the Flexicurve Technique , 1991, Spine.

[12]  O. Madsen.  Trunk Extensor and Flexor Strength Measured by the Cybex 6000 Dynamometer: Assessment of Short‐Term and Long‐Term Reproducibility of Several Strength Variables , 1996, Spine.

[13]  J. Salminen,et al.  Spinal Mobility and Trunk Muscle Strength in 15‐Year-Old Schoolchildren With and Without Low‐Back Pain , 1992, Spine.

[14]  P. J. Mayer,et al.  Analysis of spine motion variability using a computerized goniometer compared to physical examination. A prospective clinical study. , 1994, Spine.

[15]  G B Andersson,et al.  Motion of the Lumbar Spine Reliability of Two Measurement Techniques , 1991, Spine.

[16]  C. Tingvall,et al.  Measurement of Spinal Sagittal Configuration and Mobility with Debrunner's Kyphometer , 1989, Spine.

[17]  J. M. Rothstein,et al.  Reliability of the attraction method for measuring lumbar spine backward bending. , 1987, Physical therapy.

[18]  D. Moher,et al.  Completeness of reporting of trials published in languages other than English: implications for conduct and reporting of systematic reviews , 1996, The Lancet.

[19]  L. Cocchiarella,et al.  Guides to the evaluation of permanent impairment , 2000 .

[20]  P. Stratford,et al.  Interrater reliability of six tests of trunk muscle function and endurance. , 1997, The Journal of orthopaedic and sports physical therapy.

[21]  Y Hattori,et al.  Test-retest reliability of isometric and isoinertial testing in symmetric and asymmetric lifting. , 1998, Ergonomics.

[22]  F. Biering-Sørensen.  Physical measurements as risk indicators for low-back trouble over a one-year period. , 1984, Spine.

[23]  M J Pearcy,et al.  Correlation between radiographic and clinical measurement of lumbar spine movement. , 1983, British journal of rheumatology.

[24]  G. Andersson,et al.  Variance in the Measurement of Sagittal Lumbar Spine Range of Motion Among Examiners, Subjects, and Instruments , 1995, Spine.

[25]  J. Hildebrandt,et al.  Lumbar Range of Motion: Reliability and Validity of the Inclinometer Technique in the Clinical Measurement of Trunk Flexibility , 1996, Spine.

[26]  G. Mellin.  Measurement of thoracolumbar posture and mobility with a Myrin inclinometer. , 1986, Spine.

[27]  L. Haugh,et al.  Repeatability of Four Clinical Methods for Assessment of Lumbar Spinal Motion , 1988, Spine.

[28]  S. Henry,et al.  Endurance training of trunk extensor muscles. , 1993, Physical therapy.

[29]  van de Stadt Rj,et al.  Objectivity and repeatability of measurements in low back pain. , 1982 .

[30]  M. Strube,et al.  Reliability of Isokinetic Measurements of Trunk Muscle Performance , 1991, Spine.

[31]  P. Pynsent,et al.  1989 Volvo Award in Clinical Sciences: Reproducibility of Physical Signs in Low-Back Pain , 1989, Spine.

[32]  G. Wickström,et al.  Reproducibility of nine tests to measure spinal mobility and trunk muscle strength. , 2020, Scandinavian journal of rehabilitation medicine.

[33]  S. McGill,et al.  Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. , 1999, Archives of physical medicine and rehabilitation.

[34]  H. Biedermann,et al.  Median frequency estimates of paraspinal muscles: reliability analysis. , 1990, Electromyography and clinical neurophysiology.

[35]  I. Vuori,et al.  Reproducibility of computer measurement of maximal isometric strength and electromyography in sedentary middle-aged women , 2004, European Journal of Applied Physiology and Occupational Physiology.

[36]  G. Grégoire,et al.  Selecting the language of the publications included in a meta-analysis: is there a Tower of Babel bias? , 1995, Journal of clinical epidemiology.

[37]  J L Merritt,et al.  Measurement of trunk flexibility in normal subjects: reproducibility of three clinical methods. , 1986, Mayo Clinic proceedings.

[38]  R. Laukkanen,et al.  Health-related fitness test battery for adults: aspects of reliability. , 1996, Archives of physical medicine and rehabilitation.

[39]  H. Alaranta,et al.  Flexibility of the spine: normative values of goniometric and tape measurements. , 1994, Scandinavian journal of rehabilitation medicine.

[40]  H. Vet,et al.  Balneotherapy and quality assessment: interobserver reliability of the Maastricht criteria list and the need for blinded quality assessment. , 1998, Journal of clinical epidemiology.

[41]  D B Chaffin,et al.  Ergonomics guide for the assessment of human static strength. , 1975, American Industrial Hygiene Association journal.

[42]  H. Biedermann,et al.  Electromyographic power spectrum analysis of the paraspinal muscles. Long-term reliability. , 1993, Spine.

[43]  M. Szpalski,et al.  Reproducibility of trunk isoinertial dynamic performance in patients with low back pain. , 1992, Journal of spinal disorders.

[44]  G. Mellin.  Accuracy of measuring lateral flexion of the spine with a tape. , 1986, Clinical biomechanics.

[45]  E. H. Chen,et al.  Reliability of three lumbar sagittal motion measurement methods: surface inclinometers. , 1997, Journal of occupational and environmental medicine.

[46]  A. Taube,et al.  Interexaminer Reliability in Physical Examination of Patients With Low Back Pain , 1997, Spine.

[47]  R. Rondinelli,et al.  ESTIMATION OF NORMAL LUMBAR FLEXION WITH SURFACE INCLINOMETRY: A Comparison of Three Methods , 1992, American journal of physical medicine & rehabilitation.

[48]  K. JØrgensen,et al.  Two methods for determining trunk extensor endurance , 1986, European Journal of Applied Physiology and Occupational Physiology.

[49]  C. Lengeler,et al.  Language bias in randomised controlled trials published in English and German , 1997, The Lancet.

[50]  H. Alaranta,et al.  Isokinetic performance capacity of trunk muscles. Part I: The effect of repetition on measurement of isokinetic performance capacity of trunk muscles among healthy controls and two different groups of low-back pain patients. , 1996, Scandinavian journal of rehabilitation medicine.

[51]  Low-frequency magnetic field technology: quantifying spinal range of motion. , 1989, Archives of physical medicine and rehabilitation.

[52]  H Suzuki,et al.  Lumbar trunk muscle endurance testing: an inexpensive alternative to a machine for evaluation. , 1996, Archives of physical medicine and rehabilitation.

[53]  Serge H. Roy,et al.  Lumbar Muscle Fatigue and Chronic Lower Back Pain , 1989, Spine.

[54]  G. Smidt,et al.  Assessment of Abdominal and Back Extensor Function: A Quantitative Approach and Results for Chronic Low‐Back Patients , 1983, Spine.

[55]  K. Refshauge,et al.  The reliability and validity of the Biering-Sorensen test in asymptomatic subjects and subjects reporting current or previous nonspecific low back pain. , 1999, Spine.

[56]  Karl H.E. Kroemer,et al.  Testing individual capability to lift material: Repeatability of a dynamic test compared with static testing , 1985 .

[57]  V. Wright,et al.  An objective clinical method to measure spinal extension. , 1972, Rheumatology and physical medicine.

[58]  R. Burdett,et al.  Reliability and validity of four instruments for measuring lumbar spine and pelvic positions. , 1986, Physical therapy.

[59]  R Williams,et al.  Reliability of the modified-modified Schöber and double inclinometer methods for measuring lumbar flexion and extension. , 1993, Physical therapy.

[60]  S. Stuckey,et al.  Reliability of measuring trunk motions in centimeters. , 1982, Physical therapy.

[61]  A R Jadad,et al.  Assessing the quality of reports of randomized clinical trials: is blinding necessary? , 1996, Controlled clinical trials.

[62]  M. Pollock,et al.  Quantitative Assessment of Full Range‐of-Motion Isometric Lumbar Extension Strength , 1990, Spine.

[63]  S M McGill,et al.  Reliability of spectral EMG parameters of healthy back extensors during submaximum isometric fatiguing contractions and recovery. , 1998, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[64]  J M Rothstein,et al.  Reliability of clinical measurements of forward bending using the modified fingertip-to-floor method. , 1990, Physical therapy.

[65]  G. Waddell,et al.  Reliability and Validity of Clinical Measurement of the Lumbar Spine in Patients with Chronic Low Back Pain , 1991 .

[66]  A E Chapman,et al.  Measurements of the sagittal mobility of the lumbar spine and hips. , 1968, Annals of physical medicine.

[67]  A. Nargol,et al.  Factors in the reproducibility of electromyographic power spectrum analysis of lumbar paraspinal muscle fatigue. , 1999, Spine.

[68]  P Latikka,et al.  Correlations of isokinetic and psychophysical back lift and static back extensor endurance tests in men. , 1995, Clinical biomechanics.

[69]  P. Sparling,et al.  Development of a cadence curl-up test for college students. , 1997, Research quarterly for exercise and sport.

[70]  T. Rönnemaa,et al.  Measurement of low back mobility, isometric strength and isoinertial performance with isostation B-200 triaxial dynamometer: reproducibility of measurement and development of functional indices. , 1994, Journal of spinal disorders.

[71]  W. M. Keyserling,et al.  Preemployment strength testing: an updated position. , 1978, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[72]  J H van Dieën,et al.  Reproducibility of isometric trunk extension torque, trunk extensor endurance, and related electromyographic parameters in the context of their clinical applicability , 1996, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[73]  P M Reynolds,et al.  Measurement of spinal mobility: a comparison of three methods. , 1975, Rheumatology and rehabilitation.

[74]  J. Fleiss.  The design and analysis of clinical experiments , 1987 .

[75]  K. H. Nilsen,et al.  Assessment of the Progress of the Back-Pain Patient , 1982, Spine.

[76]  D. Karras.  Statistical methodology: II. Reliability and validity assessment in study design, Part B. , 1997, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[77]  U. Moritz,et al.  Trunk muscle strength and back muscle endurance in construction workers with and without low back disorders. , 1992, Scandinavian journal of rehabilitation medicine.

[78]  Charles L. Webber,et al.  Lumbar paraspinal muscle fatigability in repetitive isoinertial loading: EMG spectral indices, Borg scale and endurance time , 1997, European Journal of Applied Physiology and Occupational Physiology.

[79]  Joshua R. Smith,et al.  Quantification of Lumbar Function: Part 5: Reliability of Range-of-Motion Measures in the Sagittal Plane and an In Vivo Torso Rotation Measurement Technique , 1986, Spine.

[80]  F. Hoehler,et al.  Low back pain and its treatment by spinal manipulation: measures of flexibility and asymmetry. , 1982, Rheumatology and rehabilitation.

[81]  C. Richardson,et al.  Reliability of electromyographic power spectral analysis of back muscle endurance in healthy subjects. , 1996, Archives of physical medicine and rehabilitation.

[82]  C. Chiarello,et al.  Interrater reliability of the Cybex EDI-320 and fluid goniometer in normals and patients with low back pain. , 1993, Archives of physical medicine and rehabilitation.

[83]  L. Haugh,et al.  Some endurance measures in persons with chronic low back pain. , 1994, The Journal of orthopaedic and sports physical therapy.

[84]  H. Alaranta,et al.  Non-dynamometric trunk performance tests: reliability and normative data. , 1994, Scandinavian journal of rehabilitation medicine.

[85]  K. Storheim,et al.  Intra‐ and interobserver reproducibility of Cybex EDI 320 measuring spinal mobility , 1997, Scandinavian journal of medicine & science in sports.