Arthrokinematics in a Subgroup of Patients Likely to Benefit From a Lumbar Stabilization Exercise Program

Abstract

Background and PurposeA clinical prediction rule (CPR) has been reported to identify patients with low back pain who are likely to benefit from stabilization exercises. The aim of this study was to characterize the spinal motion, using digital fluoroscopic video, of a subgroup of subjects with low back pain.SubjectsTwenty subjects who were positive on the CPR were compared with 20 control subjects who were healthy.MethodsThe magnitude and timing of lumbar sagittal-plane intersegmental angular and linear displacement were assessed. Receiver operating characteristic curves and accuracy statistics were used to develop a kinematic model.ResultsA 10-variable model was developed that could distinguish group membership. Seven of these variables described a disruption in timing of angular or linear displacement during mid-range movements. None of the variables suggested hypermobility.Discussion and ConclusionThe findings suggest that individuals with mid-range aberrant motion without signs of hypermobility are likely to benefit from these exercises. The developed model describes altered kinematics of this subgroup of subjects and helps to provide construct validity for the developed CPR.