Movement control impairment tests in patients with low back pain and healthy controls and its correlation with clinical measures

Abstract

BACKGROUND: To find out whether there is any movement impairment difference in the normal mechanics of musculoskeletal system between low back pain (LBP) patients and healthy individuals, applying battery of movement control impairment (MCI) tests and also relationship of diagnosis to major clinical measures. METHODS: Design is a case–control study. Three-trained physiotherapists executed a test battery of six tests, for which the reliability has been shown to be acceptable. A total of 180 participants, ninety LBP patients and ninety age-matched normal individuals were recruited to participate in the study after given consent. The differences between the groups were analyzed using the effect size (ES) (d). Chi-square test with cross-tabulation was done to find out odds and risk ratios of the participants to represent or remain in the patient group. A correlation analysis was done between all the movement impairment tests and the clinical measures such as numerical pain rating scale, straight leg raising, pain location, flexion, and extension ROM and pain duration. RESULTS: This study results demonstrated that there is a difference between participants with and without back pain which could be a diagnostic and in clinical practice may help to identify subgroups of patients in LBP. Tests such as one leg standing, rocking backward, and prone knee flexion are negatively related to back pain functional outcome indicating more difficulty in function if they are positive with LBP patients. There was no difference found regarding the presence or positive test result between the acute and chronic pain patients. CONCLUSION: The present study concluded that there was a significant difference between patients with LBP and normal individuals without back pain in actively controlling the movements of the low back. The ES between patients with LBP and healthy controls in movement control is large. Moreover, the pain score and extension range of motion are not related to any of the MCI tests.