Abstract
Objective: To identify those clinical tests that most expediently examine the body functional categories “muscle function” and “emotional function” of the Brief ICF Core Sets (International Classification of Disability and Health [2001]) for chronic low back pain (CLBP). Design: Case-control study. Setting: Outpatient department of physical medicine and rehabilitation. Participants: 32 consecutive CLBP patients and 19 nonathletic healthy controls, matched in age, body mass index, and sex. Interventions: Not applicable. Main Outcome Measures: Following a comprehensive standardized clinical examination, all patients and controls underwent extensive objective muscle function tests that measured trunk muscle strength, endurance, and postural performance. Assessment of the category “emotional function” included the Symptom Checklist−90−Revised, the Beck Depression Inventory, the Fear-Avoidance Beliefs Questionnaire (FABQ-D), and body experience (Borg Category Ratio Scales about exertion, tension, fear of harm and [re-]injury). Results: A series of logistic regression analyses that included the significant and clinically relevant muscle function and emotional and cognitive functional variables revealed back muscle endurance and somatization to explain 50% of the between group variances. Furthermore, the variables Sensory Organization Test (SOT) composite score and FABQ were the strongest predictors of disablement in CLBP. Conclusions: In the Brief ICF Core Set for CLBP, the category “muscle function” would be best examined by back muscle endurance tests whereas that of “emotional function” by tests that examine somatization. Furthermore, both the SOT and the FABQ would, in addition to the muscle endurance and somatization tests, optimize the clinical relevance of the 2 ICF categories for CLBP.
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