Abstract
BackgroundObjectively measured reduction in lumbar posterior-to-anterior (PA) stiffness is associated with pain relief in some, but not all persons with low back pain. Unfortunately, these measurements can be time consuming to perform. In comparison, the Lumbar Spine Instability Questionnaire (LSIQ) is intended to measure spinal instability and the Lumbar Spine Disability Index (LSDI) is created for self-reporting functional disability due to increased spinal stiffness. Given the above, the aim of this study is to compare measures of the LSIQ and LSDI with objective measures of lumbar PA stiffness as measured by a mechanical device, Vertetrack (VT), in patients with persistent non-specific low back pain (nsLBP).MethodsTwenty-nine patients with nsLBP completed the LSIQ and LSDI at baseline and after two weeks. On these same occasions, PA spinal stiffness was measured using the VT. Between measurements, patients received four sessions of spinal manipulation. The resulting data was analyzed to determine the correlation between the self-report and objective measures of stiffness at both time points. Further, the patients were categorized into responders and non-responders based on pre-established cut points depending on values from the VT and compared those to self-report measures in order to determine whether the LSIQ and the LSDI were sensitive to change.ResultsTwenty-nine participants completed the study. Measures from the LSIQ and LSDI correlated poorly with objectively measured lumbar PA stiffness at baseline and also with the change scores. The change in objectively measured lumbar PA stiffness following spinal manipulation did not differ between those who improved, and those who did not improve according to the pre-specified cut-points. Finally, a reduction in lumbar PA stiffness following intervention was not associated with improvement in LSIQ and LSDI outcomes.ConclusionsThe current data indicate that the LSIQ and LSDI questionnaires do not correlate with measures obtained objectively by VT. Our results suggest that these objective and self- reported measures represent different domains and as such, cannot stand in place of one another.
Highlights
Low back pain (LBP) is the primary cause of years lived with disability globally (Haldeman et al, 2012; Collaborators GB of of DS 2013, 2015)
The patients were categorized into responders and non-responders based on pre-established cut points depending on values from the VT and compared those to self-report measures in order to determine whether the Lumbar Spine Instability Questionnaire (LSIQ) and the Lumbar Spine Disability Index (LSDI) were sensitive to change
The current data indicate that the LSIQ and LSDI questionnaires do not correlate with measures obtained objectively by VT
Summary
Low back pain (LBP) is the primary cause of years lived with disability globally (Haldeman et al, 2012; Collaborators GB of of DS 2013, 2015). Manual assessment of segmental spinal stiffness has relatively poor intra- and interrater reliability, and numerous devices have been developed for obtaining quantified measures of spinal stiffness, albeit mainly for research use, and the reported test-retest reliability of these devices is generally high (Wong & Kawchuk, 2016) One such device is the Vertetrack (VT) (Brown et al, 2017). The aim of this study is to compare measures of the LSIQ and LSDI with objective measures of lumbar PA stiffness as measured by a mechanical device, Vertetrack (VT), in patients with persistent non-specific low back pain (nsLBP). Our results suggest that these objective and self- reported measures represent different domains and as such, cannot stand in place of one another
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