Back Pain Treatments

Performance Testing of Low Back Pain Patients

This study was designed to evaluate if physical performance tests were reliable and valid in low back pain patients. Using a sample of 44 LBP patients and 48 pain-free subjects, the authors compared the two groups as they performed in multiple tests—such as the "Lumbar Flexion," "Five-Minute Walk," "Sorensen fatigue test," and "Repeated Sit-to-Stand." As well, the subjects took self-report tests to express their perceived levels of pain and disability, as a means of comparison to the physical functioning and endurance tests.

The authors found the battery of tests reliable. Another benefit of these tests is that since they are easily administered, good reliability can be found in a clinical context. And after testing and retesting subjects, scores still were stable—which indicates a patient only has to perform the task/test once, and a reliable score will emerge.

The authors found a moderate correlation between the physical performance tests and the self-report pain questionnaires:

"Further, although physical performance and self-report of disability were moderately correlated, the correlation between disability and lumbar flexion was trivial. This shows that physical performance measures are much better indicators of a patient�s ability to function than the frequently used impairment measure of spinal range of motion. Low back pain is a problem of activity intolerance; therefore, clinical assessments should be activity based."

The authors conclude that the battery of tests are useful indicators of disability. A strong correlation between the self-reports of disability and the tests confirmed an association between a patient�s perception of their disability and their actual physical performance.

Simmonds MJ, Olson SL, Jones S, et al. Psychometric characteristics and clinical usefulness of physical performance tests in patients with low back pain. Spine 1998; 23(22):2412-2421.