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Chiropractic Research Review

Do Tests of Lumbopelvic Dysfunction Help Differentiate LBP?

Standard premanipulative tests for spine and/or pelvic dysfunction involve observation, palpation, and patient pain response in relation to various postures, movements or manual pain-provoking maneuvers.

Only a few studies have assessed the clinical validity of such tests, a shortcoming that may have prompted the current study.

Eighty-three sets of twins (166 total subjects) served as the study population in this investigation of the relationship between positive chiropractic test results and low back pain (LBP) status. The study also assessed the sensitivity, specificity and predictive values (positive and negative) of these tests. One twin pair was examined per day, with an experienced chiropractor (approximately 10 years of experience) performing a variety of tests to determine whether or not each subject had LBP. Subjects did not inform the clinician of back pain status and did not answer questions on LBP status during the examination.

No single test fulfilled all five of the authors criteria (i.e., high sensitivity and specificity, logical pattern in relation to LBP status, high positive and negative predictive values). However, lack of the individual lumbar ranges of movement met all criteria except high sensitivity. Although no individual test was accurate, diagnostic discrimination on the basis of these tests was satisfactory.

The authors conclude: "It is encouraging that it was often possible to diagnose the presence or absence of LBP solely on the basis of a series of tests of lumbopelvic dysfunction, and that it was possible to interpret tests of dysfunction in an objective manner."

Leboeuf-Yde C, Kyvik KO. Is it possible to differentiate people with or without low-back pain on the basis of tests of lumbopelvic dysfunction? Journal of Manipulative and Physiological Therapeutics, March/April 2000:23(3), pp160-67.
Reprints: Tel: (800) 325-4177 (ext. 4350); Fax: (314) 432-1380

Chiropractic Research Review

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