Background

Clinical observation of aberrant movement patterns during prone hip extension (PHE) is commonly used in clinical practice to identify patients with low back pain. It could be clinically useful to identify individuals with chronic low back pain during remission (CLBP_remission) to provide proactive intervention to prevent exacerbation of low back symptoms.

Objectives

This study aimed to establish inter-rater reliability of clinical observation of PHE and association between aberrant movement pattern and CLBP_remission.

Design

A cross-sectional study.

Method

Twenty-six participants with CLBP_remission and 18 participants without history of low back pain (NoLBP) performed 3 repetitions of active PHE, while 2 examiners concurrently observed and independently rated the movements as “presence” or “absence” of aberrant movement. Kappa statistics were used to establish inter-rater reliability based on rating data from 2 examiners, while chi-square tests were used to determine the association between aberrant movement and CLBP_remission based on ratings (presence and absence) and known groups (CLBP_remission and NoLBP).

Results

Kappa values ranged from fair to moderate (Kappa = 0.36–0.58). Result also demonstrated a significant association (P < 0.05) between presence of aberrant movement and CLBP_remission. Findings indicate fair to moderate inter-rater reliability which are sufficient for clinical practice. The findings also indicated presence of aberrant movement patterns during active PHE was associated with CLBP_remission.

Conclusions

These findings suggested the usefulness of clinical observation of aberrant movement pattern during PHE to identify CLBP_remission. The detection of aberrant movement would help clinicians to provide preventive program to minimize the risk of recurrent episodes of low back symptoms.

中文翻译：

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俯卧髋伸展临床观察的评分者间信度以及异常运动与慢性腰痛的关联

背景

俯卧髋伸展 (PHE) 过程中异常运动模式的临床观察通常用于临床实践以识别腰痛患者。识别缓解期间慢性腰痛（CLBP_缓解）的个体以提供主动干预以防止腰背症状恶化，这在临床上可能是有用的。

目标

本研究旨在建立 PHE 临床观察的评估者间可靠性以及异常运动模式与 CLBP_缓解之间的关联。

设计

一项横断面研究。

方法

26 名 CLBP_缓解的参与者和 18 名没有腰痛病史 (NoLBP) 的参与者进行了 3 次主动 PHE 重复，而 2 名检查员同时观察并独立将这些运动评定为异常运动的“存在”或“不存在”。Kappa 统计用于根据来自 2 名检查员的评分数据建立评分者间信度，而卡方检验用于根据评分（存在和不存在）和已知组（_CLBP缓解和无LBP）。

结果

Kappa 值范围从一般到中等 (Kappa = 0.36–0.58)。结果还表明 异常运动的存在与 CLBP_{缓解之间存在显着关联 (} P < 0.05) 。研究结果表明，对于临床实践而言，评估者间信度为中等至中等。研究结果还表明，在活动性 PHE 期间存在异常运动模式与 CLBP_缓解有关。

结论

这些发现表明临床观察 PHE 期间异常运动模式对识别 CLBP_缓解的有用性。异常运动的检测将有助于临床医生提供预防方案，以尽量减少腰背症状反复发作的风险。