ABSTRACT
OBJECTIVE: To assess test-retest reliability of the Posturo-Locomotion-Manual(PLM) test in patients with chronic low back pain. DESIGN: A controlled study in which the PLM test was used repeatedly on patients with chronic low back pain and persons without back pain. SUBJECTS: Twelve patients with treatment-resistant chronic low back pain, selected by 2 orthopaedic spine surgeons and 12 age- and sex-matched individuals with no back pain history. METHODS: An optoelectronic camera and a computer were used to quantify the performance during a simple test in which subjects picked up an object from the floor and transported it up to a shelf, thereby forcing the body through postural, locomotor and manual movements. The outcome measures were: movement time, simultaneity index and phase times for postural, locomotion and arm movement phases. Statistical analyses regarding intra-individual agreement between the measurements (reliability analysis) and changes over time were carried out. RESULTS: The effect of test movement habituation was minimized when the lowest mean value of any of 3 consecutive measures (tri-average) was used. In the control group, variation between test occasions was small. In the group of patients with chronic low back pain there was a random measurement error before intervention (sensory motor learning). After intervention the PLM test had the same precision in both groups. CONCLUSION: When the tri-average measure is used, the influence of test movement habituation is minimized and the optoelectronic PLM test is found to be reliable and responsive. It proved to be a useful tool to quantify dynamic performance in freely moving patients with chronic low back pain.
Subject(s)
Low Back Pain/physiopathology , Movement , Adult , Aged , Chronic Disease , Diagnosis, Computer-Assisted , Female , Humans , Locomotion/physiology , Low Back Pain/diagnosis , Male , Middle Aged , Motor Skills/physiology , Posture/physiology , Psychomotor Performance/physiology , Reproducibility of ResultsABSTRACT
STUDY DESIGN: The effect of sensory motor learning (SML) on chronic low back pain (CLBP) patients' movement capacity was evaluated with the optoelectronic Posturo-Locomotion-Manual (PLM) test. OBJECTIVE: To study SML changes of an intentional dynamic behavior of daily life in a group of CLBP patients and compare the performance with an age- and sex-matched group of back-healthy individuals. SUMMARY OF BACKGROUND DATA: In a previous study, the PLM test was found reliable when used in CLBP patients. SML addresses dynamic movement capacity. There is little scientific evidence of the effectiveness of educational interventions in improving motor behavior. METHODS: Twelve patients with treatment-resistant CLBP were selected by two orthopedic spine surgeons. Twelve back-healthy age- and sex-matched individuals were included as controls. The patients participated in weekly SML lessons during a maximum of 12 months. All study participants were investigated with the PLM test, before intervention, directly after intervention, and 10 to 12 months after completion of the intervention, and patients were compared with controls. RESULTS: Before intervention significant differences in performance were found between the group of patients and the healthy control group. After the intervention, the CLBP patients had improved their performance so there were no longer any significant differences between the groups. The results were retained 12 months after intervention. CONCLUSIONS: The study shows that the CLBP patients had learned and retained a more efficient behavior. The results suggest that SML is an effective intervention for nonspecific CLBP patients.
