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Clinical Tests to Diagnose Lumbar Segmental Instability : A Systematic Review / Abdullah Alqarni in Journal of Orthopaedic & Sports Physical Therapy, vol.41, 03 (Mars 2011)
[article]
in Journal of Orthopaedic & Sports Physical Therapy > vol.41, 03 (Mars 2011) . - 130-140
Titre : Clinical Tests to Diagnose Lumbar Segmental Instability : A Systematic Review Type de document : article de périodique Auteurs : Abdullah Alqarni, Auteur Article en page(s) : 130-140 Descripteurs (mots clés) : [Thésaurus HELB]:Paramédical:accuracy physical validity
[Thésaurus HELB]:Paramédical:examination,
[Thésaurus HELB]:Paramédical:low back pain,Mots-clés : accuracy physical validity examination, low back pain, Résumé : STUDY DESIGN: Systematic literature review. OBJECTIVES: To evaluate the diagnostic accuracy of clinical tests used to diagnose patients with structural lumbar segmental instability (LSI). BACKGROUND: Patients with structural LSI represent an important, identifiable subgrouping of individuals with low back pain. Numerous clinical tests have been proposed to diagnose structural LSI; however, data on the diagnostic accuracy of these tests have not yet been evaluated through a systematic review of the literature. METHODS: A systematic review was conducted in 6 electronic databases for diagnostic accuracy studies, published between January 1950 and March 2010, that evaluated clinical tests against radiological diagnosis of structural LSI. The diagnostic accuracy of the clinical tests from the retrieved articles was independently evaluated, reviewed, and quality scored using the QUADAS tool. RESULTS: Four articles and a total of 11 clinical tests used in the diagnosis of structural LSI met the study inclusion criteria. The majority of tests had high specificity but low sensitivity, with positive likelihood ratios ranging from very small to moderate. QUADAS scores ranged from 16 to 25 out of a possible 26. The passive lumbar extension test was the most accurate clinical test, with high sensitivity (84%), specificity (90%), and a positive likelihood ratio of 8.8 (95% CI: 4.5, 17.3), indicating that this clinical test may be useful in the differential diagnosis of structural LSI. CONCLUSION: This systematic review found that the majority of clinical tests routinely employed to diagnose structural LSI demonstrated only limited ability to do so. The results do, however, indicate that the passive lumbar extension test may be useful in orthopaedic clinical practice to diagnose structural LSI. Additional research is required to further validate its use for diagnosing structural LSI in all populations of those with low back pain. LEVEL OF EVIDENCE: Diagnosis, level 2a. Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité Périodique Erasme - périodiques Périodiques Disponible Short-term Effects of Thoracic Spine Thrust Manipulation, Exercise, and Education in Individuals With Low Back Pain: A Randomized Controlled Trial / Lara, R. Fisher in Journal of Orthopaedic & Sports Physical Therapy, Vol. 50,1 (Janvier 2020)
[article]
in Journal of Orthopaedic & Sports Physical Therapy > Vol. 50,1 (Janvier 2020) . - p. 24-32
Titre : Short-term Effects of Thoracic Spine Thrust Manipulation, Exercise, and Education in Individuals With Low Back Pain: A Randomized Controlled Trial Type de document : article de périodique Auteurs : Lara, R. Fisher, Auteur ; Joshua Cleland, Auteur ; [et al.], Auteur Année de publication : 2020 Article en page(s) : p. 24-32 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus HELB]:Paramédical:low back pain,
[Thésaurus Mesh]LombalgieRésumé : Objective To determine the short-term effectiveness of thoracic manipulation when compared to sham manipulation for individuals with low back pain (LBP). Design Randomized controlled trial.
Methods
Patients with LBP were stratified based on symptom duration and randomly assigned to a thoracic manipulation or sham manipulation treatment group. Groups received 3 visits that included manipulation or sham manipulation, core stabilization exercises, and patient education. Factorial repeated-measures analysis of variance and multiple regression were performed for pain, disability, and fear avoidance. The Mann-Whitney U test was used to analyze patient-perceived improvement, via the global rating of change scale, at follow-up.
Results
Ninety participants completed the study (mean ± SD age, 38 ± 11.5 years; 70% female; 72% with chronic LBP). The overall group-by-time interaction was not significant for the Modified Oswestry Disability Questionnaire, numeric pain-rating scale, and Fear-Avoidance Beliefs Questionnaire outcomes. The global rating of change scale was not significantly different between groups.
Conclusion
Three sessions of thoracic manipulation, education, and exercise did not result in improved outcomes when compared to a sham manipulation, education, and exercise in individuals with chronic LBP. Future studies are needed to identify the most effective management strategies for the treatment of LBP.Level of Evidence Therapy, level 1b.Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité J Périodique Erasme - périodiques Périodiques Disponible