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Arthrokinematics in a Subgroup of Patients Likely to Benefit From a Lumbar Stabilization Exercise Program

DS Teyhen, PT, PhD, OCS, is Assistant Professor, US Army-Baylor Doctoral Program in Physical Therapy, and Research Consultant for the Spine Research Center and the Defense Spinal Cord Column and Injury Center, MCCS/HMT, 3151 Scott Rd, Room 1303, Fort Sam Houston, TX 78234-6138 (USA)
TW Flynn, PT, PhD, OCS, FAAOMPT, is Associate Professor and Coordinator–Manual Therapy Fellowship, Department of Physical Therapy, Regis University, Denver, Colo
JD Childs, PT, PhD, MBA, OCS, FAAOMPT, is Assistant Professor and Director of Research, US Army-Baylor Doctoral Program in Physical Therapy
LD Abraham, EdD, is Professor, Movement Science Program, Department of Kinesiology and Health Education, and Chair, Department of Curriculum and Instruction, University of Texas in Austin, Austin, Tex

Address all correspondence to Dr Teyhen at: Deydre.teyhen{at}amedd.army.mil

Background and Purpose: A clinical prediction rule (CPR) has been reported to identify patients with low back pain who are likely to benefit from stabilization exercises. The aim of this study was to characterize the spinal motion, using digital fluoroscopic video, of a subgroup of subjects with low back pain.

Subjects: Twenty subjects who were positive on the CPR were compared with 20 control subjects who were healthy.

Methods: The magnitude and timing of lumbar sagittal-plane intersegmental angular and linear displacement were assessed. Receiver operating characteristic curves and accuracy statistics were used to develop a kinematic model.

Results: A 10-variable model was developed that could distinguish group membership. Seven of these variables described a disruption in timing of angular or linear displacement during mid-range movements. None of the variables suggested hypermobility.

Discussion and Conclusion: The findings suggest that individuals with mid-range aberrant motion without signs of hypermobility are likely to benefit from these exercises. The developed model describes altered kinematics of this subgroup of subjects and helps to provide construct validity for the developed CPR.