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Identifying clinical tests that are predictive of temporary low back pain development during the prolonged standing test
Dissertation   Open access

Identifying clinical tests that are predictive of temporary low back pain development during the prolonged standing test

Eric Folkins
Doctor of Health Science (D.H.Sc.), Drexel University
Dec 2022
DOI:
https://doi.org/10.17918/00001432
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Abstract

Backache Lumbar vertebrae Forced standing Prolonged standing
OBJECTIVE: To assess the ability of hip and lumbopelvic neuromuscular control, endurance hip range of motion tests to predict transient low back pain development during 2 hours of prolonged standing in physical therapy students without a history of low back pain. DESIGN: Observational prospective study METHODS: Seventy-two physical therapy students with no history of back pain completed nine tests designed to assess hip and lumbopelvic neuromuscular control. They completed a 2-hour prolonged standing test on a second day during which the development of any low back pain was assessed using a 10 cm visual analog scale (VAS). Participants were classified as transient pain developers (PD) if they reported a [greater than or equal to]10mm increase on the VAS for low back pain. RESULTS: Thirty-seven and a half percent of students developed transient low back pain during the standing test. A cluster of three positive tests (self-rated active hip abduction, total hip passive internal rotation > 81.6 degrees, and non-dominant single leg squat > 5) demonstrated an increased probability (94.9%) of identifying PDs. Negative outcomes on the same three tests decreased the probability of developing transient back pain to 10.7%. Overall, the classification accuracy for the three-test model was 72.2%. The sensitivity for the model was 63% and specificity 77.8%. CONCLUSION: A 3-test cluster of hip and lumbopelvic neuromuscular control tests and hip internal rotation range of motion is an effective screening tool to identify physical therapy students who may develop transient LBP during 2 hours of prolonged standing. Key Words: back pain, prolonged standing, lumbar spine, low back

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