Ability to Discriminate Between Healthy and Low Back Pain Sufferers Using Ultrasound During Maximum Lumbar Extension

作者：Cuesta Vargas Antonio I^*; Gonzalez Sanchez Manuel

来源：Archives of Physical Medicine and Rehabilitation, 2014, 95(6): 1093-1099.

DOI：10.1016/j.apmr.2014.01.023

• Electromyography
• Low back pain
• Rehabilitation
• Ultrasound

Objective: To analyze the ability to discriminate between healthy individuals and individuals with chronic nonspecific low back pain (CNLBP) by measuring the relation between patient-reported outcomes and objective clinical outcome measures of the erector spinae (ES) muscles using an ultrasound during maximal isometric lumbar extension. %26lt;br%26gt;Design: Cross-sectional study with screening and diagnostic tests with no blinded comparison. %26lt;br%26gt;Setting: University laboratory. %26lt;br%26gt;Participants: Healthy individuals (n = 33) and individuals with CNLBP (n = 33). %26lt;br%26gt;Interventions: Each subject performed an isometric lumbar extension. With the variables measured, a discriminate analysis was performed using a value %26gt;= 6 in the Roland and Morris disability questionnaire (RMDQ) as the grouping variable. Then, a logistic regression with the functional and architectural variables was performed. A new index was obtained from each subject value input in the discriminate multivariate analysis. %26lt;br%26gt;Main Outcome Measures: Morphologic muscle variables of the ES muscle were measured through ultrasound images. The reliability of the measures was calculated through intraclass correlation coefficients (ICCs). The relation between patient-reported outcomes and objective clinical outcome measures was analyzed using a discriminate function from standardized values of the variables and an analysis of the reliability of the ultrasound measurement. %26lt;br%26gt;Results: The reliability tests show an ICC value %26gt;.95 for morphologic and functional variables. The independent variables included in the analysis explained 42% (P = .003) of the dependent variable variance. %26lt;br%26gt;Conclusions: The relation between objective variables (electromyography, thickness, pennation angle) and a subjective variable (RMDQ %26gt;= 6) and the capacity of this relation to identify CNLBP within a group of healthy subjects is moderate. These results should be considered by clinicians when treating this type of patient in clinical practice.

• 出版日期2014-6