• Physical Therapy Korea
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• v.18 no.3
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• pp.85-93
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• 2011

The purpose of this study was to establish the reliability and validity of the passive lumbar extension (PLE) test and prone instability test (PIT). Thirty-three subjects (14 males, 19 females) with lower back pain enrolled in the study and the subjects were divided into 2 groups (positive and negative instability groups) on the basis of radiographies of flexion and extension. Reliability was determined by the kappa coefficient and validity was examined using calculated sensitivity, specificity, and the likelihood ratio. The results showed that the reliability of the PLE test was higher than the PIT (intra-rater reliability: k=.86 and k=.81, interrater reliability: k=.65 and k=.62) and the validity of the PLE test was also higher than the PIT (sensitivity: 91% and 62%, specificity: 95% and 85% positive likelihood ratio: 20.00 and 4.10, negative likelihood ratio: .10 and .45). In conclusion, we think that the PLE test was a more reliable and valid method for lumbar instability than the PIT.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.2
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• pp.49-59
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• 2023

PURPOSE: This study examined the relationship between lumbar instability and shortening of the iliopsoas muscles in patients with chronic low back pain. METHODS: Forty-nine patients with chronic low back pain participated in this study. The modified Thomas test was used to examine the shortening state of the iliopsoas muscle. The length of the iliopsoas muscle was measured using the hip flexion angle, and those with a flexion angle of 10° or more were classified as positive. Five subtests were used for the lumbar instability test: testing for prone lumbar instability, passive lumbar extension, anterior-posterior mobility, passive straight leg raise, and age. Those who tested positive for at least three of these tests were classified as positive for the lumbar segment instability test. RESULTS: There was a significant association between the results of the lumbar instability test and the shortening of the iliopsoas test (p < .05). After analyzing the association between the iliopsoas length test and the five lumbar instability subtests, the results of the prone lumbar instability test (p < .001) and the anterior-posterior mobility test (p < .05) showed a significant association with the iliopsoas length test. CONCLUSION: The association between lumbar instability and shortening of the iliopsoas muscles was examined in 49 patients with chronic low back pain. Patients with shortened iliopsoas muscles tested positive in the lumbar instability tests more often. Hence, the length test of the iliopsoas muscle can be used to determine lumbar instability in patients with chronic low back pain.

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.370-375
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• 2022

Objective: The purpose of this study was to compare the hip joint muscle strength of patients with chronic back pain with lumbar instability and normal subjects. Design: A case control study. Methods: Five types of lumbar instability test were conducted on forty young women with chronic low back pain for more than six months, and those who had 3 or more positive tests were selected as subjects. To select chronic back pain patients with lumbar instability group, aberrant movement patterns during lumbar flexion test (FMT), prone instability test (PIT), posterior-anterior mobility test (PAT), passive lumbar extension test (PLE), and pressure bio-feedback (PBF) were applied. In addition, a digital muscle strength meter was used to measure the hip flexor, extensor, adductor, and abductor muscles of chronic low back pain patients with lumbar instability group (n=20) and normal subject group (n=20). Results: As a result of comparing the hip joint muscle strength between the chronic back pain patient group with lumbar instability and the normal group, there were significant differences in the hip extensor, abductor, and adductor muscles (p<0.05). Conclusions: Patients of chronic back pain with lumbar instability were found to have weak hip joint muscle strength. Therefore, this study suggest that include hip joint strength exercise for functional recovery of chronic back pain patients.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.39-48
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• 2015

PURPOSE: This study aimed to compare the degree of lumbopelvic rotation during the active straight leg raise (ASLR) test in chronic low back pain with and without lumbar segmental instability. METHODS: A total of 71 patients with chronic low back pain were recruited for this study. The subjects who tested positive for more than three of the five lumbar segmental instability tests (prone lumbar instability, lumbar passive extension test, anterior posterior mobility test, passive straight leg raise, age) were categorized into the lumbar segmental instability positive group. Patients who tested positive for less than three of the five tests were categorized into the lumbar segmental instability negative group. The lumbopelvic rotation was measured three times during ASLR and a mean was determined. Subjective heaviness during the ASLR was measured on 6 point scale. RESULTS: There was a statistically significant difference in the lumbopelvic rotation angle between the groups with and without lumbar segmental instability (p<.01). There was no significant difference in the subjective heaviness during ASLR. The mean lumbopelvic rotation angle during ASLR was $13.54{\pm}2.86^{\circ}$, and $8.81{\pm}2.47^{\circ}$ in the positive and negative groups, respectively (p<.01). The cut-off value of the lumbopelvic rotation during was $10.5^{\circ}$, the sensitivity was 82.9%, and the specificity was 80.6%. CONCLUSION: These results suggest that lumbopelvic rotation is more prevalent in patients without lumbar segmental instability. Clinically, this important when diagnosing chronic low back pain with lumbar segmental instability, as the lumbopelvic rotation angle during the ASLR test can be used to aid in diagnosis.