Validity of a Screening Tool for Patients with a Sub-Threshold Level of Lumbar Instability: A Cross-Sectional Study

Arisa Leungbootnak, Rungthip Puntumetakul, Jaturat Kanpittaya, Thiwaphon Chatprem and Rose Boucaut
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Arisa Leungbootnak: Research Center of Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Department of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
Rungthip Puntumetakul: Research Center of Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Department of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
Jaturat Kanpittaya: Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
Thiwaphon Chatprem: Research Center of Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Department of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
Rose Boucaut: International Centre for Allied Health Evidence (iCAHE), School of Health Sciences (Physiotherapy), University of South Australia, Adelaide, SA 5001, Australia

IJERPH, 2021, vol. 18, issue 22, 1-10

Abstract: Lumbar instability (LI) comprises one subgroup of those with chronic low back pain (CLBP); it indicates the impairment of at least one of the spinal stabilizing systems, and radiographic criteria of translation and rotation are used for its diagnosis. Previous studies have developed and tested a screening tool for LI where patients with sub-threshold lumbar instability (STLI) were detected in the initial stage of lumbar pathology using radiographs as a gold standard for diagnosis. The radiographic measurement in STLI lies between the range of translation and rotation of the LI and asymptomatic lumbar motion. However, there are no studies indicating the validity and cut-off points of the screening tool for STLI. The current study aimed to determine the validity of an LI screening tool to support the diagnostic process in patients with STLI. This study design was cross-sectional in nature. A total of 135 participants with CLBP, aged between 20 and 60 years, who had undergone flexion and extension radiographs, answered a screening tool with 14 questions. The cut-off score for identifying STLI using the screening tool was at least 6/14 positive responses to the LI questions. The findings suggested that the LI screening tool we tested is effective for the detection of STLI. The tool can be used in outpatient settings.

Keywords: sub-threshold lumbar instability; non-radiological lumbar instability; lumbar instability; radiography; lumbar translation; lumbar rotation; screening tool; X-ray; sensitivity; specificity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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