Physical performance tests for people with spinal pain--sensitivity to change.
OBJECTIVE
The sensitivity to change for six physical performance tests for assessing impairments and activity limitations in persons with spinal pain was examined.


METHODS
Eighty men and 106 women with long-term spinal pain participating in a randomized controlled study went through the tests on inclusion in the study, and were then invited to follow-up tests after 5 weeks and 6 months. The tests were a 'step-on-stool test', three gait tests and two lifting tests (PILE tests). Sensitivity to change was examined by relating changes in physical performance to self-rated concepts assumed to reflect a real change in the individual. Effect sizes were calculated.


RESULTS
Sensitivity to change in absolute values was revealed for the gait test with burden, the stair-climbing test and the PILE cervical test for women. Only the PILE cervical test showed responsiveness to clinically important change according to our criteria. Moderate to high effect sizes were found for all tests. Relatively few subjects improved to an extent considered clinically important. Improvement was greater in subjects whom inclusion measurements showed to be less fit.


CONCLUSIONS
The sensitivity to change was moderate over a 6-month period for the physical performance tests. The gait test with burden, the stair-climbing test and the PILE tests were most sensitive to change. It is suggested that these tests be incorporated in an 'assessment instrument bank' for physiotherapists, supplemented with other reliable and valid tests relevant to the problems for the individual with spinal pain.
Ljungquist
Therese
T
Department of Clinical Neuroscience, Section for Personal Injury Prevention, Karolinska Institutet, Stockholm, Sweden. Therese.Ljungquist@kirurgi.ki.se
Nygren
Ake
A
Jensen
Irene
I
Harms-Ringdahl
Karin
K
D000203:Activities of Daily Living; D000367:Age Factors; D016022:Case-Control Studies; D002908:Chronic Disease; D004185:Disability Evaluation; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000534:rehabilitation; D008297:Male; D010147:Pain Measurement; D010809:Physical Fitness / Q000502:physiology*; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013122:Spinal Diseases / Q000175:diagnosis* / Q000534:rehabilitation*; D018709:Statistics, Nonparametric