title: Responsiveness to change of 10 physical tests used for patients with back pain.
abstract: BACKGROUND
  Few studies have examined the responsiveness of physical tests.
  
  
  OBJECTIVE
  The purpose of this study was to explore the responsiveness of 10 physical tests used for patients with back pain in order to illuminate the significance of changes in scores.
  
  
  METHODS
  Cross-sectional and longitudinal designs within a prospective cohort study were applied.
  
  
  METHODS
  Distribution-based and anchor-based methods were used. Ninety-eight patients (18-65 years of age) with long-lasting back pain were recruited consecutively at an outpatient spine clinic. Measurements The participants were assessed using 10 physical tests and 2 questionnaires (Hannover Functional Ability Questionnaire and Roland-Morris Disability Questionnaire) at inclusion and after rehabilitation. Six predefined hypotheses for each test were examined regarding the association between changes in scores on the physical tests and the self-report measures of functioning and regarding the relationship of changes in scores on the physical tests and external anchors of important change.
  
  
  RESULTS
  Five physical tests demonstrated responsiveness by both distribution-based and anchor-based methods: spondylometry, lateral flexion test, fingertip-to-floor test, lift test, and Back Performance Scale (4 hypotheses confirmed). The minimal important change values were all within the range of the smallest detectable change for individual patients. Responsiveness by distribution-based methods only (3 hypotheses confirmed) was shown for the Biering-Sørensen test and the loaded reach test, whereas little evidence of responsiveness (1 hypothesis confirmed) was shown for the Global Physiotherapy Examination flexibility subscale, the Progressive Isoinertial Lifting Evaluation, and the 15-m (50-ft) walk test. Limitations The smallest detectable change values were examined in a small sample of patients and need further exploration.
  
  
  CONCLUSIONS
  Responsiveness varied among the 10 physical tests.
authors.affiliation: Department of Public Health and Primary Health Care, Physiotherapy Research Group, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway. liv.strand@isf.uib.no
authors.forename: Liv Inger
authors.initials: LI
authors.lastname: Strand
authors.forename: Bodil
authors.initials: B
authors.lastname: Anderson
authors.forename: Hildegunn
authors.initials: H
authors.lastname: Lygren
authors.forename: Jan Sture
authors.initials: JS
authors.lastname: Skouen
authors.forename: Raymond
authors.initials: R
authors.lastname: Ostelo
authors.forename: Liv Heide
authors.initials: LH
authors.lastname: Magnussen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000503:physiopathology* / Q000534:rehabilitation*; D015331:Cohort Studies; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D011237:Predictive Value of Tests; D020127:Recovery of Function; D015203:Reproducibility of Results; D057566:Self Report; D055815:Young Adult