title: The validity of physical therapy assessment of low back pain via telerehabilitation in a clinical setting.
abstract: BACKGROUND
  Back pain is a common and disabling condition for people in rural and remote areas. In these areas, access to rehabilitation services is limited by service availability. Telerehabilitation is suggested as a solution for providing physical therapy services; however, the validity of clinical assessment is largely unproven. The aim of this study was to establish the validity of clinically pragmatic remote assessment of spinal posture, active movements of the lumbar spine, and the passive straight leg raise (SLR) test.
  
  
  METHODS
  Face-to-face physical therapist assessment was compared with telerehabilitation assessment of spinal posture, active movements of the lumbar spine, and the SLR test. Twenty-six participants recruited from a rural population with current or recent low back pain (LBP) were assessed by a face-to-face physical therapist and a remote physical therapist. Pain, disability, and clinical measurements were assessed. Outcomes were compared to establish agreement.
  
  
  RESULTS
  High levels of agreement were found with detecting pain with specific lumbar movements, eliciting symptoms, and sensitizing the SLR test. Moderate agreement occurred with identifying the worst lumbar spine movement direction, SLR range of motion, and active lumbar spine range of motion. Poor agreement occurred with postural analysis and identifying reasons for limitations to lumbar movements.
  
  
  CONCLUSIONS
  Conducted in a rural clinical setting, this study validates elements of the physical assessment of the lumbar spine and identifies technical and clinical issues to be addressed by future research. Important components of the standard musculoskeletal assessment of LBP are valid via telerehabilitation in a clinical setting.
authors.affiliation: 1 School of Physiotherapy, Curtin University of Technology , Bentley, Western Australia, Australia .
authors.forename: Piers
authors.initials: P
authors.lastname: Truter
authors.forename: Trevor
authors.initials: T
authors.lastname: Russell
authors.forename: Robyn
authors.initials: R
authors.lastname: Fary
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D009068:Movement; D015588:Observer Variation; D010808:Physical Examination; D026741:Physical Therapy Modalities; D011187:Posture; D016059:Range of Motion, Articular; D012046:Rehabilitation / Q000379:methods*; D015203:Reproducibility of Results; D012424:Rural Population; D016037:Single-Blind Method; D017216:Telemedicine / Q000379:methods*