title: A comparison of pain levels after the Biering-Sorensen and the modified 20-metre shuttle test in patients with chronic low back pain.
abstract: OBJECTIVE
  The Biering-Sorensen Test (BST) is a useful and well validated assessment tool in patients with chronic lumbar pain. However there is sometimes concern that it may lead to an unwarranted increase in pain. This study compared pain levels before and after the BST against a currently accepted functional assessment tool- the modified 20-metre shuttle test (MST)- in military patients with chronic low back pain.
  
  
  METHODS
  56 patients with non-specific lumbar pain of more than three months duration were tested on admission and discharge from a three week in-patient rehabilitation programme using the BST and the MST. A questionnaire was used to assess pain levels before and after both tests on admission and discharge from the group. The BST was carried out before the MST, with a time delay of 30-60 minutes.
  
  
  RESULTS
  There were significant increases in pain immediately after both the MST and the BST (range of mean increase: 2.2 to 3.2 points, p< 0.001). The mean absolute levels of pain after the BST on admission and discharge were 0.26 and 0.80 more than the levels after the MST. The mean increases were 0.36 and 1.16 more after the BST compared to that after the MST. Pain levels returned to normal within 60 minutes of the BST being completed.
  
  
  CONCLUSIONS
  Using either comparison method, although the initial increases after the BST were slightly more, the amounts were comparable and much less that the minimal clinically important difference in pain which is 1.5.
authors.affiliation: Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey, UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Roberts
authors.affiliation: Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey, UK English Institute of Sport, Centre for Sport and Exercise Medicine, University College Hospital, London, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Seah
authors.affiliation: Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey, UK.
authors.forename: Jonathan C W
authors.initials: JC
authors.lastname: Dickens
authors.affiliation: Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey, UK.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Ferry
authors.affiliation: Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey, UK.
authors.forename: Allyson J
authors.initials: AJ
authors.lastname: Reece
authors.affiliation: Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey, UK.
authors.forename: Tim G
authors.initials: TG
authors.lastname: Jones
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000175:diagnosis* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000175:diagnosis* / Q000534:rehabilitation*; D008297:Male; D008889:Military Personnel; D010147:Pain Measurement / Q000379:methods*; D010343:Patient Admission; D010351:Patient Discharge; D010808:Physical Examination / Q000379:methods*; D026741:Physical Therapy Modalities; D011795:Surveys and Questionnaires
keywords: Biering-Sorensen; low back pain; multi-stage test; validity