title: Computer-aided combined movement examination of the lumbar spine and manual therapy implications: Case report.
abstract: Combined movement examination (CME) of the lumbar spine has been recommended for clinical examination as it confers information about mechanical pain patterns. However, little quantitative study has been undertaken to validate its use in manual therapy practice. This study used computer aided CME to develop a normal reference range, and to guide provisional diagnosis and management. Two cases were assessed, before and after manual therapy using CME, a pain Visual Analogue Scale, the Roland Morris Low Back Pain and Disability Questionnaire and the Short Form (SF-12) Health Survey. Diagnosis and management were guided by comparing each CME pattern with the age and gender matched reference range. Self-reports data and CME total change scores were markedly improved for both cases, particularly for the most painful and restricted CME directions. This report describes how computer-aided CME and a normal reference range may be used objectively to inform a diagnosis and as an outcome measure in cases of mechanical LBP. Future investigations of cases with specific lumbar pathologies are required to validate this concept.
authors.affiliation: Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Perth, Western Australia 6009, Australia. Electronic address: aubrey.monie@research.uwa.edu.au.
authors.forename: A P
authors.initials: AP
authors.lastname: Monie
authors.affiliation: Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Perth, Western Australia 6009, Australia.
authors.forename: C J
authors.initials: CJ
authors.lastname: Barrett
authors.affiliation: Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Perth, Western Australia 6009, Australia; Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia 6009, Australia.
authors.forename: R I
authors.initials: RI
authors.lastname: Price
authors.affiliation: Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Perth, Western Australia 6009, Australia; Department of Neurosurgery, Sir Charles Gairdner Hospital, Perth, Western Australia 6009, Australia.
authors.forename: C R P
authors.initials: CR
authors.lastname: Lind
authors.affiliation: Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Perth, Western Australia 6009, Australia.
authors.forename: K P
authors.initials: KP
authors.lastname: Singer
mesh_terms: D000328:Adult; D000367:Age Factors; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000503:physiopathology*; D008161:Lumbosacral Region / Q000503:physiopathology*; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D026201:Musculoskeletal Manipulations / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D016059:Range of Motion, Articular; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Combined movement examination; Low back pain; Lumbar movement; Lumbar spine; Manual therapy