title: Validation of a Clinical Test of Thoracolumbar Dissociation in Chronic Low Back Pain.
abstract: METHODS
  Clinical test validation.
  
  
  OBJECTIVE
  Preliminary study of concurrent and discriminant validity of a clinical test of thoracolumbar dissociation.
  
  
  BACKGROUND
  Control deficits of back muscles and trunk movement are common in chronic/recurrent low back pain (LBP). A reliable clinical test to rate an individual's ability to dissociate lumbopelvic movement from the thoracolumbar region has been described. This test rates the performance quality of 5 key aspects against criterion standards.
  
  
  METHODS
  Concurrent validity was examined by comparison of clinical test scores (overall score and each individual criterion) against spine kinematics. Discriminant validity was evaluated by comparison of scores between pain-free controls and participants with LBP. A receiver operating characteristic curve was calculated to determine the optimal cutoff or score to differentiate between good and poor performers.
  
  
  RESULTS
  Concurrent validity was supported by the significant correlation between the total score and motion of the T5 vertebra relative to the S1 vertebra (P<.05). Scores for some (4 correlations of 14 measures) but not all individual criteria were correlated with the kinematic features that each criterion was expected to reflect. Discriminant validity was supported by higher test scores for pain-free controls than for participants with LBP after 2 minutes of training (P = .045). Scores of less than 5.5 were more prevalent in the LBP group (pretraining LBP versus control, 72% versus 35%; P = .008; posttraining LBP versus control, 48% versus 16%; P = .018).
  
  
  CONCLUSIONS
  This preliminary study of concurrent and discriminant validity of the test provides a foundation to further investigate its utility to characterize thoracolumbar movement patterns in individuals with LBP.
authors.affiliation: Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
authors.forename: Edith
authors.initials: E
authors.lastname: Elgueta-Cancino
authors.forename: Siobhan
authors.initials: S
authors.lastname: Schabrun
authors.forename: Lieven
authors.initials: L
authors.lastname: Danneels
authors.forename: Wolbert
authors.initials: W
authors.lastname: van den Hoorn
authors.forename: Paul
authors.initials: P
authors.lastname: Hodges
mesh_terms: D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000503:physiopathology*; D008159:Lumbar Vertebrae / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009068:Movement; D011187:Posture / Q000502:physiology; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D013904:Thoracic Vertebrae / Q000503:physiopathology*; D055815:Young Adult
keywords: lumbar movements; movement control; spinal motion