title: Laterality judgments in people with low back pain--A cross-sectional observational and test-retest reliability study.
abstract: BACKGROUND
  Disruption of cortical representation, or body schema, has been indicated as a factor in the persistence and recurrence of low back pain (LBP). This has been observed through impaired laterality judgment ability and it has been suggested that this ability is affected in a spatial rather than anatomical manner.
  
  
  OBJECTIVE
  We compared laterality judgment performance of foot and trunk movements between people with LBP with or without leg pain and healthy controls, and investigated associations between test performance and pain. We also assessed the test-retest reliability of the Recognise Online™ software when used in a clinical and a home setting.
  
  
  METHODS
  Cross-sectional observational and test-retest study.
  
  
  METHODS
  Thirty individuals with LBP and 30 healthy controls performed judgment tests of foot and trunk laterality once supervised in a clinic and twice at home.
  
  
  RESULTS
  No statistically significant group differences were found. LBP intensity was negatively related to trunk laterality accuracy (p = 0.019). Intraclass correlation values ranged from 0.51 to 0.91. Reaction time improved significantly between test occasions while accuracy did not.
  
  
  CONCLUSIONS
  Laterality judgments were not impaired in subjects with LBP compared to controls. Further research may clarify the relationship between pain mechanisms in LBP and laterality judgment ability. Reliability values were mostly acceptable, with wide and low confidence intervals, suggesting test-retest reliability for Recognise Online™ could be questioned in this trial. A significant learning effect was observed which should be considered in clinical and research application of the test.
authors.affiliation: Ystad Rehab Center, Aulingatan 22A, 271 39 Ystad, Sweden. Electronic address: Martin.linder@mail.com.
authors.forename: Martin
authors.initials: M
authors.lastname: Linder
authors.affiliation: Department of Health Sciences, Luleå University of Technology, 971 87 Luleå, Sweden. Electronic address: Peter.michaelson@ltu.se.
authors.forename: Peter
authors.initials: P
authors.lastname: Michaelson
authors.affiliation: Department of Health Sciences, Luleå University of Technology, 971 87 Luleå, Sweden. Electronic address: Ulrik.roijezon@ltu.se.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Röijezon
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003657:Decision Making; D004185:Disability Evaluation; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007600:Judgment; D007869:Leg Injuries / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D017116:Low Back Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Body schema; Low back pain; Psychomotor performance; Sensorimotor cortex