title: Multiplanar lumbopelvic control in patients with low back pain: is multiplanar assessment better than single plane assessment in discriminating between patients and healthy controls?
abstract: OBJECTIVE
  Patients with low back pain (LBP) commonly have lumbopelvic control deficits. Lumbopelvic assessment during sagittal motion is incorporated into commonly used clinical examination algorithms for Treatment Based Classification. The purpose of this study was to investigate whether combined assessment of lumbopelvic control during sagittal and frontal plane motion discriminates between people with and without LBP better than single plane assessment alone.
  
  
  METHODS
  Nineteen patients with LBP and 18 healthy control participants volunteered for this study. The active straight leg raise (ASLR) and active hip abduction (AHAbd) tests were used to assess lumbopelvic control during sagittal and frontal plane motion, respectively. The tests were scored as positive or negative using published scoring criteria. Contingency tables were created for each test alone and for the combined tests (both positive/both negative) with presence/absence of LBP as the reference standard to calculate accuracy statistics of sensitivity (sn), specificity (sp), likelihood (+LR and -LR), and diagnostic odds ratios (OR).
  
  
  RESULTS
  Active straight leg raise and AHAbd tests alone had sn of 0·63, 0·74, respectively, sp of 0·61, 0·50, respectively, and OR of 2·7, 2·8, respectively. The combined tests had sn = 0·89, sp = 0·60, and OR = 12·0. Forty percent of patients with LBP had control deficits in both planes of motion.
  
  
  CONCLUSIONS
  The AHAbd and ALSR tests appear to have greater diagnostic discrimination when used in combination than when used independently. A percentage of patients with LBP had control deficits in both planes, while others demonstrated uniplanar deficits only. These findings highlight the importance of multiplanar assessment in patients with LBP.
authors.affiliation: Regis University School of Physical Therapy, Denver, CO, USA.
authors.forename: E
authors.initials: E
authors.lastname: Nelson-Wong
authors.affiliation: Regis University School of Physical Therapy, Denver, CO, USA.
authors.forename: P
authors.initials: P
authors.lastname: Gallant
authors.affiliation: Regis University School of Physical Therapy, Denver, CO, USA.
authors.forename: S
authors.initials: S
authors.lastname: Alexander
authors.affiliation: Regis University School of Physical Therapy, Denver, CO, USA.
authors.forename: K
authors.initials: K
authors.lastname: Dehmer
authors.affiliation: Regis University School of Physical Therapy, Denver, CO, USA.
authors.forename: S
authors.initials: S
authors.lastname: Ingvalson
authors.affiliation: Regis University School of Physical Therapy, Denver, CO, USA.
authors.forename: B
authors.initials: B
authors.lastname: McClenahan
authors.affiliation: Regis University School of Physical Therapy, Denver, CO, USA.
authors.forename: A
authors.initials: A
authors.lastname: Piatte
authors.affiliation: Regis University School of Physical Therapy, Denver, CO, USA.
authors.forename: K
authors.initials: K
authors.lastname: Poupore
authors.affiliation: Regis University School of Physical Therapy, Denver, CO, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Davis
keywords: Active hip abduction; Active straight leg raise; Low back pain; Lumbopelvic assessment