Index > Vol. 38/2006 > Iss. 6/November > pp. 360-367 > Abstract
 

OPTOELECTRONIC MOVEMENT ANALYSIS TO MEASURE MOTOR PERFORMANCE IN PATIENTS WITH CHRONIC LOW BACK PAIN: TEST OF RELIABILITY1The Editor-in-Chief has not had the responsibility for this article (which originates from his own department) and it has been handled fully by one of the Associate Editors who has made the decision for acceptance.

Issue: Volume 38, Issue 6, November 2006

Pages: 360-367

DOI: 10.1080/16501970600769214

Abstract:

Objective: To assess test-retest reliability of the Posturo-Locomotion-Manual(PLM) test in patients with chronic low back pain.

Design: A controlled study in which the PLM test was used repeatedly on patients with chronic low back pain and persons without back pain.

Subjects: Twelve patients with treatment-resistant chronic low back pain, selected by 2 orthopaedic spine surgeons and 12 age- and sex-matched individuals with no back pain history.

Methods: An optoelectronic camera and a computer were used to quantify the performance during a simple test in which subjects picked up an object from the floor and transported it up to a shelf, thereby forcing the body through postural, locomotor and manual movements. The outcome measures were: movement time, simultaneity index and phase times for postural, locomotion and arm movement phases. Statistical analyses regarding intra-individual agreement between the measurements (reliability analysis) and changes over time were carried out.

Results: The effect of test movement habituation was minimized when the lowest mean value of any of 3 consecutive measures (tri-average) was used. In the control group, variation between test occasions was small. In the group of patients with chronic low back pain there was a random measurement error before intervention (sensory motor learning). After intervention the PLM test had the same precision in both groups.

Conclusion: When the tri-average measure is used, the influence of test movement habituation is minimized and the optoelectronic PLM test is found to be reliable and responsive. It proved to be a useful tool to quantify dynamic performance in freely moving patients with chronic low back pain.

Authors:

Christina U. M. Schön-Ohlsson A1, Jan A. G. Willén A2, Bo E. A. Johnels A3
A1 From the Sahlgrenska Academy at Göteborg University, Institute of Neuroscience and Physiology, Göteborg, Sweden
A2 Departments of Orthopaedics, Göteborg, Sweden
A3 Neurology, Sahlgrenska University Hospital, Göteborg, Sweden

Key words:

chronic low back pain, optoelectronic measurement, test-retest reliability, PLM, quantitative movement analysis

References:

  1. World Health Organization. International classification of functioning, disability and health: ICF. Geneva: World Health Organization; 2001.
  2. Johnels, B and Ingvarsson, PE and Steg, G and Olsson, T. (2001) The Posturo-Locomotion-Manual Test. A simple method for the characterization of neurological movement disturbances Adv Neurol, 87, pp. 91 - 100.
  3. Steg, G and Johnels, B. (1993) Physiological mechanisms and assessment of motor disorders in Parkinson's disease Adv Neurol, 60, pp. 358 - 365.
  4. Johnels, B and Ingvarsson, PE and Thorselius, M and Valls, M and Steg, G. (1989) Disability profiles and objective quantitative assessment in Parkinson's disease Acta Neurol Scand, 79, pp. 227 - 238.
  5. Guo, X and Matousek, M and Sonn, U and Skoog, I and Bjorkelund, C and Steen, B. (2003) A longitudinal study on changes of movement performance and their relation to medical conditions in a female population followed from age 70 to 78 Arch Gerontol Geriatr, 36, pp. 127 - 140.
    [CrossRef]
  6. Samson, MM and Crowe, A and Duursma, SA and Dessens, JA and Verhaar, HJ. (1998) Spatial-temporal analysis of mobility over the adult age range using the Postural-Locomotor-Manual Test J Gerontol A Biol Sci Med Sci, 53, pp. M242 - 247.
  7. Matousek, M and Wikkelso, C and Blomsterwall, E and Johnels, B and Steg, G. (1995) Motor performance in normal pressure hydrocephalus assessed with an optoelectronic measurement technique Acta Neurol Scand, 91, pp. 500 - 505.
  8. KoesBW, van TulderMW, OsteloR, Kim BurtonA, WaddellG. Clinical guidelines for the management of low back pain in primary care: an international comparison. Spine 2001; 26: 2504–2513; discussion 2513–2514.
  9. Nachemson, AL and Jonsson, E.(2000) Neck and back pain: the scientific evidence of causes, diagnosis, and treatment. Philadelphia : Lippincott Williams & Wilkins.
  10. Waddell, G. (1996) Low back pain: a twentieth century health care enigma Spine, 21, pp. 2820 - 2825.
    [CrossRef]
  11. Rudy, TE and Boston, JR and Lieber, SJ and Kubinski, JA and Delitto, A. (1995) Body motion patterns during a novel repetitive wheel-rotation task. A comparative study of healthy subjects and patients with low back pain Spine, 20, pp. 2547 - 2554.
    [CrossRef]
  12. Esola, MA and Mc Clure, PW and Fitzgerald, GK and Siegler, S. (1996) Analysis of lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain Spine, 21, pp. 71 - 78.
    [CrossRef]
  13. Luoto, S and Taimela, S and Alaranta, H and Hurri, H. (1998) Psychomotor speed in chronic low-back pain patients and healthy controls: construct validity and clinical significance of the measure Percept Mot Skills, 87, pp. 1283 - 1296.
  14. Magnusson, ML and Bishop, JB and Hasselquist, L and Spratt, KF and Szpalski, M and Pope, MH. (1998) Range of motion and motion patterns in patients with low back pain before and after rehabilitation Spine, 23, pp. 2631 - 2639.
    [CrossRef]
  15. Newcomer, KL and Laskowski, ER and Yu, B and Johnson, JC and An, KN. (2000) Differences in repositioning error among patients with low back pain compared with control subjects Spine, 25, pp. 2488 - 2493.
  16. Radebold, A and Cholewicki, J and Polzhofer, GK and Greene, HS. (2001) Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain Spine, 26, pp. 724 - 730.
    [CrossRef]
  17. Feipel, V and Parent, C and Dugailly, PM and Brassinne, E and Salvia, P and Rooze, M. (2003) Development of kinematics tests for the evaluation of lumbar proprioception and equilibration Clin Biomech (Bristol, Avon), 18, pp. 612 - 618.
  18. Madeleine, P and Prietzel, H and Svarrer, H and Arendt-Nielsen, L. (2004) Quantitative posturography in altered sensory conditions: a way to assess balance instability in patients with chronic whiplash injury Arch Phys Med Rehabil, 85, pp. 432 - 438.
    [CrossRef]
  19. Jette, AM. (1995) Outcomes research: shifting the dominant research paradigm in physical therapy Phys Ther, 75, pp. 965 - 970.
  20. Main, CJ and Waddell, G. (1998) Behavioral responses to examination. A reappraisal of the interpretation of “nonorganic signs” Spine, 23, pp. 2367 - 2371.
    [CrossRef]
  21. Deyo, RA and Battie, M and Beurskens, AJ and Bombardier, C and Croft, P and Koes, B and (1998) Outcome measures for low back pain research. A proposal for standardized use Spine, 23, pp. 2003 - 2013.
    [CrossRef]
  22. Feldenkrais, M.(1987) Awareness through movement: health exercises for personal growth. Harmondsworth : Penguin.
  23. Johnson, D.(1995) Bone, breath & gesture: practices of embodiment. Berkeley CA: North Atlantic Books.
  24. FritzellP, HaggO, WessbergP, NordwallA; Swedish Lumbar Spine Study Group. 2001 Volvo Award Winner in Clinical Studies: Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group. Spine 2001; 26: 2521–2532; discussion 2532–2534.
  25. Schon-Ohlsson, CU and Willen, JA and Johnels, BE. (2005) Sensory motor learning in patients with chronic low back pain: a prospective pilot study using optoelectronic movement analysis Spine, 30, pp. E509 - 516.
    [CrossRef]
  26. Altman, DG.(1999) Practical statistics for medical research. Boca Raton FL: Chapman & Hall/CRC.
  27. Bland, JM and Altman, DG. (1996) Measurement error proportional to the mean BMJ, 313, pp. 106.
  28. Sage, GH.(1977) Introduction to motor behavior: a neuropsychological approach. 2nd edn. Reading MA: Addison-Wesley Pub. Co..
  29. Hatze, H. (1986) Motion variability – its definition, quantification, and origin J Mot Behav, 18, pp. 5 - 16.
  30. Grillner, S and Wallen, P. (2004) Innate versus learned movements – a false dichotomy? Prog Brain Res, 143, pp. 3 - 12.
  31. Laban, Rv and Lawrence, FC.(1974) Effort; economy of human movement 2nd edn. London : Macdonald & Evans.
  32. VanSant, AF. (1990) Life-span development in functional tasks Phys Ther, 70, pp. 788 - 798.
  33. Woollacott, MH and Shumway-Cook, A. (1990) Changes in posture control across the life span – a systems approach Phys Ther, 70, pp. 799 - 807.