S R Locke | PubMed Health

PubMed1994

Pattern of performance in workers with low back pain during a comprehensive motor performance evaluation.

STUDY DESIGN: Tests of limb and back motor performance were administered to males with low back pain at the completion of a back-school program. OBJECTIVES: The objective of the study was to determine the relationship between such motor performance and the propensity for abnormal illness behavior as indicated by the Waddell score. SUMMARY OF BACKGROUND DATA: Previous studies in similar subjects had revealed a nonbiologic pattern of lumbar strength and movement in back-school patients, and correlations between lumbar variables, Waddell score, and 'global' psychologic measures. This suggested that psychologic factors might affect motor performance in body segments unrelated to the low back in such patients. RESULTS: Mean performance of the group with a high Waddell score (indicating a propensity for abnormal illness behavior) was lower on all tests, including those that did not involve the low back, in comparison to the group with a low Waddell score (P < .01, sign test). CONCLUSION: For all members of this population of patients, motor performance on dynamometry of any body segment does not necessarily reflect the maximum physical capacity.

Adult↗

PubMed1992

Serial lumbar dynamometry in low back pain.

To determine the significance of changes in motor performance as measured by lumbar dynamometry, serial lumbar dynamometry was performed on a group of 45 male Workers' Compensation patients with chronic "mechanical" low back pain and in a group of 20 healthy male volunteers. The patients were men aged 20-60 years, whose current episode of low back pain had lasted for at least 3 months (mean 19.5 weeks, range 12-47 weeks). Testing was performed at entry into a "back school" program of therapy and again 2 weeks and 4 weeks later. The control group showed a slight improvement in almost all variables of strength and range of motion between the first and second tests but no significant change between the second and third tests. This was consistent with a learning effect. The patient group was analyzed as a whole and also in two groups based on their response to the Waddell maneuvers at entry: Waddell score 0-2 (no excessive illness behavior) and 3-5 (excessive illness behavior). As a whole, the patients showed significant progressive improvement in most variables on successive tests. The group with the low Waddell score had significantly greater strength and range of motion than the group with the high Waddell score but the trend of improvement with time was similar in the two groups. The authors conclude that in this sample of patients with low back pain, serial lumbar dynamometry reveals a progressive improvement in performance, which is greater than the improvement expected from the natural history of physical recovery and greater than the improvement expected from an increase in strength and range of motion attributable to the therapeutic exercises performed and is much larger than any learning effect related to the test procedure.

Adult↗