Preliminary validity study comparing the prone lumbar hypermobility test against the prone instability test
| Autor | Gordon Lawson, David Gryfe |
| Cargo | Ontario/Ontario |
| Páginas | 397-413 |
Anuario Jurídico y Económico Escurialense, LIV (2021) 397-414 / ISSN: 1133-3677
Preliminary validity study comparing
the prone lumbar hypermobility test against
the prone instability test*
Gordon LAWSON, y
David GRYFE
Ontario, Canadá.
Abstract:
Objective:
The Prone Instability Test (PIT) is an established orthopaedic test that
predicts the probability of low back pain patients responding positively to a
spinal stabilization program (.71 sensitivity, .57 specificity for PIT). This
preliminary study suggests the Prone Lumbar Hypermobility Test (PLHT) as
an effective alternative to the PIT that is more suitable for a wider population
due to the modified patient positioning. In contrast to the PIT, the PLHT has the
patient's entire body supported by the examination table. This is hypothesized to
maximize patient comfort while still maintaining clinical effectiveness for
the chronic low back pain population. The purpose of this preliminary study
is to determine whether the PLHT is comparable to the PIT in diagnostic
effectiveness when predicting the benefits of stabilization interventions.
Methods:
To compare the clinical effectiveness of the PLHT to the PIT, each subject
underwent parts I and II (relaxed and contracted) of each test (PIT and PLHT).
36 subjects received both parts of PIT and PLHT (in a randomized order).
* Este artículo obtuvo, el pasado año académico 2019-2020, el Premio María Cristina, en su
séptima edición, en la modalidad de Quiropráctica. El jurado calificador estuvo conformado por:
Dª. Ana Paula Albuquerque Facchinato Campos (Presidenta), Coordinadora de la Formación
Clínica. Facultad de Quiropráctica de Los Ángeles. Southern California University of Health
Sciences; D. Danilo Messa da Silva, Decano de Quiropráctica, Universidad Feevale, Novo
Hamburgo, Brasil; D. Fernando Redondo Moreira Azevedo, Decano de Quiropráctica de la
Universidade Anhembi-Morumbi, Sao Paulo, Brasil, y D. Ricardo Fuji kawa (Secretario), Director
de Estudios de Quiropráctica en el RCU Escorial María Cristina.
GORDON LAWSON / DAVID GRYFE
AJEE, LIV (2021) 397-414/ISSN 1133-3677
398
Subjects assumed each of the four positions and 4 kg/cm2 of pressure was
applied directly on the skin over the L4 spinous process, using an algometer.
The subjects verbally indicated perceived pain following each of the 4 positions.
Results:
Of the 36 participants included in the study, 23 participants had a negative
PIT and a negative PLHT and six had a positive PIT and a positive PLHT. Three
participants had a positive PIT and negative PLHT and four had a positive
PLHT and negative PIT. This indicates that the PIT and PLHT have a statistically
significant level of agreement.
Conclusions:
This study found that the PLHT is valid in identifying negative results in
the predicted negative population, as well as positive results in the predicted
positive population. For future investigations, a larger sample size is advantageous
- particularly with an evenly distributed and accurate sample of positive and
negative participants. This will more accurately determine the validity of the
PLHT and broaden the application of the PLHT to the population for which
the test is aimed to identify in clinical practice.
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