A comparison of lumbar range of motion and functional ability scores in patients with low back pain: assessment for range of motion validity.

Abstract

A clinical convenience sample of workers with low back problems was tested once for a variety of parameters. To quantify the links between lumbar range of motion and scores obtained from functional evaluation tests. Although lumbar range of motion traditionally has been the standard used to determine disability for the purposes of compensation, a concern arises from the fact that a discrete physical impairment associated with low back pain and diminished range of motion often is never found. This study involved 18 workers with chronic low back pain referred to a rehabilitation center for determination of compensation and fitness for return to work. Lumbar range of motion was precisely and accurately measured with a three-dimensional lumbar motion instrument. In addition, typical functional tests were performed for each patient. Comparisons were made between all the lumbar range of motion values and each of the functional ability scores. The most notable finding was the lack of significant correlation between most of the lumbar range of motion values and the functional test scores. Only 9 of a possible 144 correlations were significant. The relation between lumbar range of motion measures and functional ability is weak or nonexistent. This has implications for clinical practice as it relates to disability determination for patients with chronic low back pain, and perhaps for the current impairment guidelines of the American Medical Association.