Diagnostic value of trunk flexion-extension testing in old chronic low back pain patients.

Abstract

Dynamic trunk flexion-extension testing has been proven to objectively diagnose low back pain in persons under the age of 60 years but older persons have difficulty complying with standardized movement velocity. 190 patients and 71 matched healthy volunteers (18-90 years of age) performed modified testing by holding static positions at standing, half, and full trunk flexion. Lumbar extensor muscle activity in isometric positions was significantly higher in patients with higher activity in the oldest (60-90 years) and the middle-aged (40-59 years) but not in the youngest (18-39 years) subgroups compared to normal. There were no differences in gross trunk range of motion, half flexion relaxation ratio, proprioception, muscle activity differences between positions, and fear-avoidance behavior. The diagnostic accuracy as expressed by the area under the curve was fair (0.74). Lumbar extensor muscle activity demonstrated moderate to good diagnostic value in old patients.