Validity of increasing the number of motor control tests within a test battery for discrimination of low back pain conditions in people attending a physiotherapy clinic: a case–control study

Objectives To develop a time-efficient motor control (MC) test battery while maximising diagnostic accuracy of both a two-level and three-level classification system for patients with non-specific low back pain (LBP).Design Case–control study.Setting Four private physiotherapy practices in northern...

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Main Authors: Christoph Biele, Dirk Möller, Harry von Piekartz, Toby Hall, Nikolaus Ballenberger
Format: Article
Language:English
Published: BMJ Publishing Group 2019-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/11/e032340.full
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author Christoph Biele
Dirk Möller
Harry von Piekartz
Toby Hall
Nikolaus Ballenberger
author_facet Christoph Biele
Dirk Möller
Harry von Piekartz
Toby Hall
Nikolaus Ballenberger
author_sort Christoph Biele
collection DOAJ
description Objectives To develop a time-efficient motor control (MC) test battery while maximising diagnostic accuracy of both a two-level and three-level classification system for patients with non-specific low back pain (LBP).Design Case–control study.Setting Four private physiotherapy practices in northern Germany.Participants Consecutive males and females presenting to a physiotherapy clinic with non-specific LBP (n=65) were compared with 66 healthy-matched controls.Primary outcome measures Accuracy (sensitivity, specificity, Youden index, positive/negative likelihood ratio, area under the curve (AUC)) of a clinically driven consensus-based test battery including the ideal number of test items as well as threshold values and most accurate items.Results For both the two and three-level categorisation system, the ideal number of test items was 10. With increasing number of failed tests, the probability of having LBP increases. The overall discrimination potential for the two-level categorisation system of the test is good (AUC=0.85) with an optimal cut-off of three failed tests. The overall discrimination potential of the three-level categorisation system is fair (volume under the surface=0.52). The optimal cut-off for the 10-item test battery for categorisation into none, mild/moderate and severe MC impairment is three and six failed tests, respectively.Conclusion A 10-item test battery is recommended for both the two-level (impairment or not) and three-level (none, mild, moderate/severe) categorisation of patients with non-specific LBP.
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spelling doaj-art-c82a941c2b7b495c8eb3584ac08f0a282025-08-20T01:52:37ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-032340Validity of increasing the number of motor control tests within a test battery for discrimination of low back pain conditions in people attending a physiotherapy clinic: a case–control studyChristoph Biele0Dirk Möller1Harry von Piekartz2Toby Hall3Nikolaus Ballenberger41 Social Sciences, Osnabrück University of Applied Sciences, Osnabrueck, Germany1 Social Sciences, Osnabrück University of Applied Sciences, Osnabrueck, Germany1 Social Sciences, Osnabrück University of Applied Sciences, Osnabrueck, Germany2 School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia1 Social Sciences, Osnabrück University of Applied Sciences, Osnabrueck, GermanyObjectives To develop a time-efficient motor control (MC) test battery while maximising diagnostic accuracy of both a two-level and three-level classification system for patients with non-specific low back pain (LBP).Design Case–control study.Setting Four private physiotherapy practices in northern Germany.Participants Consecutive males and females presenting to a physiotherapy clinic with non-specific LBP (n=65) were compared with 66 healthy-matched controls.Primary outcome measures Accuracy (sensitivity, specificity, Youden index, positive/negative likelihood ratio, area under the curve (AUC)) of a clinically driven consensus-based test battery including the ideal number of test items as well as threshold values and most accurate items.Results For both the two and three-level categorisation system, the ideal number of test items was 10. With increasing number of failed tests, the probability of having LBP increases. The overall discrimination potential for the two-level categorisation system of the test is good (AUC=0.85) with an optimal cut-off of three failed tests. The overall discrimination potential of the three-level categorisation system is fair (volume under the surface=0.52). The optimal cut-off for the 10-item test battery for categorisation into none, mild/moderate and severe MC impairment is three and six failed tests, respectively.Conclusion A 10-item test battery is recommended for both the two-level (impairment or not) and three-level (none, mild, moderate/severe) categorisation of patients with non-specific LBP.https://bmjopen.bmj.com/content/9/11/e032340.full
spellingShingle Christoph Biele
Dirk Möller
Harry von Piekartz
Toby Hall
Nikolaus Ballenberger
Validity of increasing the number of motor control tests within a test battery for discrimination of low back pain conditions in people attending a physiotherapy clinic: a case–control study
BMJ Open
title Validity of increasing the number of motor control tests within a test battery for discrimination of low back pain conditions in people attending a physiotherapy clinic: a case–control study
title_full Validity of increasing the number of motor control tests within a test battery for discrimination of low back pain conditions in people attending a physiotherapy clinic: a case–control study
title_fullStr Validity of increasing the number of motor control tests within a test battery for discrimination of low back pain conditions in people attending a physiotherapy clinic: a case–control study
title_full_unstemmed Validity of increasing the number of motor control tests within a test battery for discrimination of low back pain conditions in people attending a physiotherapy clinic: a case–control study
title_short Validity of increasing the number of motor control tests within a test battery for discrimination of low back pain conditions in people attending a physiotherapy clinic: a case–control study
title_sort validity of increasing the number of motor control tests within a test battery for discrimination of low back pain conditions in people attending a physiotherapy clinic a case control study
url https://bmjopen.bmj.com/content/9/11/e032340.full
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