The relationship of lumbar flexion to disability in patients with low back pain

Abstract

Background and Purpose. Physical therapists routinely assess spinal active range of motion (AROM) in patients with low back pain (LBP). The purpose of this study was to use 2 approaches to examine the relationship between impairment of lumbar spine flexion AROM and disability. One approach relied on the use of normative data to determine when an impairment in flexion AROM was present. The other approach required therapists to make judgments of whether the flexion AROM impairment was relevant to the patient's disability. Subjects. Fifteen physical therapists and 81 patients with LBP completed in the study. Methods. Patients completed the Roland- Morris Back Pain Questionnaire (RMQ), and the therapists assessed lumbar spine flexion AROM using a dual-inclinometer technique at the initial visit and again at discharge. Results. Correlations between the lumbar flexion AROM measure and disability were low and did not vary appreciably for the 2 approaches tested. Conclusion and Discussion. Measures of lumbar flexion AROM should not be used as surrogate measures of disability. Lumbar spine flexion AROM and disability are weakly correlated, suggesting that flexion AROM measures should not be used as treatment goals.