Methods for assessment of trunk stabilization,a systematic review |
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| Institution: | 1. MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands;2. Department of Anesthesiology, VU University Medical Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;1. Department of Industrial Engineering, University of Miami, Coral Gables, FL, USA;2. Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL, USA;3. Department of Orthopaedics, University of Miami, Miami, FL, USA;1. School of Physical Therapy and Athletic Training, Old Dominion University, United States;2. School of Recreation, Health, and Tourism, George Mason University, United States;3. School of Exercise and Nutrition Sciences, Queensland University of Technology, Australia;4. Department of Kinesiology, Pennsylvania State University, United States;1. Hospital Clínic de Barcelona, Institut Clínic del Tòrax (ICT), Servei de Pneumologia, Centre de Diagnòstic Respiratori, Institut d’Investigacions Biomèdiques August Pi i Sunyner (IDIBAPS), Universitat de Barcelona, Barcelona, Cataluña, Spain;2. Unitat d’Atenció Integrada, Direcció Mèdica i d’Infermeria, Hospital Clínic, CIBER en Enfermedades Respiratorias (CIBERES), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Cataluña, Cataluña, Spain;3. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Bunyola, Mallorca, Spain;4. Hospital del Mar-Parc de Salut Mar, Servei de Pneumologia, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Pompeu Fabra, Barcelona, Cataluña, Spain;5. Departament de Direcció Mèdica i d’Infermeria, Hospital Clínic, Barcelona, Cataluña Spain;6. Facultat de Ciències de la Salut Blanquerna, Universitat Ramon Llull, Grup de Recerca en Salut, Activitat Física i Esport (SAFE), Barcelona, Cataluña, Spain;1. School of Healthcare Science, Manchester Metropolitan University, Manchester, UK;2. School of Computing Mathematics and Digital Technology, Manchester Metropolitan University, Manchester, UK;3. Health, Exercise and Active Living (HEAL), Manchester Metropolitan University, Cheshire, UK;4. The Movement Centre, Robert Jones and Agnes Hunt Hospital, Oswestry, Shropshire, UK |
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| Abstract: | Trunk stabilization is achieved differently in patients with low back pain compared to healthy controls. Many methods exist to assess trunk stabilization but not all measure the contributions of intrinsic stiffness and reflexes simultaneously. This may pose a threat to the quality/validity of the study and might lead to misinterpretation of the results. The aim of this study was to provide a critical review of previously published methods for studying trunk stabilization in relation to low back pain (LBP). We primarily aimed to assess their construct validity to which end we defined a theoretical framework operationalized in a set of methodological criteria which would allow to identify the contributions of intrinsic stiffness and reflexes simultaneously. In addition, the clinimetric properties of the methods were evaluated. A total of 133 articles were included from which four main categories of methods were defined; upper limb (un)loading, moving platform, unloading and loading. Fifty of the 133 selected articles complied with all the criteria of the theoretical framework, but only four articles provided information about reliability and/or measurement error of methods to assess trunk stabilization with test–retest reliability ranging from poor (ICC 0) to moderate (ICC 0.72). When aiming to assess trunk stabilization with system identification, we propose a perturbation method where the trunk is studied in isolation, the perturbation is unpredictable, force controlled, directly applied to the upper body, completely known and results in small fluctuations around the working point. |
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| Keywords: | Lumbar spine Low back pain System identification Intrinsic stiffness Reflexes |
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