Reliability of physical functioning tests in patients with low back pain: a systematic review.

Publication date: Available online 4 September 2017
Source:The Spine Journal
Author(s): Lenie Denteneer, Ulrike Van Daele, Steven Truijen, Willem De Hertogh, Jill Meirte, Gaetane Stassijns
ObjectiveThe aim of this study was to provide a comprehensive overview of physical functioning tests in patients with low back pain (LBP) and to investigate their reliability.Data sourcesA systematic computerized search was finalized in four different databases on the 24th of June 2017: Pubmed, Web of Science, Embase and Medline.Study selectionPRISMA guidelines were followed during all stages of this review. Clinical studies that investigate the reliability of physical functioning tests in patients with LBP were eligible. The methodological quality of the included studies was assessed with the use of the COSMIN checklist. To come to final conclusions for reliability of the identified clinical tests, the current review assessed three factors namely outcome assessment, methodological quality and consistency of description.Data synthesisA total of 20 studies were found eligible and 38 clinical tests were identified. Good overall test retest reliability was concluded for the extensor endurance (ICC = .93-.97), flexor endurance (ICC = .90-.97), 5 minute walking (ICC = .89-.99), 50 foot walking (ICC = .76-.96), shuttle walk (ICC = .92-.99), sit to stand (ICC = .91-.99) and the loaded forward reach test (ICC = .74-.98). For interrater reliability, only one test namely the Biering-Sörensen (ICC = .88-.99) test could be concluded to have an overall good interrater reliability. None of the identified clinical tests could be concluded to have a good intrarater reliability.ConclusionsFurther investigation should focus on a better overall study methodology and the use of identical protocols for the description of clinical tests. The assessment of reliability is only a first step in the recommendation process for the use of clinical tests. In future research, the identified clinical tests in the current review should be further investigated for validity. Only when these clinimetric properties of a clinical test have been thoroughly investigated, a final conclusion regarding the clinical and scientific use of the identified tests can be made.



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