Comparison of Physical Examination Test Validity for Determining Clinical Decision Making of Lumbar Stabilization Exercise

Background: As a high false positive rate of Imaging based on patholo-anatomical models, it is difficult to classify and diagnose patients and with asymptomatic with only diagnoses by imaging. To provide more accurate diagnoses, subjective information based on the patterns of pain should be obtained physical tests should be conducted together with diagnoses by imaging. However, there is no study to examine the validity of physical tests. Objectives: The purpose of this study was to investigate the sensitivity, specificity, prediction rates, and likelihood ratios for those who had been diagnosed with the herniation of intervertebral discs or degenerative vertebral diseases and those who had not been diagnosed with these diseases through radiology. Methods: A total of 211 subjects were recruited in this study, with 137 chronic low back pain group (58 males, 79 females) receiving a medical diagnosis and 74 healthy control group (34 males, 40 females) not receiving a medical diagnosis. Physical examination tests in this study were rated using a positive and negative categorical scale. Then, the sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (LR+, LR-) of the physical examination and medical diagnosis between chronic LBP and control group also were determined. Results Active movement test is high sensitivity, specificity, positive and negative predictive, positive and negative likelihood ratio than passive movement test. As increased age, the sensitivity was higher in passive movement test. Conclusions: The prone instability test (PIT), the active straight leg raise (ASLR), and the active hip abduction test (AHAT) are considered to be useful in diagnostic tests of chronic low back pain patients in clinics, and in particular, these tests are more sensitive to elderly persons aged 60 years or more.