Reliability of measures to characterize lumbar movement patterns, in repeated seated reaching, in a mixed group of participants with and without low-back pain: A test-retest, within- and between session

Meta H. Wildenbeest*, Henri Kiers, Matthijs Tuijt, Jaap H. van Dieën

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Literature highlights the need for research on changes in lumbar movement patterns, as potential mechanisms underlying the persistence of low-back pain. Variability and local dynamic stability are frequently used to characterize movement patterns. In view of a lack of information on reliability of these measures, we determined their within- and between-session reliability in repeated seated reaching. Thirty-six participants (21 healthy, 15 LBP) executed three trials of repeated seated reaching on two days. An optical motion capture system recorded positions of cluster markers, located on the spinous processes of S1 and T8. Movement patterns were characterized by the spatial variability (meanSD) of the lumbar Euler angles: flexion–extension, lateral bending, axial rotation, temporal variability (CyclSD) and local dynamic stability (LDE). Reliability was evaluated using intraclass correlation coefficients (ICC), coefficients of variation (CV) and Bland-Altman plots. Sufficient reliability was defined as an ICC ≥ 0.5 and a CV < 20%. To determine the effect of number of repetitions on reliability, analyses were performed for the first 10, 20, 30, and 40 repetitions of each time series. MeanSD, CyclSD, and the LDE had moderate within-session reliability; meanSD: ICC = 0.60–0.73 (CV = 14–17%); CyclSD: ICC = 0.68 (CV = 17%); LDE: ICC = 0.62 (CV = 5%). Between-session reliability was somewhat lower; meanSD: ICC = 0.44–0.73 (CV = 17–19%); CyclSD: ICC = 0.45–0.56 (CV = 19–22%); LDE: ICC = 0.25–0.54 (CV = 5–6%). MeanSD, CyclSD and the LDE are sufficiently reliable to assess lumbar movement patterns in single-session experiments, and at best sufficiently reliable in multi-session experiments. Within-session, a plateau in reliability appears to be reached at 40 repetitions for meanSD (flexion–extension), meanSD (axial-rotation) and CyclSD.

Original languageEnglish
Article number110435
Pages (from-to)1-8
Number of pages8
JournalJournal of Biomechanics
Volume121
Early online date15 Apr 2021
DOIs
Publication statusPublished - 24 May 2021

Bibliographical note

Funding Information:
The authors are grateful to the Dutch Organization for Scientific Research (NWO, The Hague, The Netherlands) for financial support of this research.

Funding Information:
This work was supported by the Dutch Organization for Scientific Research: NWO, The Hague, The Netherlands [grant number 0.23 0.12 0.25].

Publisher Copyright:
© 2021 The Author(s)

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Keywords

  • Reliability
  • Spinal control
  • Stability
  • Test-retest
  • Variability

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