Intra-and inter-raters reliability of lumbar joint repositioning sense test in seated sedentary behavior with chronic low back pain
Article Sidebar
Main Article Content
Abstract
The lumbar joint repositioning sense (LJRS) test is commonly used to assess the effectiveness of interventions in low back pain (LBP). Currently, it is still not known whether the LJRS tests carried out by novice rater exhibit reproducibility different from that of experienced rater. The aim of this study was to investigate the intra- and inter-raters reliability of novice and experienced raters utilizing the LJRS test in individuals with chronic low back pain (CLBP). Fifteen male and fifteen female participants with CLBP were recruited. Novice and experienced raters performed the LJRS test in the same day. For intra-rater reliability, each subject performed the test with both novice and experienced raters three times, with 10-minute rest intervals between repetitions. For inter-rater reliability, each subject performed the test one time with 30-minute rest intervals between raters. Intraclass correlation coefficient (ICC) and Minimal Detectable Change (MDC) were used for statistical analysis. The results demonstrated that the ICC (3,1) for the experienced rater was 0.96, with an MDC of 0.18 centimeters, and the novice rater had an ICC (3,1) of 0.95, with an MDC of 0.19 centimeters. The ICC (2,1) for inter-rater reliability was 0.97, with an MDC of 0.15 centimeters. Based on the results of this study, it can be concluded that both experienced and novice raters exhibit good intra- and inters reliability. The novice rater, a physical therapy student who has received 3 hours of training, can use this test in a clinical setting to assess activities that may pose a risk or may lead to lumbar joint repositioning sense errors, thus contributing to increased low back pain.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Keawduangdee P, Puntumetakul R, Swangnetr M, Laohasiriwong W, Settheetham D, Yamauchi J, et al. Prevalence of low back pain and associated factors among farmers during the rice transplanting process. J Phys Ther Sci 2015;27:2239–45.
Sitthipornvorakul E, Janwantanakul P, Lohsoonthorn V. The effect of daily walking steps on preventing neck and low back pain in sedentary workers: A 1-year prospective cohort study. Eur Spine J 2015;24:417–24.
Montakarn C, Nuttika N. Physical activity levels and prevalence of low back pain in Thai call-center operators. Indian J Occup Environ Med 2016;20:125.
Chaiklieng S, Suggaravetsiri P, Stewart J. Incidence and risk factors associated with lower back pain among university office workers. Int J Occup Saf Ergon 2021;27(4):1215–21.
Manchikanti L, Singh V, Falco FJE, Benyamin RM, Hirsch JA. Epidemiology of low back pain in adults. Neuromodulation 2014;17:3–10.
Olafsson G, Jonsson E, Fritzell P, Hagg O, Borgstrom F. A health economic lifetime treatment pathway model for low back pain in Sweden. J Med Econ 2017;20:1281–9.
Panjabi MM. Clinical spinal instability and low back pain. J Electromyogr Kinesiol 2003;13:371–9.
Hlaing SS, Puntumetakul R, Khine EE, Boucaut R. Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC Musculoskelet Disord 2021;22(1):1-13.
Saiklang P, Puntumetakul R, Siritaratiwat W, Boucaut R. Effect of time of day on the magnitude of stature change response variability in participants with chronic low back pain on consecutive 2 days. Trends Sci 2021;18(23):678.
Lephart SM, Pincivero DM, Giraido JL, Fu FH. The role of proprioception in the management and rehabilitation of athletic injuries. Am J Sports Med 1997;25(1):130-7.
Roijezon U, Clark NC, Treleaven J. Proprioception in musculoskeletal rehabilitation. Part 1: Basic science and principles of assessment and clinical interventions. Man Ther 2015;20(3):368-77.
Clark NC, Roijezon U, Treleaven J. Proprioception in musculoskeletal rehabilitation. Part 2: Clinical assessment and intervention. Man ther 2015;20(3):378-87.
Saiklang P, Puntumetakul R, Selfe J, Yeowell G. An evaluation of an innovative exercise to relieve chronic low back pain in sedentary workers. Hum Factors 2022;64(5):820-34.
Brumagne S, Cordo P, Lysens R, Verschueren S, Swinnen S. The role of paraspinal muscle spindles in lumbosacral position sense in individuals with and without low back pain. Spine 2000;25(8):989-94.
Waongenngarm P, Rajaratnam BS, Janwantanakul P. Internal oblique and transversus abdominis muscle fatigue induced by slumped sitting posture after 1 hour of sitting in office workers. Saf Health Work 2016;7(1):49-54.
Jung KS, Jung JH, In TS, Cho HY. Effects of prolonged sitting with slumped posture on trunk muscular fatigue in adolescents with and without chronic lower back pain.
Medicina 2020;57(1):3.
Tong MH, Mousavi SJ, Kiers H, Ferreira P, Refshauge K, van Dieen J. Is there a relationship between lumbar proprioception and low back pain? A systematic review with meta-analysis. Arch Phys Med Rehabil 2017;98(1):120-36.
O'Sullivan PB, Burnett A, Floyd AN, Gadsdon K, Logiudice J, Miller D et al. Lumbar repositioning deficit in a specific low back pain population. Spine 2003;28(10):1074–9.
Enoch F, Kjaer P, Elkjaer A, Remvig L, Juul-Kristensen B. Inter-examiner reproducibility of tests for lumbar motor control. BMC Musculoskelet Disord 2011;12(1):1-12.
Koumantakis GA, Winstanley J, Oldham JA. Thoracolumbar proprioception in individuals with and without low back pain: intratester reliability, clinical applicability, and validity. J Orthop Sports Phys Ther 2002;32(7):327-35.
Walter SD, Eliasziw M, Donner A: Sample size and optimal designs for reliability studies. Stat Med 1998;17:101–10.
Motantasut P, Hunsawong T, Mato L, Donpunha W. Reliability of novice and experienced physiotherapists using the normalized navicular height truncated and the foot posture index-6 for classifying static foot posture in adults. J Phys Ther Sci 2019;31(4):392–7.
Saiklang P, Puntumetakul R, Swangnetr Neubert M, Boucaut R. The immediate effect of the abdominal drawing-in maneuver technique on stature change in seated sedentary workers with chronic low back pain. Ergon 2021;64(1):55-68.
Boonstra AM, Stewart RE, Koke AJ, Oosterwijk RF, Swaan JL, Schreurs KM, et al. Cut-off points for mild, moderate, and severe pain on the numeric rating scale for pain in patients with chronic musculoskeletal pain: variability and influence of sex and catastrophizing. Front Psychol 2016;7:1466.
Puntumetakul R, Chalermsan R, Hlaing SS, Tapanya W, Saiklang P, Boucaut R. The effect of core stabilization exercise on lumbar joint position sense in patients with subacute non-specific low back pain: a randomized controlled trial. J Phys Ther Sci 2018;30(11):1390-5.
Hlaing SS, Puntumetakul R, Wanpen S, Boucaut R. Balance control in patients with subacute non-specific low back pain, with and without lumbar instability: a cross-sectional study. J Pain Res 2020;13:795.
Hagins M, Brown M, Cook C, Gstalder K, Kam M, Kominer G, et al. Intratester and intertester reliability of the palpation meter (PALM) in measuring pelvic position. J Man Manip Ther 1998;6(3):130-6.
Petrone MR, Guinn J, Reddin A, Sutlive TG, Flynn TW, Garber MP. The accuracy of the palpation meter (PALM) for measuring pelvic crest height difference and leg length discrepancy. J Orthop Sports Phys Ther 2003;33(6):319-25.
WG Hopkins. Measures of reliability in sports medicine and science. Sports Med 2000; 30:1-15.
Portney LG, Watkins MP. Foundations of clinical research: applications to practice. 3rd ed. FADavis Company: Philadelphia; 2015. p.608.
Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res 2005;19:231-40.
Kwon YH, Nam KS. Circadian fluctuations in three types of sensory modules in healthy subjects. Neural Regen Res 2014;9(4):436-9.