Background In the past few decades, a large number of physical performance (PP) tests for clinical assessment of patients with low back pain (LBP) have been introduced. Knowledge is limited, however, on the their appropriateness for treatment outcome, clinical and epidemiological studies, which require a high level of reliability and validity of measurements.
Objectives Our review focus on the psychometric properties and clinical usefulness of physical performance measurements in patients with LBP.
Methods In order to comprehensively identify instruments of physical performance measurement in LBP patients and studies on their reliability, validity and clinical usefulness, MEDLINE searches were performed for the time interval from 1998 to 2000 using the following controlled vocabulary: low back pain, measurement (s), outcome, tests, function, physical performance, muscle strength, range of motion, reliability, sensitivity, validity. In the second step reference lists of the retrieved papers were used for identification further studies, which were not included in MEDLINE database. The literature about sophisticated, special equipment requiring functional measurements, which application due to cost and time demand in daily clinical practise is restricted, was excluded from analysis.
Results 162 papers reporting on physical performance tests in patients with low back pain were analysed. Validity and reliability has been more comprehensively studied for ?Timed-up-and-go?, ?Loaded reach? and ?Sit-to-stand? tests. The high level of reliability of these test were reported (correlation coefficients ranged from r = 0,89 to r = 0.99). No one prospective follow-up study on responsiveness of PP tests was found.
Conclusion In our literature search we found that all validated PP tests were designed as a discriminative instruments, whose purpose was to measure differences between the people. In order to use them as a qualitative clinical outcome measurement instruments, their psychometric property such a responsiveness should be investigated.
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