Background Chronic low back pain has an important socio-economic burden. It is frequent but the treatment models are different. One of the most successful and well documented is the multidisciplinary approach. But which patient will respond? There are the yellow and black flags that give bad prognostic. In 2003, Hicks presented a muscular test for segmental instability. As physical decondition is frequent present, the question is if this muscular test would allow us to select the patients that would respond in a recondition program.
Methods We have studied the results of 240 patients who have accomplished this interdisciplinary program, follow-up on 18 months. In the rehab program they have physical reconditioning, occupational exercises the whole in a TCC context.
All patients had the Hicks Test at inclusion (predictive test to choose between surgery and conservative treatment in chronic low back pain in the 90ths) and studied its association with pain evolution, functional capacity and work capacity
Results We separated the patients in 2 groups: those with a positive Hicks test and those who were negative. We observed that the 2 groups had better pain scales, but the decrease was better in the positive group, as was the work capacity at 18 months (from 39 to 52% in the negative group, against 53 to 83% in the positive group. The Oswestry functional questionnaire showed slight better results in the positive group compared with the negative, the results were the same at 18 months.
Conclusions To be able to choose the patient that would respond to a multidisciplinary rehabilitation program in low back pain the long standing results would be increased by using Hicks test (stabilisation test). In fact the patients with a positive test have a better return to work, and a more better decrease in pain.
Hicks GE, Fritz JM, Delitto A, Mishock J. Interrater reliability of clinical examination measures for identification of lumbar segmental instability. Arch Phys Med Rehabil 2003;84:1858-64.
Disclosure of Interest None declared