![]() ![]() ![]() However, the fingertip-to-floor test came to be appreciated as an invalid (construct) measure for between-subjects comparison of lumbar motion because anatomic variations of the cephalad extremities and thoracic region as well as motion throughout the thoracic region and at the hips are confounding variables. Until the 1980s, lumbar FB range of motion was commonly measured with the fingertip-to-floor test. 22, 37- 41 Research on potential confounding variables has focused on the influence of age, sex, time of day, warm-up or no warm-up, motion at the hips, and, recently, motion at the knees and ankles. Interexaminer reliability has been difficult to establish for standing lumbar FB. In the present study, we focused specifically on forward bending (FB) of the spine in the standing context. 32 In spite of these limitations, lumbar range of motion continues to be used as a fundamental indicator of function for clinical evaluation. Indeed, the results of these efforts have been sufficiently problematic-especially with regard to interexaminer reliability-such that spinal range of motion is no longer recognized as a criterion for impairment ratings by the American Medical Association (AMA). 17, 21- 31 An unrecognized confounding variable would undermine these efforts. 3, 4 However, published studies 5- 20 continue to reveal confusing evidence about what relationships exist between lumbar motion and low back pain syndromes.Īn array of techniques for measuring spinal motion continues to be explored with reference to validity, reliability, safety, and practicality. Thus, at least 1 benefit of manipulative medicine for low back pain has been hypothesized to be the restoration of spinal mobility. 1, 2 Osteopathic manipulative medicine is understood, in part, as a means to restore available range of motion at a joint. Manipulative medicine has been recognized as an effective treatment for patients with low back pain. Low back pain is well recognized as an enormous cost to society both in direct health care expense and in being the most frequent cause of disability in working-age adults. Statistically significant differences were also found in both whole trunk (15.72 cm) and lumbar (7.38°) FB when the cervical spine was backward bent before thoracolumbar spine FB ( P<.05).Ĭonclusion: Cervical spine bending influences the ability of the trunk and lumbar spine to bend forward and is, therefore, a confounding variable during tests of whole trunk and lumbar spine FB. Statistically significant differences were found in both whole trunk (6.96 cm) and lumbar (3.95°) FB range of motion when the cervical spine was backward bent after full spine FB ( P<.05). Results: Two hundred thirty-six participants met the study criteria. Range of motion was measured for whole trunk FB and lumbar FB by using the fingertip-to-floor and double digital inclinometer techniques, respectively. Each participant underwent 4 FB tests with varying cervical starting positions. Methods: Participants were recruited from the faculty, staff, and student population of Nova Southeastern University's Health Professions Division. Objective: To examine the role of cervical spine bending on the range of whole trunk and lumbar FB. However, there is limited research on cervical spine bending as a confounding variable in whole trunk and lumbar FB. Precluding bending at the knees has, therefore, long been standard protocol to produce valid and reproducible results. Context: Knee bending during tests of lumbar forward bending (FB) may introduce confounding variability. ![]()
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