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Reliability of Musculoskeletal Fitness Tests and Movement Control Impairment Test Battery in Female Health-Care Personnel with Re-Current Low Back Pain

Raija Pia Annika Taulaniemi, Markku Juhani Kankaanpää, Kari Juhani Tokola, Hannu Antero Luomajoki and Jaana Helena Suni

Background: Low back pain (LBP) is one of the most important causes of work absenteeism in health-care personnel. Low performance levels for fitness components, and movement control impairment (MCI) of the spine have been posited to be risk factors for persistent LBP. The aims of this study were to examine the long-term reliability (test I – test II) of selected motor and musculoskeletal fitness tests and the standard MCI test battery in female health-care personnel with nonspecific LBP, and to investigate associations between change in intensity of LBP and variation in test results in two measurement points.

Methods: The participants (n=47) were workers in geriatric wards. Long-term reliability of six field tests assessing motor abilities, flexibility and muscular strength, and the MCI test battery were studied. Mean test I – test II time-span was 18 days (SD 7.9). The estimates of reliability for interval-scale measurements (fitness) were typical error (s) of measurement and the coefficient of variation (CV). The reliability of nominal-scale measurements was analysed by the kappa coefficient.

Results: The lowest within-subject variation was found in running figure of eight test (s=0.22 s, CV=2.8%) and the highest for modified push-ups (s=1.04 repetitions, CV=12.2%). The kappa values for the dorsal pelvic tilt, sitting knee extension, the anterior pelvic tilt, and lying-prone knee flexion varied between 0.71 and 0.45 but were lower for rocking forwards and backwards (k=0.31) and the one-leg stance (k=0.16). Change in the pain intensity was associated only with variation in test I – test II results for modified push-ups (p=0.045).

Conclusions: All of the tests assessing musculoskeletal fitness and four of the MCI tests had an acceptable level of long-term reliability. The two tests for MCI that had poor reliability need to be better standardised in order to serve as reliable clinical measurement tools.