Aktuelle Evidenz der Reliabilität und Validität klinischer Tests zur Evaluation der Bewegungskontrolle bei lumbalen
                    Rückenschmerzen

Ronny Petzold; H. Thieme

doi:10.1055/s-0042-112274

manuelletherapie, Inhaltsverzeichnis

manuelletherapie 2016; 20(04): 179-189
DOI: 10.1055/s-0042-112274

Originalia

Literaturstudie

Georg Thieme Verlag KG Stuttgart · New York

Aktuelle Evidenz der Reliabilität und Validität klinischer Tests zur Evaluation der Bewegungskontrolle bei lumbalen Rückenschmerzen

Systematische LiteraturübersichtCurrent Evidence of Reliability and Validity of Clinical Tests for the Assessment of Movement Control in Lumbar Back PainSystematic Literature Review

Ronny Petzold

¹atr – Ambulantes Therapiezentrum für Rehabilitation am Stadtpark, Chemnitz

,

H. Thieme

²Klinik Bavaria, Kreischa

› Institutsangaben

Abstract

Zusammenfassung

Im klinischen Alltag stehen eine verminderte lumbale Bewegungskontrolle und unspezifische Rückenschmerzen häufig in Zusammenhang.

Das Ziel der systematischen Übersichtsarbeit war es, die aktuelle Evidenz der diagnostischen Gütekriterien klinischer Bewegungskontrolltests bei Patienten mit lumbalen Rückenschmerzen zu ermitteln und die zuverlässigsten Tests oder Testkombinationen zu identifizieren, um Empfehlungen für die Praxis zu geben.

Die Analyse der einzelnen Gütekriterien der ausgewählten 23 Tests und deren Kombinationen zeigte sehr variable Ergebnisse. Bei einem Großteil der Tests ließen sich für die Reliabilität ausreichend gute Ergebnisse hinsichtlich der diagnostischen Wertigkeit und klinischen Anwendbarkeit nachweisen.

Aufgrund ungenügender Evidenz zur diskriminativen Validität zwischen gesunden Personen und Patienten mit Rückenschmerzen sind Bewegungskontrolltests und deren Kombinationen aktuell nur bedingt zu empfehlen. Jeder angewandte klinische Test/Testkombination sollte standardisiert durchgeführt und wegen fehlender einheitlicher Beurteilungskriterien nur im Kontext mit den Anamnesedaten und weiteren physischen Untersuchungsbefunden bewertet werden.

Abstract

A correlation between reduced lumbar movement control and unspecific back pain is often found in clinical practice.

The aim of this systematic literature review was to identify the current evidence of diagnostic performance criteria of movement control tests in patients with lumbar back pain as well as the most reliable tests or test combinations in order to give daily practice recommendations.

The analysis of the individual performance criteria of the selected 23 tests and their combinations showed variable results. Adequate reliability for the diagnostic value and clinical feasibility could be shown for most of the tests.

There is currently insufficient evidence concerning the discriminant validity between healthy subjects and patients with back pain of movement control tests and their combinations. They can therefore only be recommended conditionally.

Each applied clinical test/test combination should be performed standardized. Due to the lack of consistent evaluation criteria they should only be evaluated in the context of the individual case history and additional physical examination findings.

Schlüsselwörter

unspezifischer Rückenschmerz - lumbale Instabilität - Bewegungstests - Bewegungskontrolltests - motorische Kontrolltests - Reliabilität - Sensitivität - Spezifität - Validität

Keywords

unspecific back pain - lumbar instability - movement tests - movement control tests - motor control tests - reliability - sensitivity - specificity - validity

Volltext

Referenzen

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