Clinimetric analysis of pressure biofeedback and transversus abdominis function in individuals with stabilization classification low back pain

Dustin R. Grooms, Terry L. Grindstaff, Theodore Croy, Joseph M. Hart, Susan A. Saliba

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

OBJECTIVE: To determine if a proposed clinical test (pressure biofeedback) could detect changes in transversus abdominis (TrA) muscle thickness during an abdominal drawing-in maneuver. BACKGROUND: Pressure biofeedback may be used to assess abdominal muscle function and TrA activation during an abdominal drawing-in maneuver but has not been validated. METHODS: Forty-nine individuals (18 men, 31 women) with low back pain who met stabilization classification criteria underwent ultrasound imaging to quantify changes in TrA muscle thickness while a pressure transducer was used to measure pelvic and spine position during an abdominal drawing-in maneuver. A paired t test was used to compare differences in TrA activation ratios between groups (able or unable to maintain pressure of 40 ± 5 mmHg). The groups were further dichotomized based on TrA activation ratio (high, greater than 1.5; low, less than 1.5). Sensitivity, specificity, and likelihood ratios were calculated. RESULTS: There was not a significant difference (P = .57) in TrA activation ratios (able to maintain pressure, 1.59 ± 0.28; unable to maintain pressure, 1.54 ± 0.24) between groups. The pressure biofeedback test had low sensitivity of 0.22 (95% confidence interval [CI]: 0.10, 0.42) but moderate specificity of 0.77 (95% CI: 0.58, 0.89), a positive likelihood ratio of 0.94 (95% CI: 0.33, 2.68), and a negative likelihood ratio of 1.02 (95% CI: 0.75, 1.38). CONCLUSION: Successful completion on pressure biofeedback does not indicate high TrA activation. Unsuccessful completion on pressure biofeedback may be more indicative of low TrA activation, but the correlation and likelihood coefficients indicate that the pressure test is likely of minimal value to detect TrA activation.

Original languageEnglish
Pages (from-to)184-193
Number of pages10
JournalJournal of Orthopaedic and Sports Physical Therapy
Volume43
Issue number3
DOIs
StatePublished - Mar 2013

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Abdominal Muscles
Low Back Pain
Pressure
Confidence Intervals
Pressure Transducers
Muscles
Ultrasonography
Spine

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Clinimetric analysis of pressure biofeedback and transversus abdominis function in individuals with stabilization classification low back pain. / Grooms, Dustin R.; Grindstaff, Terry L.; Croy, Theodore; Hart, Joseph M.; Saliba, Susan A.

In: Journal of Orthopaedic and Sports Physical Therapy, Vol. 43, No. 3, 03.2013, p. 184-193.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: To determine if a proposed clinical test (pressure biofeedback) could detect changes in transversus abdominis (TrA) muscle thickness during an abdominal drawing-in maneuver. BACKGROUND: Pressure biofeedback may be used to assess abdominal muscle function and TrA activation during an abdominal drawing-in maneuver but has not been validated. METHODS: Forty-nine individuals (18 men, 31 women) with low back pain who met stabilization classification criteria underwent ultrasound imaging to quantify changes in TrA muscle thickness while a pressure transducer was used to measure pelvic and spine position during an abdominal drawing-in maneuver. A paired t test was used to compare differences in TrA activation ratios between groups (able or unable to maintain pressure of 40 ± 5 mmHg). The groups were further dichotomized based on TrA activation ratio (high, greater than 1.5; low, less than 1.5). Sensitivity, specificity, and likelihood ratios were calculated. RESULTS: There was not a significant difference (P = .57) in TrA activation ratios (able to maintain pressure, 1.59 ± 0.28; unable to maintain pressure, 1.54 ± 0.24) between groups. The pressure biofeedback test had low sensitivity of 0.22 (95{\%} confidence interval [CI]: 0.10, 0.42) but moderate specificity of 0.77 (95{\%} CI: 0.58, 0.89), a positive likelihood ratio of 0.94 (95{\%} CI: 0.33, 2.68), and a negative likelihood ratio of 1.02 (95{\%} CI: 0.75, 1.38). CONCLUSION: Successful completion on pressure biofeedback does not indicate high TrA activation. Unsuccessful completion on pressure biofeedback may be more indicative of low TrA activation, but the correlation and likelihood coefficients indicate that the pressure test is likely of minimal value to detect TrA activation.",
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