PMID- 27559274
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160825
LR  - 20240325
IS  - 1066-9817 (Print)
IS  - 2042-6186 (Electronic)
IS  - 1066-9817 (Linking)
VI  - 24
IP  - 2
DP  - 2016 May
TI  - Manual unloading of the lumbar spine: can it identify immediate responders to 
      mechanical traction in a low back pain population? A study of reliability and 
      criterion referenced predictive validity.
PG  - 53-61
LID - 10.1179/2042618614Y.0000000072 [doi]
AB  - BACKGROUND: To date, no research has examined the reliability or predictive 
      validity of manual unloading tests of the lumbar spine to identify potential 
      responders to lumbar mechanical traction. PURPOSE: To determine: (1) the intra 
      and inter-rater reliability of a manual unloading test of the lumbar spine and 
      (2) the criterion referenced predictive validity for the manual unloading test. 
      METHODS: Ten volunteers with low back pain (LBP) underwent a manual unloading 
      test to establish reliability. In a separate procedure, 30 consecutive patients 
      with LBP (age 50.86+/-11.51) were assessed for pain in their most provocative 
      standing position (visual analog scale (VAS) 49.53+/-25.52 mm). Patients were 
      assessed with a manual unloading test in their most provocative position followed 
      by a single application of intermittent mechanical traction. Post traction, pain 
      in the provocative position was reassessed and utilized as the outcome criterion. 
      RESULTS: The test of unloading demonstrated substantial intra and inter-rater 
      reliability K = 1.00, P = 0.002, K = 0.737, P = 0.001, respectively. There were 
      statistically significant within group differences for pain response following 
      traction for patients with a positive manual unloading test (P<0.001), while 
      patients with a negative manual unloading test did not demonstrate a 
      statistically significant change (P>0.05). There were significant between group 
      differences for proportion of responders to traction based on manual unloading 
      response (P = 0.031), and manual unloading response demonstrated a moderate to 
      strong relationship with traction response Phi = 0.443, P = 0.015. DISCUSSION AND 
      CONCLUSION: The manual unloading test appears to be a reliable test and has a 
      moderate to strong correlation with pain relief that exceeds minimal clinically 
      important difference (MCID) following traction supporting the validity of this 
      test.
FAU - Swanson, Brian T
AU  - Swanson BT
AD  - Texas Woman's University, Houston, TX, USA.
FAU - Riley, Sean P
AU  - Riley SP
AD  - University of Connecticut Health Center, Farmington, CT, USA.
FAU - Cote, Mark P
AU  - Cote MP
AD  - University of Connecticut Health Center, Farmington, CT, USA.
FAU - Leger, Robin R
AU  - Leger RR
AD  - Salem State University, MA, USA.
FAU - Moss, Isaac L
AU  - Moss IL
AD  - University of Connecticut Health Center, Farmington, CT, USA.
FAU - Carlos, John Jr
AU  - Carlos J Jr
AD  - Andrews University, Berrien Springs, MI, USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Man Manip Ther
JT  - The Journal of manual & manipulative therapy
JID - 9433812
PMC - PMC4984809
OTO - NOTNLM
OT  - Low back pain
OT  - Reliability
OT  - Traction
OT  - Unloading
OT  - Validity
EDAT- 2016/08/26 06:00
MHDA- 2016/08/26 06:01
PMCR- 2017/05/01
CRDT- 2016/08/26 06:00
PHST- 2016/08/26 06:00 [entrez]
PHST- 2016/08/26 06:00 [pubmed]
PHST- 2016/08/26 06:01 [medline]
PHST- 2017/05/01 00:00 [pmc-release]
AID - yjmt-24-53 [pii]
AID - 10.1179/2042618614Y.0000000072 [doi]
PST - ppublish
SO  - J Man Manip Ther. 2016 May;24(2):53-61. doi: 10.1179/2042618614Y.0000000072.