Fingertip-to-Floor Test and Straight Leg Raising Test: Validity, Responsiveness, and Predictive Value in Patients With Acute/Subacute Low Back Pain

• Published in: Archives of physical medicine and rehabilitation Vol. 93; no. 12; pp. 2210 - 2215
• Main Authors: Ekedahl, Harald, Jönsson, Bo, Frobell, Richard B.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.12.2012; Elsevier
• Subjects: Acute Disease; Adult; Annan medicin och hälsovetenskap; Biological and medical sciences; Disability Evaluation; Diseases of the osteoarticular system; Diseases of the spine; Female; Humans; Leg; Longitudinal Studies; Low back pain; Low Back Pain - rehabilitation; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Miscellaneous; Other Medical and Health Sciences; Other Medical and Health Sciences not elsewhere specified; Other Medical Sciences; Other Medical Sciences not elsewhere specified; Physical Medicine and Rehabilitation; Physical Therapy Modalities; Predictive value of tests; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Range of motion; Range of Motion, Articular; Rehabilitation; Reproducibility of Results; Övrig annan medicin och hälsovetenskap; Range of motion; Low back pain; CI; ROC; VAS; BL; Predictive value of tests; MDC; ES; RMDQ; AUC; SLR; FTF; Rehabilitation; LBP; straight leg raising; receiver operating characteristics; fingertip-to-floor test; area under the curve; baseline; visual analog scale; minimal detectable change; Roland Morris Disability Questionnaire; confidence interval; effect size; Human; Motion; Lumbar spine; Acute; Diseases of the osteoarticular system; Finger; Spine disease; Leg; Validity; Pain; Reeducation; Orthopedics; Rachialgia; Predictive value; Subacute
• ISSN: 0003-9993; 1532-821X; 1532-821X
• DOI: 10.1016/j.apmr.2012.04.020

Ekedahl H, Jönsson B, Frobell RB. Fingertip-to-floor test and straight leg raising test: validity, responsiveness, and predictive value in patients with acute/subacute low back pain. To investigate the validity over time of the fingertip-to-floor test (FTF) and the straight leg raising test (SLR) using the Roland Morris Disability Questionnaire (RMDQ) and correlation coefficient (r), and to assess the predictive value of factors related to the change in RMDQ over 12 months using multivariate regression analysis. Longitudinal study. Outpatient physical therapy clinic. Subjects (N=65) with acute/subacute low back pain (≤13wk of symptoms). Thirty-eight (58%) had radicular pain as determined by the slump test. Not applicable. Self-reported disability was used as a reference variable and was measured using the RMDQ at baseline and after 1 and 12 months. The FTF and SLR were measured at baseline and after 1 month. Responsiveness and imprecision were assessed by using effect size (ES) and minimal detectable change (MDC). The sample was stratified by the presence or absence of radicular pain (categorized by the slump test). The change in FTF results was significantly correlated to the 1-month change in RMDQ, both in the entire sample (r=.63) and in the group with radicular pain (r=.66). Similar analysis for the SLR showed a weak relationship to RMDQ. FTF showed adequate responsiveness (ES range, 0.8–0.9) in contrast to SLR (ES range, 0.2–0.5). The MDC for FTF and SLR were 4.5cm and 5.7°, respectively. The change in FTF results over 1 month was independently more strongly associated with the 12-month (R2=.27–.31) change in RMDQ than any of the other variables and multivariate combinations. Our results suggest that the FTF has good validity in patients with acute/subacute low back pain and even better validity in those with radicular pain. The change in FTF results over the first month was a valid predictor of the change in self-reported disability over 1 year. In contrast, the validity of SLR can be questioned in the present group of patients.