Purpose: Identify patients presenting with low back pain who will likely respond favorably to a stabilization exercise program.
Rule:
1. Age less than 40
2. Straight leg raise greater than ~90°
3. Aberrant movement present
4. Positive prone instability test
Item | 2 + variables | 3+ variables |
SN | 0.83 | 0.56 |
SP | 0.56 | 0.83 |
+LR | 1.9 | 4.0 |
-LR | 0.30 | 0.52 |
PPV | ||
NPV |
SN = sensitivity – ‘SnOut’ helps rule out a disease (higher number is better – >0.9 is excellent)
SP = Specificity – ‘SpIn’ helps rule in a disease (higher number is better – greater than 0.90 is excellent))
+LR = positive likelihood ratio – ratio of positive test results in a patients with the pathology (true positives) higher number is better (> 10 is excellent)
-LR = negative likelihood ratio – ratio of negative test results in a patients with the pathology (false negatives) lower number is better (< 0.1 is excellent)
PPV = positive predictive value – percentage of patients who both test positive & have the disease (true positives)
NPV = negative predictive value – percentage of patients who both test negative & do not have disease (true negatives)
References:
1. Hicks GE, Fritz JM, Delitto A, McGill SM. Preliminary Development of a Clinical Prediction Rule for Determining Which Patients With Low Back Pain Will Respond to a Stabilization Exercise Program. Arch Phys Med Rehabil. 2005; 86(9): 1753–1762.