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.