The abdominal drawing-in manoeuvre for detecting activity in the deep abdominal muscles : is this clinical tool reliable and valid?
| Autor: | Eva Rasmussen-Barr, Björn O. Äng, Karsten Kaping |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Cross-sectional study Population Concurrent validity Validity Physical examination Sensitivity and Specificity Rehabilitation Medicine Young Adult ULTRASONOGRAPHY Abdominal muscles Health Sciences medicine Humans Single-Blind Method education Physical Examination Abdominal Muscles Abdominal Muscles/diagnostic imaging/*physiopathology Aged Low Back Pain/*diagnosis/physiopathology Ultrasonography Observer Variation education.field_of_study medicine.diagnostic_test business.industry Research Reproducibility of Results General Medicine Gold standard (test) Middle Aged Hälsovetenskaper Low back pain Cross-Sectional Studies Case-Control Studies Physical therapy Female medicine.symptom business Low Back Pain Physical Examination/*methods |
| Zdroj: | BMJ Open |
| Popis: | Objective The abdominal drawing-in manoeuvre (ADIM) is a common clinical tool for manually assessing whether a preferential activation of the deep abdominal muscles in patients with low back pain (LBP) is ‘correct’ or not. The validity and reliability of manual assessment of the ADIM are, however, as yet unknown. This study evaluated the concurrent and discriminative validity and reliability of the manually assessed ADIM. Design Single-blinded cross-sectional study. Settings General population in Stockholm County, Sweden. Participants The study sample comprised 38 participants seeking care for LBP, and 15 healthy subjects. Measures The manual ADIM was assessed as correct or not following a standard procedure. Ultrasound imaging (USI) was used as the concurrent reference (gold standard) for the manually assessed ADIM by calculating a ratio of the change in muscle thickness between the resting and the contracted states: the correlation between manual test and USI was calculated. Discriminative validity was analysed by calculating sensitivity and specificity. A sample of 24 participants was analysed with κ coefficients for interobserver reliability between two raters. Results The concurrent validity between the manual ADIM and the ADIM–USI ratios showed poor correlations (r=0.13–0.40). The discriminative validity of the manually assessed ADIM to predict LBP showed a sensitivity/specificity of 0.30/0.73, while the ADIM–USI ratio to predict LBP showed 0.19/0.87. The interobserver reliability for the manually assessed ADIM revealed substantial agreement: K=0.71, CI (95%) 0.41 to 1.00. Conclusions Although the interobserver reliability of the manually assessed ADIM was high, the concurrent and discriminative validity were both low for examining the preferential activity of the deep abdominal muscles. Neither the manually assessed ADIM nor the ultrasound testing discriminated between participants with LBP and healthy subjects regarding preferential activity of the transversus muscle as this ability/inability was also present in healthy subjects. |
| Databáze: | OpenAIRE |
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