Comparison of Posteroanterior Spinal Stiffness Measures to Clinical and Demographic Findings at Baseline in Patients Enrolled in a Clinical Study of Spinal Manipulation for Low Back Pain - Back Pain Research

Comparison of Posteroanterior Spinal Stiffness Measures to Clinical and Demographic Findings at Baseline in Patients Enrolled in a Clinical Study of Spinal Manipulation for Low Back Pain
Received 16 April 2007; received in revised form 11 June 2007
Edward F. Owens Jr., MS, DCa, James W. DeVocht, DC, PhDa, M. Ram Gudavalli, PhDa, David G. Wilder, PhDb, William C. Meeker, DC, MPHc
Journal of Manipulative and Physiological Therapeutics

Abstract
Objective
A system for measuring posterior-to-anterior spinal stiffness (PAS) was developed for use in clinical trials of manipulation for low back pain (LBP). The current report is an analysis of the baseline PAS data, with particular emphasis on relationships between PAS and clinical and demographic characteristics.

Methods
Posterior-to-anterior spinal stiffness measurements were recorded over the spinous processes of the lumbar spines from patients who had LBP. The system uses electronic sensors to record displacement and force, whereas a human operator provides the force of indentation. Clinical and outcome measures were compared with spinal stiffness.

Results
We recruited 192 patients (89 female and 103 male; average age, 40.0 years; SD, 9.4 years). The average Roland-Morris score was 9.7 (SD, 3.2) on a 24-point scale. The Visual Analog Scale pain scores were 55.7 (SD, 20.9) on a 100-mm scale. Stiffness values ranged from 4.16 to 39.68 N/mm (mean, 10.80 N/mm; SD, 3.72 N/mm). Females' lumbar spines were, on the average, 2 N/mm more compliant than males (P < .001).

Conclusions
The PAS system of computer-monitored equipment with human operation performed well in this clinical study of LBP. Spinal stiffness was found to be different between males and females, and age and body mass index were related to PAS. We found no significant relationship between the severity or chronicity of the LBP complaint and spinal stiffness. There was little agreement between the stiff or tender segments identified by the clinicians using palpation and the segment that measured most stiff using the PAS device.

Key Indexing Terms: Chiropractic, Lumbar Spine, Biomechanics, Low Back Pain, Stiffness, Tests and Measurement, Manipulation, Spinal
a Associate Professor of Research, Palmer Center for Chiropractic Research, Davenport, Iowa

b Associate Professor, Departments of Biomedical Engineering and Orthopaedics, Iowa Spine Research Center, University of Iowa

c President, Palmer College of ChiropracticÛWest

Submit request for reprints to: Edward F. Owens Jr, MS, DC, Associate Professor of Research, Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA 52803, USA.

PII: S0161-4754(07)00201-1

doi:10.1016/j.jmpt.2007.07.009

© 2007 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

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