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Man Ther. 2016 Sep;25:27-34. doi: 10.1016/j.math.2016.05.332. Epub 2016 Jun 1.

The validity of a clinical test for the diagnosis of lumbar spinal stenosis.

Author information

1
Physiotherapy Department, Chesterfield Royal Hospital, Chesterfield, Derbyshire, UK.
2
38 Collegiate Crescent, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield S10 2BP, UK. Electronic address: s.may@shu.ac.uk.

Abstract

BACKGROUND:

The diagnosis and management of acquired lumbar spinal stenosis (ALSS) is an area of growing interest with an increase in its prevalence and detection in the older population.

OBJECTIVES:

To investigate the diagnostic accuracy of a modified extension test (MExT) for diagnosing ALSS in subjects aged fifty or over.

METHODS:

Symptomatic response of the bi-component MExT was evaluated and compared against magnetic resonance imaging (MRI) findings in 30 subjects. Estimates of sensitivity, specificity, likelihood ratios (LRs) and post-test probabilities were all calculated, and the capability of the test to discriminate between grade and location of stenosis was also appraised.

RESULTS:

MExT sensitivity was high at 92% (95% confidence intervals (CI), 72-99%) leading to a significant negative likelihood ratio at -LR 0.2 (95% CI, 0.03-1.36); conversely, specificity was low at 40% (95% CI, 7-82%) with only a small positive likelihood ratio of +LR 1.53 (95% CI, 0.74-3.16). All correlations between the MExT and concurrent grade, or location of stenosis appeared weak and insignificant.

CONCLUSIONS:

The MExT was found to demonstrate acceptable criterion validity in relation to ruling-out a diagnosis when a negative result was observed; however, further validation appears warranted.

KEYWORDS:

Diagnosis; Extension test; Lumbar; Spinal stenosis; Validity

PMID:
27422594
DOI:
10.1016/j.math.2016.05.332
[Indexed for MEDLINE]

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