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1.  Intrarater Reliability of Pain Intensity, Tissue Blood Flow, Thermal Pain Threshold, Pressure Pain Threshold and Lumbo-Pelvic Stability Tests in Subjects with Low Back Pain 
Purpose
This preliminary study aimed to determine the intrarater reliability of the quantitative tests for the study of non-specific low back pain.
Methods
Test-retest reliability of the measurements of ratio data was determined by an intraclass correlation coefficient (ICC), standard error of measurements (SEMs), coefficient of variation (CV), and one-way repeated measures ANOVA using the values collected from 13 young individuals (25.8 ± 6.2 years) with chronic non-specific low back pain on two occasions separated by 2 days. Percent agreement of the ordinal data was also determined by Cohen's Kappa statistics (kappa). The measures consisted of tissue blood flow (BF), average pain visual analog scales (VAS), pressure pain threshold (PPT), cold pain threshold (CPT), heat pain threshold (HPT) and lumbo-pelvic stability test (LPST). An acceptable reliability was determined as the ICC values of greater than 0.85, SEMs less than 5%, CV less than 15%, the kappa scores of greater than 80% and no evidence of systematic error (ANOVA, P>0.05).
Results
ICC of all measures in the lumbo-sacral area were greater than 0.87. The kappa was also greater than 83%. Most measures demonstrated a minimal error of measurements and less potential of systemic error in nature. Only the SEMs and the CV of the CPT exceeded the acceptable level.
Conclusions
It is concluded that most of the quantitative measurements are reliable for the study of non-specific low back pain, however the CPT should be applied with care as it has a great variation among individuals and potential of measurement error.
PMCID: PMC3307961  PMID: 22461960
Reliability; Low back pain; Outcome measures; Lumbo-pelvic stability; Pain
2.  Effects of Pilates Training on Lumbo-Pelvic Stability and Flexibility 
Purpose
This study was performed to assess and compare the effects of Pilates exercise on flexibility and lumbo-pelvic movement control between the Pilates training and control groups.
Methods
A randomized single-blinded controlled design was utilized in the study. Forty healthy male and female volunteers (mean age 31.65±6.21 years) were randomly divided into Pilates-based training (20 subjects) and the control groups (20 subjects). The Pilates group attended 45-minute training sessions, 2 times per week, for a period of 8 weeks. Flexibility and lumbo-pelvic stability tests were determined as outcome measures using a standard “sit and reach test” and “pressure biofeedback” respectively at 0, 4 and 8 weeks of the study.
Results
The results showed that the Pilates training group improved flexibility significantly (P<0.001) during time intervals. This effect was also significantly greater than the control group for both 4 weeks and 8 weeks of the training period (P<0.001). There were 65% and 85% of the subjects from Pilates group passing the lumbo-pelvic stability test at 4 and 8 weeks of training periods respectively. No subjects from the control group passed the test at any stages.
Conclusions
Pilates can be used as an adjunctive exercise program to improve flexibility, enhance control-mobility of trunk and pelvic segments. It may also prevent and attenuate the predisposition to axial musculoskeletal injury.
PMCID: PMC3289190  PMID: 22375213
Pilates Training; Pilates-Based Exercises; Flexibility; Lumbo-pelvic stability; Exercise
3.  Adolescent standing postural response to backpack loads: a randomised controlled experimental study 
Background
Backpack loads produce changes in standing posture when compared with unloaded posture. Although 'poor' unloaded standing posture has been related to spinal pain, there is little evidence of whether, and how much, exposure to posterior load produces injurious effects on spinal tissue. The objective of this study was to describe the effect on adolescent sagittal plane standing posture of different loads and positions of a common design of school backpack. The underlying study aim was to test the appropriateness of two adult 'rules-of-thumb'-that for postural efficiency, backpacks should be worn high on the spine, and loads should be limited to 10% of body weight.
Method
A randomised controlled experimental study was conducted on 250 adolescents (12–18 years), randomly selected from five South Australian metropolitan high schools. Sagittal view anatomical points were marked on head, neck, shoulder, hip, thigh, knee and ankle. There were nine experimental conditions: combinations of backpack loads (3, 5 or 10% of body weight) and positions (backpack centred at T7, T12 or L3). Sagittal plane photographs were taken of unloaded standing posture (baseline), and standing posture under the experimental conditions. Posture was quantified from the x (horizontal) coordinate of each anatomical point under each experimental condition. Differences in postural response were described, and differences between conditions were determined using Analysis of Variance models.
Results
Neither age nor gender was a significant factor when comparing postural response to backpack loads or conditions. Backpacks positioned at T7 produced the largest forward (horizontal) displacement at all the anatomical points. The horizontal position of all anatomical points increased linearly with load.
Conclusion
There is evidence refuting the 'rule-of-thumb' to carry the backpack high on the back. Typical school backpacks should be positioned with the centre at waist or hip level. There is no evidence for the 10% body weight limit.
doi:10.1186/1471-2474-3-10
PMCID: PMC111061  PMID: 11960561

Results 1-3 (3)