- Email: [email protected]
The utility of ESP triage in a specialist secondary care spinal centre: A service evaluation
Abstracts / Manual Therapy 25 (2016) e57ee169
e115
Disclosure of Interest: None Declared
Methods: A systematic search was conducted in PubMed, EMBASE, Cochrane, PsychINFO, CINAHL, PEDro and Scopus including articles from September 5th 2015. All articles were examined for eligibility. Methodological quality was examined by a checklist based on the COREQ statement for qualitative research, checklist by Schoeb et al. and checklist of the BMJ. The studies were examined for either a model or factors of patientcenteredness in physiotherapy. Data was extracted using a data extraction form and analyzed following ‘thematic synthesis’. Results: 14 articles were included. Methodological quality was high in five studies. Six major descriptive themes were identified. The descriptive themes were: The descriptive themes were: The physiotherapist (with subcategories Social characteristics, Confidence and Knowledge):A patient-centered physiotherapist should be respectful, open, confident and competent. Individuality (with subcategories: Getting to know the patient, Individualized treatment) concerns specific patient-tailored education, communication and treatment. Communication (with subcategory Nonverbal communication): the need of an ongoing dialogue with patients in clear and lay speech. Education primarily involves advice about every part of the assessment and treatment. Goal setting: Patient-centered physiotherapists try to allow the patients to define their own goals. The last theme was Support (with subcategory Empowerment), this consists of a mixture of individuality, equality of responsibility, understanding, reassuring, and empowerment. Conclusion: Patient-centredness in physiotherapy entails the characteristics; the physiotherapist (having social skills, being confident and showing knowledge), offering an individualized treatment, continuous communication (verbal and non-verbal), education during all aspects of treatment, working with patient defined goals in a treatment in which the patient is supported and empowered. Further research is needed, in order to further enhance our understanding about the clinical applicability of the conceptual framework and to assess the implementation and implications. Implications: It is hoped the conceptual framework developed from these study findings will assist physiotherapists in their understanding of patient-centeredness and the implications of patient-centeredness in clinical practice. Funding Acknowledgements: This study was not funded Ethics Approval: Ethics approval was not required
Keywords: Back pain, Beliefs, Physiotherapist-patient communication
Disclosure of Interest: None Declared
Changing roles and scope of practice PO4-AP-001 PATIENT-CENTEREDNESS IN PHYSIOTHERAPY: WHAT DOES IT ENTAIL? A SYSTEMATIC REVIEW OF QUALITATIVE STUDIES
Keywords: Patient centered, Qualitative research, Review
therapists. Where therapists employed a 'passive' style, using weak response tokens, rapid topic shifts, failure to pick up on patient cues and maintain eye contact, then patient participation was limited. Some examples show, however, that when therapists failed to respond to patient cues, patients were still prepared to pursue their concern. When therapists responded with a facilitating approach, using open questions, formulating a version of the patient's talk, and affirmative head nodding, then active patient participation was enhanced. However, responses to the therapist’s enquiries were not always straightforward if the patient was unable/unwilling to disclose. When therapists provided reassurance and offered pain explanations without fully exploring/understanding the patients’ beliefs, the result was weak patient alignment and in some cases explicit patient disagreement. Alternatively reassurance accompanied with pain explanations congruent with the patient’s pain beliefs, produced stronger agreement[IC1] . [IC1]1238 Conclusion: Patient beliefs are a core part of pain perception and response to pain, yet empirical data is lacking as to how physiotherapists effectively and systematically explore them. This study suggests that a more facilitating communication style accommodates increased patient input if the patient is willing and able to disclose[IC1]. [IC1]455 Implications: Raising awareness of the interactional consequences of different therapist communication styles and patients’ responses to therapists’ enquiries will help develop understanding of how to incorporate principles of person-centred communication practice into physiotherapy [IC1]. [IC1]575 Funding Acknowledgements: Private Physiotherapy Educational Foundation (PPEF) Musculoskeletal Association of Chartered Physiotherapists Ethics Approval: The North East London Local Research Ethics committee has approved the study protocol (reference Number: 2352) and the study has been successfully reviewed by the East Midlands-Nottingham 2 NRES committee (14/EM/1045[IC1] ). [IC1]Total characters so far 2278
A. Wijma 1, *, A. Bletterman 2, J. Clark 3, S. Vervoort 4, A. Beetsma 5, D. Keizer 6, J. Nijs 7, P. van Wilgen 1. 1 Faculty of Physical Education and Physiotherapy, Pain in Motion research group (http://www.paininmotion.be), Transcare, Vrije Universiteit Brussel, Transdisciplinairy Painmanagment Centre, Brussel, Groningen, Netherlands; 2 Physiotherapy, Physiotherapy Stiens, Stiens, Netherlands; 3 Faculty of Health Psychology and Social Care, Pain in Motion Research Group. (www.paininmotion.be), Manchester Metropolitan University, Manchester, United Kingdom; 4 Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht, Netherlands; 5 Department of Physiotherapy, Hanze University of Applied Sciences, School of Health Studies, Netherlands; 6 Transcare, Transdisciplinary painmanagement center, Groningen, Netherlands; 7 Faculty of Physical Education and Physiotherapy, Pain in Motion research group (www.paininmotion.be), Vrije Universiteit Brussel, Brussel, Belgium * Corresponding author.
Background: Patient-centeredness has been defined in multiple ways in medicine, nursing and occupational therapy. In physiotherapy there is not yet a clear overall definition on patient-centeredness. This is an omission, as physiotherapy evolves more around the patients and their behavior and perceptions. Purpose: The goal of this review is to identify the perceptions of patient centred physiotherapy from the perspective of patients and therapists from qualitative research studies.
Changing roles and scope of practice PO4-AP-006 THE UTILITY OF ESP TRIAGE IN A SPECIALIST SECONDARY CARE SPINAL CENTRE: A SERVICE EVALUATION E. Dunstan*, L. Wood. * Corresponding author.
Background: In the field of Orthopaedic medicine growth, of extended scope physiotherapy (ESP) practice has led to musculoskeletal service redesign; many traditional medical roles are now being performed competently and effectively by ESP's, reducing unnecessary referrals to surgical consultants. A rising demand in service access for lumbar radicular presentations has been noted and the need to review the pathway for this patient group has been highlighted. Purpose: The purpose of this service evaluation is to establish legitimacy and effectiveness of a secondary care spinal ESP triage service. This evaluation aimed to establish the rate of independent ESP patient management, record surgical conversion rates and patient satisfaction. A subsection of the evaluation focussed on disc engendered radicular pain, a group previously considered at Nottingham University Hospital to require surgical opinion and management. Establishing outcome for ESP triage and management of secondary care spinal referrals consolidates the effectiveness of current service and highlights areas of service growth and redesign. Methods: A retrospective service evaluation from January 2014 to January 2015, was undertaken by members of the Extended Scope Practitioner
e116
Abstracts / Manual Therapy 25 (2016) e57ee169
(ESP) team. The following data were collected: rates of independent management, referral rates for surgical consideration, and conversion to surgery. Patients who were referred for selective nerve root block (SNRB) by the ESP team were reviewed. Inclusion criteria was determined by single-level radicular pain secondary to lumbar disc herniation (LDH) as confirmed by clinical examination and concordant MRI results. Patients with more than one compromised nerve root, those with canal or bony lateral recess stenosis, spondylolisthesis, or previous lumbar surgery, were excluded. Surgical or non-surgical outcome was recorded. Patient satisfaction rates were evaluated retrospectively from questionnaires given to discharged patients. Results: A total of 2328 patients were seen. 84% of all referrals seen by ESP’s were independently managed. The remaining16% required either a discussion with a surgeon to confirm management or for surgical review, of which 82% were considered to be suitable surgical referrals. 109 (5%) patients seen by the ESP team underwent SNRB for lumbar disc engendered radicular pain, of these 68% continued to be managed non-surgically at the 12-month time point. A 99% satisfaction rate was reported from discharged patients. Conclusion: An ESP service in a specialist secondary care spinal unit is effective at conservatively managing spinal conditions and appropriately identifying surgical candidates. This service evaluation establishes the utility of a secondary care ESP pathway and reports a high non-surgical yield in patients who present with lumbar disc engendered radicular pain. Further research is needed to confirm ESP’s diagnostic accuracy, patient outcomes and cost effectiveness. Implications: Decision-making in healthcare involves choosing interventions or pathways that not only benefit patients, but maximise benefits from the available resources. This evaluation demonstrates benefit to the spinal service by utilising ESP’s to deliver aspects of care previously delivered by medical professionals. As the benefits and validity of ESP roles become established, evaluating the outcomes of specific patient groups who are managed via these alternate pathways becomes of value and facilitates discussion regarding best practice, for both patient outcome and resource use as well as providing relevant data to inform patient and commissioning choice. Funding Acknowledgements: Unfunded Study. Ethics Approval: Service evaluation therefore ethics not required. Disclosure of Interest: None Declared Keywords: ESP, Spinal, Triage Health promotion/Public health PO1-AP-001 1000 NORMS PROJECT: HEALTH-RELATED QUALITY OF LIFE ACROSS THE LIFESPAN N. Moloney 1, *, J. Baldwin 2, M. Mackey 2, C. Hiller 2, J. Nightingale 2, J. Professions-Physiotherapy, Macquarie University, Burns 2. 1 Health Australia; 2 Faculty of Health Sciences, University of Sydney, Sydney, Australia * Corresponding author.
Background: Decision-making in healthcare, research and policy hinges on access to normative reference data, yet available data are limited. The 1000 Norms Project is developing crucial health-related quality of life (HRQOL) reference data. Patient-reported outcomes (PROs) provide valuable information regarding HRQOL and evaluation of health services. Purpose: The aims of this study were to generate HRQOL normative reference data and investigate the relationship between HRQOL, sociodemographic factors and physical function in healthy people. Methods: This study was conducted within the 1000 Norms Project, an observational study investigating measures of health and function in 1000 healthy Australians aged 3e101 years. Data for adult participants were analysed. Participant characteristics and demographics, physical activity level, workability and measures of physical function were collected. HRQOL was investigated using the AQoL-8D utility instrument assessing eight dimensions: independent living, pain, physical senses, self-worth, relationships, coping, happiness and mental health. Scores were converted to two super-dimensions (physical and mental) and a global ‘utility’ total score.
Results: Data from 732 adult participants (18e101yrs) were analysed. Adults aged 80+ years reported significantly lower scores for independent living, senses dimensions and physical super-dimension (p < .001). Females, and individuals with low physical activity, reported poorer mental super-dimension scores. Physical super-dimension scores were lower for overweight individuals and individuals with either a chronic pain or smoking history (p < .01). Similar results were identified for overall AQoL8D utility. Workability was associated with AQoL-8D utility and both super-dimension scores (p < .001). Physical super-dimension scores were negatively correlated with BMI, waist circumference and weight (p < .001), and positively with 6-minute walking distance, timed up and down stairs, chair stand, and balance scores (p < .001). Conclusion: In this sample of 1000 healthy individuals, overall HRQOL was poorer for females, individuals with low physical activity levels and individuals with chronic pain. The physical element of HRQOL was affected by age, BMI, chronic pain, smoking history and lower limb function, while the mental element of HRQOL was affected by gender and physical activity level. Implications: Comprehensive normative data are necessary for clinical, research and policy decision-making. The 1000 Norms Project is developing crucial health-related quality of life reference data including PROs and physical function, which will be freely available. Funding Acknowledgements: This Project is supported by the National Health and Medical Research Council of Australia (NHMRC, #1031893), Intersect Australia Research Data Storage and Australian Podiatry Education & Research Fund, Australasian Podiatry Council. Ethics Approval: The study is approved by The University of Sydney Human Research Ethics Committee (no:2013/640) Disclosure of Interest: None Declared Keywords: Normative, Patient-reported outcomes, Reference values Health promotion/Public health PO1-AP-003 ABILITY TO PASS MOVEMENT CONTROL TESTS e DIFFERENCES BETWEEN MEN AND WOMEN U. Aasa, B. Aasa*. Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden * Corresponding author.
Background: Standardized movement control tests are often used by physiotherapists. The tests are used to identify the pattern of movement and symtoms that characterize a persons's relevant lumbar directional tendency. In cross-sectional studies using tests of movement control, it has been suggested that the performance is different in people with and without pain in the low back region. Purpose: The aim of the study was to investigate the performance in two movement control tests in a representative sample of middle-aged men and women in the general population. A secondary aim was to investigate whether the performance was different in men and women with and without pain in the low back region. Methods: This is a study with a longitudinal design. We have followed a randomly selected cohort of 429 adolescents that was recruited in 1974 (baseline), when they were 16 years old. The participants completed physical fitness tests at 16, 34 and 52 years of age and questions about musculoskeletal pain at 34 and 52 years of age. At the age of 52 years, they also performed the Waiter's Bow and the Supine double leg lower test. These are two commonly used tests of movement control in the lumbopelvic area. The Waiter's Bow evaluates the ability to control flexion movements in the lumbar spine while bending the hips, and the Supine double leg lower test evaluates the ability to control extension while extending the hips. Results: A higher percentage of the participants were able to perform the Waiter's Bow (men 43% and women 64%) than the Supine double leg lower test (Men 19% and women 29%) correctly. Significantly more women than men (p ¼ 0.003) were able to control flexion movements in the lumbar spine during the Waiter's bow.
e115
Disclosure of Interest: None Declared
Methods: A systematic search was conducted in PubMed, EMBASE, Cochrane, PsychINFO, CINAHL, PEDro and Scopus including articles from September 5th 2015. All articles were examined for eligibility. Methodological quality was examined by a checklist based on the COREQ statement for qualitative research, checklist by Schoeb et al. and checklist of the BMJ. The studies were examined for either a model or factors of patientcenteredness in physiotherapy. Data was extracted using a data extraction form and analyzed following ‘thematic synthesis’. Results: 14 articles were included. Methodological quality was high in five studies. Six major descriptive themes were identified. The descriptive themes were: The descriptive themes were: The physiotherapist (with subcategories Social characteristics, Confidence and Knowledge):A patient-centered physiotherapist should be respectful, open, confident and competent. Individuality (with subcategories: Getting to know the patient, Individualized treatment) concerns specific patient-tailored education, communication and treatment. Communication (with subcategory Nonverbal communication): the need of an ongoing dialogue with patients in clear and lay speech. Education primarily involves advice about every part of the assessment and treatment. Goal setting: Patient-centered physiotherapists try to allow the patients to define their own goals. The last theme was Support (with subcategory Empowerment), this consists of a mixture of individuality, equality of responsibility, understanding, reassuring, and empowerment. Conclusion: Patient-centredness in physiotherapy entails the characteristics; the physiotherapist (having social skills, being confident and showing knowledge), offering an individualized treatment, continuous communication (verbal and non-verbal), education during all aspects of treatment, working with patient defined goals in a treatment in which the patient is supported and empowered. Further research is needed, in order to further enhance our understanding about the clinical applicability of the conceptual framework and to assess the implementation and implications. Implications: It is hoped the conceptual framework developed from these study findings will assist physiotherapists in their understanding of patient-centeredness and the implications of patient-centeredness in clinical practice. Funding Acknowledgements: This study was not funded Ethics Approval: Ethics approval was not required
Keywords: Back pain, Beliefs, Physiotherapist-patient communication
Disclosure of Interest: None Declared
Changing roles and scope of practice PO4-AP-001 PATIENT-CENTEREDNESS IN PHYSIOTHERAPY: WHAT DOES IT ENTAIL? A SYSTEMATIC REVIEW OF QUALITATIVE STUDIES
Keywords: Patient centered, Qualitative research, Review
therapists. Where therapists employed a 'passive' style, using weak response tokens, rapid topic shifts, failure to pick up on patient cues and maintain eye contact, then patient participation was limited. Some examples show, however, that when therapists failed to respond to patient cues, patients were still prepared to pursue their concern. When therapists responded with a facilitating approach, using open questions, formulating a version of the patient's talk, and affirmative head nodding, then active patient participation was enhanced. However, responses to the therapist’s enquiries were not always straightforward if the patient was unable/unwilling to disclose. When therapists provided reassurance and offered pain explanations without fully exploring/understanding the patients’ beliefs, the result was weak patient alignment and in some cases explicit patient disagreement. Alternatively reassurance accompanied with pain explanations congruent with the patient’s pain beliefs, produced stronger agreement[IC1] . [IC1]1238 Conclusion: Patient beliefs are a core part of pain perception and response to pain, yet empirical data is lacking as to how physiotherapists effectively and systematically explore them. This study suggests that a more facilitating communication style accommodates increased patient input if the patient is willing and able to disclose[IC1]. [IC1]455 Implications: Raising awareness of the interactional consequences of different therapist communication styles and patients’ responses to therapists’ enquiries will help develop understanding of how to incorporate principles of person-centred communication practice into physiotherapy [IC1]. [IC1]575 Funding Acknowledgements: Private Physiotherapy Educational Foundation (PPEF) Musculoskeletal Association of Chartered Physiotherapists Ethics Approval: The North East London Local Research Ethics committee has approved the study protocol (reference Number: 2352) and the study has been successfully reviewed by the East Midlands-Nottingham 2 NRES committee (14/EM/1045[IC1] ). [IC1]Total characters so far 2278
A. Wijma 1, *, A. Bletterman 2, J. Clark 3, S. Vervoort 4, A. Beetsma 5, D. Keizer 6, J. Nijs 7, P. van Wilgen 1. 1 Faculty of Physical Education and Physiotherapy, Pain in Motion research group (http://www.paininmotion.be), Transcare, Vrije Universiteit Brussel, Transdisciplinairy Painmanagment Centre, Brussel, Groningen, Netherlands; 2 Physiotherapy, Physiotherapy Stiens, Stiens, Netherlands; 3 Faculty of Health Psychology and Social Care, Pain in Motion Research Group. (www.paininmotion.be), Manchester Metropolitan University, Manchester, United Kingdom; 4 Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, Utrecht, Netherlands; 5 Department of Physiotherapy, Hanze University of Applied Sciences, School of Health Studies, Netherlands; 6 Transcare, Transdisciplinary painmanagement center, Groningen, Netherlands; 7 Faculty of Physical Education and Physiotherapy, Pain in Motion research group (www.paininmotion.be), Vrije Universiteit Brussel, Brussel, Belgium * Corresponding author.
Background: Patient-centeredness has been defined in multiple ways in medicine, nursing and occupational therapy. In physiotherapy there is not yet a clear overall definition on patient-centeredness. This is an omission, as physiotherapy evolves more around the patients and their behavior and perceptions. Purpose: The goal of this review is to identify the perceptions of patient centred physiotherapy from the perspective of patients and therapists from qualitative research studies.
Changing roles and scope of practice PO4-AP-006 THE UTILITY OF ESP TRIAGE IN A SPECIALIST SECONDARY CARE SPINAL CENTRE: A SERVICE EVALUATION E. Dunstan*, L. Wood. * Corresponding author.
Background: In the field of Orthopaedic medicine growth, of extended scope physiotherapy (ESP) practice has led to musculoskeletal service redesign; many traditional medical roles are now being performed competently and effectively by ESP's, reducing unnecessary referrals to surgical consultants. A rising demand in service access for lumbar radicular presentations has been noted and the need to review the pathway for this patient group has been highlighted. Purpose: The purpose of this service evaluation is to establish legitimacy and effectiveness of a secondary care spinal ESP triage service. This evaluation aimed to establish the rate of independent ESP patient management, record surgical conversion rates and patient satisfaction. A subsection of the evaluation focussed on disc engendered radicular pain, a group previously considered at Nottingham University Hospital to require surgical opinion and management. Establishing outcome for ESP triage and management of secondary care spinal referrals consolidates the effectiveness of current service and highlights areas of service growth and redesign. Methods: A retrospective service evaluation from January 2014 to January 2015, was undertaken by members of the Extended Scope Practitioner
e116
Abstracts / Manual Therapy 25 (2016) e57ee169
(ESP) team. The following data were collected: rates of independent management, referral rates for surgical consideration, and conversion to surgery. Patients who were referred for selective nerve root block (SNRB) by the ESP team were reviewed. Inclusion criteria was determined by single-level radicular pain secondary to lumbar disc herniation (LDH) as confirmed by clinical examination and concordant MRI results. Patients with more than one compromised nerve root, those with canal or bony lateral recess stenosis, spondylolisthesis, or previous lumbar surgery, were excluded. Surgical or non-surgical outcome was recorded. Patient satisfaction rates were evaluated retrospectively from questionnaires given to discharged patients. Results: A total of 2328 patients were seen. 84% of all referrals seen by ESP’s were independently managed. The remaining16% required either a discussion with a surgeon to confirm management or for surgical review, of which 82% were considered to be suitable surgical referrals. 109 (5%) patients seen by the ESP team underwent SNRB for lumbar disc engendered radicular pain, of these 68% continued to be managed non-surgically at the 12-month time point. A 99% satisfaction rate was reported from discharged patients. Conclusion: An ESP service in a specialist secondary care spinal unit is effective at conservatively managing spinal conditions and appropriately identifying surgical candidates. This service evaluation establishes the utility of a secondary care ESP pathway and reports a high non-surgical yield in patients who present with lumbar disc engendered radicular pain. Further research is needed to confirm ESP’s diagnostic accuracy, patient outcomes and cost effectiveness. Implications: Decision-making in healthcare involves choosing interventions or pathways that not only benefit patients, but maximise benefits from the available resources. This evaluation demonstrates benefit to the spinal service by utilising ESP’s to deliver aspects of care previously delivered by medical professionals. As the benefits and validity of ESP roles become established, evaluating the outcomes of specific patient groups who are managed via these alternate pathways becomes of value and facilitates discussion regarding best practice, for both patient outcome and resource use as well as providing relevant data to inform patient and commissioning choice. Funding Acknowledgements: Unfunded Study. Ethics Approval: Service evaluation therefore ethics not required. Disclosure of Interest: None Declared Keywords: ESP, Spinal, Triage Health promotion/Public health PO1-AP-001 1000 NORMS PROJECT: HEALTH-RELATED QUALITY OF LIFE ACROSS THE LIFESPAN N. Moloney 1, *, J. Baldwin 2, M. Mackey 2, C. Hiller 2, J. Nightingale 2, J. Professions-Physiotherapy, Macquarie University, Burns 2. 1 Health Australia; 2 Faculty of Health Sciences, University of Sydney, Sydney, Australia * Corresponding author.
Background: Decision-making in healthcare, research and policy hinges on access to normative reference data, yet available data are limited. The 1000 Norms Project is developing crucial health-related quality of life (HRQOL) reference data. Patient-reported outcomes (PROs) provide valuable information regarding HRQOL and evaluation of health services. Purpose: The aims of this study were to generate HRQOL normative reference data and investigate the relationship between HRQOL, sociodemographic factors and physical function in healthy people. Methods: This study was conducted within the 1000 Norms Project, an observational study investigating measures of health and function in 1000 healthy Australians aged 3e101 years. Data for adult participants were analysed. Participant characteristics and demographics, physical activity level, workability and measures of physical function were collected. HRQOL was investigated using the AQoL-8D utility instrument assessing eight dimensions: independent living, pain, physical senses, self-worth, relationships, coping, happiness and mental health. Scores were converted to two super-dimensions (physical and mental) and a global ‘utility’ total score.
Results: Data from 732 adult participants (18e101yrs) were analysed. Adults aged 80+ years reported significantly lower scores for independent living, senses dimensions and physical super-dimension (p < .001). Females, and individuals with low physical activity, reported poorer mental super-dimension scores. Physical super-dimension scores were lower for overweight individuals and individuals with either a chronic pain or smoking history (p < .01). Similar results were identified for overall AQoL8D utility. Workability was associated with AQoL-8D utility and both super-dimension scores (p < .001). Physical super-dimension scores were negatively correlated with BMI, waist circumference and weight (p < .001), and positively with 6-minute walking distance, timed up and down stairs, chair stand, and balance scores (p < .001). Conclusion: In this sample of 1000 healthy individuals, overall HRQOL was poorer for females, individuals with low physical activity levels and individuals with chronic pain. The physical element of HRQOL was affected by age, BMI, chronic pain, smoking history and lower limb function, while the mental element of HRQOL was affected by gender and physical activity level. Implications: Comprehensive normative data are necessary for clinical, research and policy decision-making. The 1000 Norms Project is developing crucial health-related quality of life reference data including PROs and physical function, which will be freely available. Funding Acknowledgements: This Project is supported by the National Health and Medical Research Council of Australia (NHMRC, #1031893), Intersect Australia Research Data Storage and Australian Podiatry Education & Research Fund, Australasian Podiatry Council. Ethics Approval: The study is approved by The University of Sydney Human Research Ethics Committee (no:2013/640) Disclosure of Interest: None Declared Keywords: Normative, Patient-reported outcomes, Reference values Health promotion/Public health PO1-AP-003 ABILITY TO PASS MOVEMENT CONTROL TESTS e DIFFERENCES BETWEEN MEN AND WOMEN U. Aasa, B. Aasa*. Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden * Corresponding author.
Background: Standardized movement control tests are often used by physiotherapists. The tests are used to identify the pattern of movement and symtoms that characterize a persons's relevant lumbar directional tendency. In cross-sectional studies using tests of movement control, it has been suggested that the performance is different in people with and without pain in the low back region. Purpose: The aim of the study was to investigate the performance in two movement control tests in a representative sample of middle-aged men and women in the general population. A secondary aim was to investigate whether the performance was different in men and women with and without pain in the low back region. Methods: This is a study with a longitudinal design. We have followed a randomly selected cohort of 429 adolescents that was recruited in 1974 (baseline), when they were 16 years old. The participants completed physical fitness tests at 16, 34 and 52 years of age and questions about musculoskeletal pain at 34 and 52 years of age. At the age of 52 years, they also performed the Waiter's Bow and the Supine double leg lower test. These are two commonly used tests of movement control in the lumbopelvic area. The Waiter's Bow evaluates the ability to control flexion movements in the lumbar spine while bending the hips, and the Supine double leg lower test evaluates the ability to control extension while extending the hips. Results: A higher percentage of the participants were able to perform the Waiter's Bow (men 43% and women 64%) than the Supine double leg lower test (Men 19% and women 29%) correctly. Significantly more women than men (p ¼ 0.003) were able to control flexion movements in the lumbar spine during the Waiter's bow.