Ferrin K. Ruiz, B.A
The Spine Journal: Available online 8 November 2013: In Press

Abstract
Background Context
Lumbar pathology is often associated with axial pain or neurologic complaints. It is often presumed that such pain is associated with decreased lumbar motion; however, this correlation is not well established. The utility of various outcome measures that are used in both research and clinical practice have been studied, but the connection with range of motion has not been well documented.

Purpose
The current study was performed to objectively assess the postulated correlation of lumbar complaints (based on standardized outcome measures) with extremes of lumbar range of motion (ROM) and functional range of motion with activities of daily living (fROM) as assessed with an electrogoniometer.

Study Design/Setting
Clinical cohort study.

Patient Sample
Subjects slated to undergo a lumbar intervention (injection, decompression, and/or fusion) were voluntarily enrolled in the study.

Outcome Measures
Visual Analog Scale (VAS) for axial, lower extremity, and combined axial and lower extremity, as well as Oswestry-Disability Index (ODI).

Methods
Pain and disability scores were assessed with VAS and ODI. A previously validated electrogoniometer was used to measure ROM (extremes of motion in three planes) and fROM (functional motion during 15 simulated activities of daily living). Pain and disability scores were analyzed for statistically significant association with the motion assessments using linear regression analyses.

Results
28 males and 39 females were enrolled with an average age of 55.6 years (range 18-79). ODI and VAS were positively associated (p<0.001). Combined axial and lower extremity VAS was associated with lateral and rotational ROM (p<0.05), but not flexion/extension or any fROM. Similar findings were noted for separately analyzed axial and lower extremity VAS. On the other hand, ODI was inversely correlated with ROM in all planes and fROM in at least one plane for 10 of 15 ADLs (p<0.05).

Conclusions
Extremes of lumbar motion and motions associated with activity of daily living are of growing clinical interest. Even though ODI and VAS are associated with each other, ODI appears to be a better predictor of these motion parameters than VAS (axial, lower extremity, or combined) and may be more useful in the clinical setting when considering functional movement parameters.

Journal Abstract:  http://www.sciencedirect.com/science/article/pii/S1529943013016227