Manual Therapy, Posturology & Rehabilitation Journal
Manual Therapy, Posturology & Rehabilitation Journal
Research Article

Accuracy of motor tests related to musculoskeletal fitness as predictors of low back pain in adolescents: a pilot study

Oliveira, Raphael Gonçalves de; Oliveira, Rodrigo Franco de; Remonte, Anne Karoline; Garcia, Sandy Caroline; Sczepanski, Cláudia Roberta Brunnquell; Menossi, Berlis Ribeiro dos Santos; Santos, Claudinei Ferreira dos; Martini, Fábio Antônio Néia; Lirani, Luciana da Silva; Oliveira, Laís Campos de


Background: The prevalence of low back pain in adolescents is close to that found in the adult population. In view of the relationship between low back pain and the resistance of the spine stabilizing muscles, studies have sought to identify the ability of specific motor tests to predict this condition. Objectives: Our objective was to verify the predictive ability of three motor tests related to musculoskeletal fitness to identify adolescents with low back pain. Methods: The sample consisted of 150 adolescents, of both sexes, aged between 15 and 19 years. The Nordic questionnaire validated for Brazilian adolescents was applied to identify those with low back pain. Subsequently, three motor tests (one-minute sit-up test, Sorensen test and lateral plank test) were applied. Statistical analysis involved the ROC curve, to identify the Area Under the Curve (AUC), assuming a 95% confidence interval. Results: It was observed in males that all the tests had a low AUC (between 0.56 and 0.57), without statistical significance (p > 0.05). For females, AUC ranged from 0.62 to 0.66, with statistical significance (p < 0.05) for the cut-off points identified in the one-minute sit-up test (≤ 24 repetitions) and Sorensen test (≤ 28 seconds), however, without significance (p > 0.05) for the lateral plank test. Conclusion: Motor tests of abdominal and paravertebral muscle resistance were not predictors of low back pain in male adolescents. Despite the low accuracy, the cut-off points identified in the one-minute sit-up test and Sorensen test, can be used with some caution to predict low back pain in female adolescents.


Health Criteria, Diagnosis, Physical Fitness, Low Back Pain, Young People.


1. Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med 2007; 147: 478-491.

2. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum 2012; 64: 2028-2037.

3. Jeffries LJ, Milanese SF, Grimmer-Somers KA. Epidemiology of adolescent spinal pain: a systematic overview of the research literature. Spine 2007; 32: 2630-2637.

4. Moreno MA. Low back pain in children and adolescents. JAMA Pediatr 2017; 171: 312.

5. Hestbaek L, Leboeuf-Yde C, Kyvik KO, Manniche C. The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins. Spine (Phila Pa 1976) 2006; 31: 468-472.

6. Feldman DE, Shrier I, Rossignol M, Abenhaim L. Risk factors for the development of low back pain in adolescence. Am J Epidemiol 2001; 154: 30-36.

7. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2163-2196.

8. Allegri M, Montella S, Salici F, Valente A, Marchesini M, Compagnone C, et al. Mechanisms of low back pain: a guide for diagnosis and therapy. Version 2. F1000Res. 2016 [revised 2016 Oct 11]; 5. pii: F1000 Faculty Rev-1530.

9. Itz CJ, Ramaekers BL, Van Kleef M, Dirksen CD. Medical specialists care and hospital costs for low back pain in the Netherlands. Eur J Pain 2017; 21: 705-715.

10. MacDonald J, Stuart E, Rodenberg R. Musculoskeletal Low Back Pain in School-aged Children: A Review. JAMA Pediatr 2017; 171: 280-287.

11. Yang S, Werner BC, Singla A, Abel MF. Low Back Pain in Adolescents: A 1-Year Analysis of Eventual Diagnoses. J Pediatr Orthop 2017; 37: 344-347.

12. Alaranta H, Luoto S, Heliövaara M, Hurri H. Static back endurance and the risk of low-back pain. Clin Biomech 1995; 10: 323-324.

13. Salminen JJ, Erkintalo M, Laine M, Pentti J. Low back pain in the young. A prospective three-year follow-up study of subjects with and without low back pain. Spine (Phila Pa 1976) 1995; 20: 2101-2107.

14. Allen BA, Hannon JC, Burns RD, Williams SM. Effect of a core conditioning intervention on tests of trunk muscular endurance in school-aged children. J Strength Cond Res 2014; 28: 2063-2070.

15. Dorneles RCG, Oliveira HLR, Bergmann MLA, Bergmann GG. Flexibility and muscle strength/resistance indicators and screening of low back pain in adolescents. Rev Bras Cineantropom Desempenho Hum 2016; 18: 93-102.

16. Saint-Maurice PF, Welk GJ, Burns R, Plowman SA, Corbin CB, Hannon JC. The criterion-referenced validity of the FITNESSGRAM Trunk-Extension test. J Sports Med Phys Fitness 2015; 55: 1252-1263.

17. Committee on Fitness Measures and Health Outcomes in Youth; Food and Nutrition Board; Institute of Medicine. Fitness measures and health outcomes in youth. Pate R, Oria M, Pillsbury L. (Ed.). Washington (DC): National Academies Press; 2012.

18. Sjolie AN. Low-back pain in adolescents is associated with poor hip mobility and high body mass index. Scand J Med Sci Sports. 2004; 14: 168-175.

19. Sjölie AN. Psychosocial correlates of low-back pain in adolescents. Eur Spine J 2002; 11: 582-588.

20. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, et al. Standardised Nordic questionnaire for the analysis of musculoskeletal symptoms. Appl Ergon 1997; 18: 233-237.

21. Oliveira RG, Pires-Oliveira DAA, Oliveira LC, Remonte AK; Garcia SC, Araújo CC, et al. Translation, transcultural adaptation and validation of the Nordic questionnaire for the evaluation of low back pain in Brazilian adolescents. Man Ther Posturology Rehabil J 2017, 15: 505

22. Cox JM. Low Back Pain: Mechanism, Diagnosis, and Treatment. 6th ed. Philadelphia: Williams & Wilkins; 1999.

23. Fischer JE, Bachmann LM, Jaeschke R. A readers’ guide to the interpretation of diagnostic test properties: clinical example of sepsis. Intensive Care Med 2003; 29: 1043-1051.

24. Welk GJ, Saint-Maurice PF, Csányi T. Health-Related Physical Fitness in Hungarian Youth: Age, Sex, and Regional Profiles. Res Q Exerc Sport 2015;86 Suppl 1: S45-57.

25. Scarabottolo CC, Pinto RZ, Oliveira CB, Zanuto EF, Cardoso JR, Christofaro DGD. Back and neck pain prevalence and their association with physical inactivity domains in adolescents. Eur Spine J 2017 (In Press).

26. Bortolini A, Jaeger D, Siqueira O, Crescente L, Garlipp D. Associação entre dores nas costas, flexibilidade e força/resistência abdominal em crianças e adolescentes. Cinergis 2016; 17: 231-234.

27. Guddal MH, Stensland SØ, Småstuen MC, Johnsen MB, Zwart JA, Storheim K. Physical Activity Level and Sport Participation in Relation to Musculoskeletal Pain in a Population-Based Study of Adolescents: The Young-HUNT Study. Orthop J Sports Med 2017; 5: 2325967116685543.

28. Aartun E, Boyle E, Hartvigsen J, Ferreira PH, Maher CG, Ferreira ML, Hestbaek L. The most physically active Danish adolescents are at increased risk for developing spinal pain: a two-year prospective cohort study. BMJ Open Sport Exerc Med 2016; 2: e000097.

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