European Spine Journal

, Volume 18, Issue 7, pp 1041–1049 | Cite as

The value of physical performance tests for predicting therapy outcome in patients with subacute low back pain: a prospective cohort study

  • Babak Moradi
  • Julia Benedetti
  • Anita Zahlten-Hinguranage
  • Marcus Schiltenwolf
  • Eva Neubauer
Original Article


Considering the enormous costs of intensive multidisciplinary treatment, predictive tests for therapy outcome are needed to evaluate patients’ performance potential and increase cost effectiveness. Somatic parameters are commonly used to evaluate health status and serve as an additional means of forecasting the prognosis, yet little is known of their validity. In this study, we investigated the prognostic value of somatic parameters regarding the outcome of multidisciplinary treatment in patients with subacute low back pain. The study was designed as a prospective cohort study of 162 patients. Somatic parameters were assessed with three physical performance tests (Villiger test, Oesch test, Biering–Sørensen test) before treatment (T0), after 3 weeks’ inpatient therapy (T1) and at 6-month follow-up (T2). Psychometric characteristics of subjective pain perception (VAS), a pain disability index (PDI) and a physical capability index (FFbH-R) were recorded. Correlation coefficients between the physical performance test scores and psychometric characteristics were calculated. To predict therapy outcome, discriminant analyses were performed. A control group (n = 30) was evaluated at similar time points without receiving any therapy. Our results demonstrate good discrimination between patients and controls by means of the investigated performance tests and exhibit a significant negative correlation with the psychometric data. Lower outcome values at study entry correlated with higher pain intensity and disability after multidisciplinary treatment. However, the statistical magnitude of correlation was relatively low and further discriminant analysis did not reveal any predictive value. Consequently the physical performance tests do not have a prognostic value regarding therapy outcome.


Physical performance test Prognostic value Villiger test Oesch test Biering–Sørensen test 


Conflict of interest statement

No funds were received in support of this study. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Supplementary material

586_2009_965_Fig4_ESM.jpg (292 kb)

Oesch test. The patient lies in a supine position while holding two 3-kg weights with straight arms against gravity for 3 min. Early cessation is counted as a positive test

586_2009_965_Fig5_ESM.jpg (27 kb)

Villiger test. The patient is asked to step up and down a 30-cm-high step for 3 min, which requires four steps per cycle. We measured the number of steps and the duration. Early cessation is counted as a positive test


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Babak Moradi
    • 1
  • Julia Benedetti
    • 1
  • Anita Zahlten-Hinguranage
    • 2
  • Marcus Schiltenwolf
    • 1
  • Eva Neubauer
    • 1
  1. 1.Orthopaedic ClinicUniversity HeidelbergHeidelbergGermany
  2. 2.Department of Translational OncologyNational Center for Tumor Diseases (NCT)HeidelbergGermany

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