Clinical Prediction Rule Of Flynn | Lumbar Manipulation Success

Following items from patient history indicate a positive finding:

  1. No symptoms distal to the knee
  2. Recent onset of symptoms (<16 days)
  3. Low FABQW score (<19)
  4. Hypomobility of lumbar spine
  5. Hip internal rotation ROM>35° of at least 1 hip

 

Positive Outcome: 3 or more positive items to increase the chance of success with a lumbar manipulation (see detailed positive likelihood ratios below)

Study Reliability Sn Sp LR+ LR-
Flynn et al. (2002): 3+/5 positive signs NA 94 64 2.61 0.09
Flynn et al. (2002): 4+/5 positive signs NA 63 97 24.38 0.38
Flynn et al. (2002): 5/5 positive signs NA 19 100 0.81