Responsiveness of the Bridge maneuvers in subjects with Symptomatic Lumbar Spondylolisthesis: A prospective cohort Study

Background and Purpose: To date no study was made on the responsiveness of Bridge tests (BTs) in subjects with Low Back Pain and Spondylolisthesis (SPL) submitted to a physical therapy program. The objective of this study is to examine the responsiveness of the BTs in subjects with symptomatic lumbar SPL. Methods: 120 Patients with symptomatic SPL received physical therapy treatments for a number of sessions depending on the individual patient’s needs. Each session included supervised exercises and the teaching of home exercises aiming to improve the lumbar stability, for about one hour in total. At the beginning and immediately after the last session of treatment, participants completed the Oswestry Disability Index – Italian version (ODI-I) and the Pain Numerical Rating Scale (NRS), and performed the supine bridging (SBT) and the prone bridging (PBT). The global perception of effectiveness was measured with a 7-point Likert scale Global Perceived Effect Questionnaire. Results: The mean post-treatment change score (95% CI) was 18.2s (14.5; 21.9) for the PBT and 43.9s (35.1; 52.8) for the SBT, all P<0.001. The area under the ROC curve for the PBT was 0.83 (95% CI 0.74–0.91) and for the SBT was 0.703 (95% CI 0.61-0.80). The optimal cutoff points were 19.5s for the PBT and 62.5s for the SBT. Logistic regression revealed that PBT (OR=0.952) was associated with the type of SPL. The final regression model explained 36.4% (R2=0.36; p=0.001) of the variability. Discussion: Bridge maneuvers proved to be responsive, since their results were significantly related to pain and disability changes. BTs may be suggested to detect clinical changes after physical therapy treatment in symptomatic SPL.