Execution
- 1Check whether the patient is younger than 40 years.
- 2Perform SLR and record whether range is greater than 91°.
- 3Observe active lumbar motion for aberrant movement.
- 4Record whether FABQ work subscale score is less than 9.
- 5Perform the prone instability test and count the number of positive predictors.
Positive outcome
The rule is positive when four or more of the five predictors are present. A positive rule predicts higher likelihood of success with a lumbar stabilization exercise program. It is not a diagnostic test for radiographic instability.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Hicks et al. (2005) — CPR derivation | NA | NA | NA | 4.0 | NA |
| Rabin et al. (2014) — short-term success CPR study | NA | NA | NA | NA | NA |
CommentHicks CPR is a treatment-prediction rule for stabilization exercise response. The original rule reported a large change in success probability when four or more criteria were present, but it was preliminary and should be applied only to similar low back pain populations. The prone instability test is one criterion, not the whole rule.
High Clinical Value