hypothesis that a sub-group of subjects with low back pain (LBP) will use end range movements of the lumbar spine more routinely and have increased loading on soft issues. The poor motor program is considered the underlying mechanism, however this does not consider why the central nervous system (CNS) chooses to move the lumbar spine differently in LBP, presumably in a manner that increases soft tissue loading and may aggravate symptoms. Purpose: The purpose of this paper was to systematically review the literature to identify variables in non LBP groups that may produce or be assocaited with altered lumbar spine movement compared to hip during trunk flexion tasks. Methods: A literature search was performed using Medline , EMBASE, PsychINFO, Cinahl, Amed, and Scopus . The free text words: ‘trunk flexion, lumbar flexion, hip flexion, lifting, bending, reaching, lumbo-pelvic rhythm, were used separately and thereafter in combination with AND the free text words: ‘age, gender, fatigue, proprioception, relative flexibility, hamstring tightness'. The inclusion criteria was: analysis of lumbar and hip movement during trunk flexion tasks. The exclusion criteria was any subjects with LBP. Secondary methods: the relevant articles from reference lists of the final articles were retrieved and similar articles suggested by the search engines were reviewed. The papers were then subdivided into prospective and cross sectional and the potential mechanisms sub- grouped. A previously published critical appraisal tool for assessing risk of bias was adapted for this study. The tool score was divided into 'low', 'medium' and 'high' risk of bias by dividing the total score by three. The final papers were reviewed independently by two reviewers. Any disagreement that influenced the final results was resolved by discussion. Results: The combined initial search identified 6548 papers. After the removal of duplicate and non relevant articles, 116 papers remained. Another 37 articles were obtained through the secondary methods and 25 remained after reviewing the methods of these papers. Of these, 14 were prospective and 11 were cross sectional. Prospectively, stress, fatigue, vi- bration, and changing the starting position may alter trunk flexion tasks so that there is lumbar than hip movement during the task or a portion of the task. There was a medium risk of bias in all studies. From cross sectional research, hamstring tightness, over 60 years of age, habitual activities in trunk flexion tasks, obesity, whole body vibration in sitting and neuro- developmental disorders are associated with altered lumbo-pelvic flexion as above. There was a high risk of bias in the latter three variables and a medium risk of bias in the others. Conclusion: In subjects without LBP, 11 variables were found (4 pro- spective; 7 cross sectional) which may alter lumbo-pelvic rhythm and be involved in the etiology of this sub-group of LBP. Future work should aim to monitor the cross sectional variables in a prospective manner and test these variables with more specifically targeted clinical interventions. Implications: Current schools of thought regarding interventions recommend cognitively altering movement patterns and integrating into function. Here, the intervention is similar regardless of the mechanism of altered movement. This review highlights the need for further sub-clas- sification of the individual mechanisms. Potential mechanisms can be obtained from subjective histories and physical assessments and the mechanisms targeted using interventions available in the literature. Funding acknowledgements: There was no funding. Ethics approval: Ethics approval was not required. Disclosure of interest: None declared. Keywords: Lumbar flexion, Relative flexibility, Sub-classification Advanced assessment/practice and managing complex patients RA-LS-032 REGIONAL VARIATION WITHIN THE LUMBAR SPINE DURING SIT TO STAND IN PATIENTS WITH CHRONIC LOW BACK PAIN: A CASE- CONTROL STUDY G. Christe 1, * , L. Redhead 2 , B. Jolles-Haeberli 3 , J. Favre 4 . 1 Physiotherapy, HESAV, Lausanne, Switzerland; 2 School of Health Sciences, University of Brighton, Eastbourne, United Kingdom; 3 Orthopedics and Traumatology Department, Switzerland; 4 Swiss BioMotion Lab, CHUV-UNIL, Lausanne, Switzerland * Corresponding author. Background: In patients with chronic low back pain (CLBP), measurement of spinal kinematics could improve decision making by assessing function rather than pathoanatomy. Previous research demonstrated various ki- nematics deficits associated with CLBP, such as decreased spinal range of motion. Most of the research has been conducted with biomechanical models assuming the lumbar portion of the spine as one segment. How- ever, recent studies showed regional differences within the lumbar spine during sit to stand (STS) in asymptomatic individuals, suggesting that biomechanical models should account for the mobility within the lumbar spine. Currently, there is a paucity of data using multi-segment lumbar spine model in patients with CLBP. Purpose: To compare the lower-lumbar (LLS), upper-lumbar (ULS) and lower-thoracic (LTS) spinal kinematics during STS between asymptomatic and CLBP individuals. Methods: A case-controlled study was performed on 11 patients with non- specific CLBP (without leg pain and with minimal to moderate disability) and 10 pain-free individuals matched for age, sex and BMI (57% male; 37.7±5.9 years old; 22.3±2.7 kg/m 2 ). STS kinematics was collected in a laboratory with a three dimensional camera-based system (VICON, UK) using a previously validated biomechanical model. Mann-Whitney tests were performed to compare peak flexion and peak extension angles be- tween groups. Results: Measurement reliability was high with median ICC of 0.86 (interquartile range (IQR) 0.81-0.92) and median standard error of mea- surement of 2.02  (IQR 1.53-2.50). The experiment showed that median peak flexion (first phase of STS) was larger at the ULS in the control group (-22.38  [IQR -28.69 to -17.71]) than in the patient group (9.12  [IQR 24.4 to 5.8]; p ¼ 0.04). In addition, median peak extension (last phase of STS) was higher in the control group at the LLS (3.47  [IQR 1.0 to 9.2] vs. 0.60  [IQR -2.3 to 1.34]; p ¼ 0.01). No differences between groups were found at the LTS. Conclusion: This study suggested that patients with CLBP tended to restrict the movement of the lumbar spine during STS, with obvious regional differences compared to asymptomatic individuals. Particularly, they seemed to have less capacity to move from a flexed position to an extension position at the LLS, whereas they demonstrated a decrease in peak flexion at the ULS. Further research with larger sample size is necessary to evaluate the role of regional lumbar kinematics in the development and persistence of CLBP. Implications: This study suggested that clinicians should consider regional differences within the lumbar spine when assessing or treating movement deficits in patients with CLBP during functional activities. Funding acknowledgements: The study was not funded. Ethics approval: The research was approved by the Human Research Ethics Committee of the Canton of Vaud (CER-VD). Disclosure of interest: None declared. Keywords: Chronic low back pain, Kinematics, Sit to stand Advanced assessment/practice and managing complex patients RA-LS-033 DIAGNOSTIC UTILITY OF PATIENT EXAMINATION DATA TO DIAGNOSE FACET JOINT PAIN: A SYSTEMATIC REVIEW R. Smith * , L. Grodahl, M. Nazareth, A. Rushton, N. Heneghan. * Corresponding author. Background: The facet joint has been implicated as the pain source in up to 45% of individuals with low back pain (LBP). With recurrence of LBP between 24-80% within a year, effective diagnosis and management of facet joint pain (FJP) is essential. Additionally, recent research has provided new insights regarding the efficacy of anaesthetic facet joint blocks, which are considered the gold standard for the diagnosis of FJP. An evidence synthesis is required to establish the diagnostic accuracy of clinical ex- amination findings for FJP, where rigorous application of the reference standard has been utilised. Purpose: To provide a current evidence synthesis which draws on contemporary research to inform practice, identifying key components of the patient history and physical examination that can be used to assist clinical diagnosis. Abstracts / Musculoskeletal Science and Practice 28 (2017) e3ee27 e17