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Hubner FP, Ludwig AF, Barros MIG, Aragão FA, Carvalho ARD. Risk of unfavorable pain prognosis impacts walking physiomechanical parameters and psychophysiological workload in sufferers of chronic low back pain. J Bodyw Mov Ther 2024; 39:162-169. [PMID: 38876621 DOI: 10.1016/j.jbmt.2024.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 11/28/2023] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Tolerating physical tasks depends not only on task-specific characteristics but also on an individual's psychophysiological capacity to respond to the imposed load. People suffering from chronic low back pain (CLBP) may experience reduced psychophysiological capacity and are at risk for poor pain prognosis, which could lead to an increased walking workload. AIM To investigate how the risk of unfavorable pain prognosis in CLBP can impact walking physiomechanical parameters and psychophysiological workload. METHODS A cross-sectional observational study. The study classified 74 volunteers into four groups based on their prognosis for pain: pain-free control (CG/n = 20), low (LrG/n = 21), medium (MrG/n = 22), and high (HrG/n = 11) risk of poor prognosis for CLBP. The ground assessments identified the self-selected (SSW) and optimal (OWS) walking speeds, as well as the locomotor rehabilitation index (LRI). Treadmill assessments were conducted at two different speeds (0.83 and 1.11 m s-1, SSW and OWS) to record physiomechanical parameters. Psychophysiological workloads during walking were measured via workload impulse for the session (TRIMP), determined by variations in heart rate. RESULTS CLBP groups exhibited slower SSW and lower LRI compared to the CG. The TRIMP was lower in the LrG. However, both MrG and HrG exhibited a comparable overload to the CG, even while walking at a lower intensity with a psychophysical demand. SSW and OWS displayed an increased TRIMP compared to fixed speeds. CONCLUSION Psychosocial factors may affect SSW in people with CLBP but not among the risk strata. An unfavorable prognosis for pain could jeopardize the psychophysiological capacity to withstand walking demands.
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Affiliation(s)
- Fernanda Peron Hubner
- Integrative Biodynamics Evaluation Laboratory, Western Paraná State University (Universidade Estadual do Oeste do Paraná - UNIOESTE), Cascavel, PR, Brazil
| | - André Franco Ludwig
- Integrative Biodynamics Evaluation Laboratory, Western Paraná State University (Universidade Estadual do Oeste do Paraná - UNIOESTE), Cascavel, PR, Brazil
| | - Márcia Izabeli Guimarães Barros
- Integrative Biodynamics Evaluation Laboratory, Western Paraná State University (Universidade Estadual do Oeste do Paraná - UNIOESTE), Cascavel, PR, Brazil
| | - Fernando Amâncio Aragão
- Human Movement Search Laboratory, Western Paraná State University (Universidade Estadual do Oeste do Paraná - UNIOESTE), Cascavel, PR, Brazil
| | - Alberito Rodrigo de Carvalho
- Integrative Biodynamics Evaluation Laboratory, Western Paraná State University (Universidade Estadual do Oeste do Paraná - UNIOESTE), Cascavel, PR, Brazil; Biosciences and Health Program, Western Paraná State University (Universidade Estadual do Oeste do Paraná - UNIOESTE), Cascavel, PR, Brazil.
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Santos A, Silva MF, Dos Santos EH, Tassiana Silva C, Obara K, Bonilha Oda S, Carrasco AC, Cardoso JR. Gait analysis of individuals with specific low back pain undergoing surgery: case series report with one and six-month follow-up. Physiother Theory Pract 2024; 40:1635-1645. [PMID: 36892481 DOI: 10.1080/09593985.2023.2187267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 03/10/2023]
Abstract
INTRODUCTION In addition to pain, specific low back pain is frequently accompanied by restricted range of motion (ROM) during gait. PURPOSE To compare the behavior of kinematic and spatiotemporal gait parameters, pain, functional status, and self-efficacy, in patients with a diagnosis of herniated disk or lumbar stenosis undergoing surgery, in the pre- and postoperative periods of 1 and 6 months (PO6). METHODS Seven participants and 11 control subjects were assessed. A kinematics system comprising 10 optoelectronic cameras was used to assess gait. The Roland-Morris questionnaire, pain intensity, and self-efficacy, over three periods, were used. RESULTS The ROM of the pelvis, hip, and knee of the hernia group presented an increase after surgery and the stenosis group presented a reduction of values in the hip. During the stance phase, the pelvis and hip ROM of both groups remained smaller than the control group. There was improvement in pain in individuals with hernia and stenosis (effect size = 0.6 and 0.8, respectively) in the three analyzed moments; for functional status there was improvement in the first postoperative period (ES = 0.4) compared to the preoperative in those individuals with hernia; and those with stenosis had improvement at PO6 when compared to the time before the surgery (ES = 0.2). CONCLUSION Surgical intervention modifies the spatiotemporal parameters, the ROM of the pelvis, hip, and knee in the total gait cycle, primarily in the sagittal plane, and causes alterations, particularly in the hip joint, in these individuals during the support phase.
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Affiliation(s)
- Amanda Santos
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Mariana Felipe Silva
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Eduarda Hirle Dos Santos
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Carla Tassiana Silva
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Karen Obara
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Shigueo Bonilha Oda
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Aline Cristina Carrasco
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil
- PT Department, Universidade Estadual do Centro-Oeste, Guarapuava, PR, Brazil
| | - Jefferson Rosa Cardoso
- Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group, Universidade Estadual de Londrina, Londrina, PR, Brazil
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Drozda D, Thompson Z, Vincent KR, Nixon RM, Bolling J, Vincent HK. Gait signatures of endurance runners with low back pain: A case controlled cross sectional study. Gait Posture 2024; 113:184-190. [PMID: 38905854 DOI: 10.1016/j.gaitpost.2024.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 05/30/2024] [Accepted: 06/17/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Low back pain (LBP) is an understudied condition among runners, and it is unclear what biomechanical features could be targeted for gait retraining to mitigate pain. RESEARCH QUESTION How do running biomechanics differ between healthy individuals and those with running-related LBP? METHODS This was a case-controlled, comparative study design of community runners: running-related LBP (n=52) and healthy controls (n=52). All runners completed running history forms and performed a 3-dimensional gait analysis. Kinematic data were collected using a motion capture system and normalized to a gait cycle, while participants ran on a level grade at self-selected speed on an instrumented treadmill. Current running volume, temporal-spatial, kinetic and kinematic features were compared between groups. RESULTS The LBP group had 39.5 % lower weekly distance and 15.4 % fewer were currently training for a race (all p<.05). Runners with LBP demonstrated lower cadence (166±10 step/min vs. 171±9 step/min; p=.05), greater center of gravity lateral displacement (1.4±0.5 cm vs. 1.2 ±.3 cm; p=.044) and greater stride width variability (1.3±0.4 cm versus 1.0 ± 0.04 cm; p=.008). Runners with LBP had a greater Vertical Average Loading Rate ([VALR] 67.7±22.2 bodyweights [BW]/s vs. 62.2±21.5 BW/s; p=.022), and higher joint moments (N*m/(kg*m)) at the knee in the sagittal plane (2.13±0.50 vs. 1.87±0.56; p <.001), frontal plane (1.44±0.39 vs. 1.29±0.29; p=.013), and at the hip in the frontal plane (2.04±0.51 vs. 1.84±0.41; p=.024). No differences were found between groups in the pelvis, hip, knee, and ankle joint excursions in any plane of motion during a typical gait cycle. SIGNIFICANCE These collective motion signature may reflect challenges with control of motion and VALR in the presence of back pain. Cadence training to increase step rate, coupled with core/hip muscle activation, may be an important strategy to reduce motion variability, impact loading rate and pain symptoms while running.
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Affiliation(s)
- David Drozda
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Zane Thompson
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Kevin R Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Ryan M Nixon
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Jamie Bolling
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, United States.
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Zhang Z, Zou J, Lu P, Hu J, Cai Y, Xiao C, Li G, Zeng Q, Zheng M, Huang G. Analysis of lumbar spine loading during walking in patients with chronic low back pain and healthy controls: An OpenSim-Based study. Front Bioeng Biotechnol 2024; 12:1377767. [PMID: 38817923 PMCID: PMC11138492 DOI: 10.3389/fbioe.2024.1377767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/30/2024] [Indexed: 06/01/2024] Open
Abstract
Low back pain (LBP) is one of the most prevalent and disabling disease worldwide. However, the specific biomechanical changes due to LBP are still controversial. The purpose of this study was to estimate the lumbar and lower limb kinematics, lumbar moments and loads, muscle forces and activation during walking in healthy adults and LBP. A total of 18 healthy controls and 19 patients with chronic LBP were tested for walking at a comfortable speed. The kinematic and dynamic data of the subjects were collected by 3D motion capture system and force plates respectively, and then the motion simulation was performed by OpenSim. The OpenSim musculoskeletal model was used to calculate lumbar, hip, knee and ankle joint angle variations, lumbar moments and loads, muscle forces and activation of eight major lumbar muscles. In our results, significant lower lumbar axial rotation angle, lumbar flexion/extension and axial rotation moments, as well as the muscle forces of the four muscles and muscle activation of two muscles were found in patients with LBP than those of the healthy controls (p < 0.05). This study may help providing theoretical support for the evaluation and rehabilitation treatment intervention of patients with LBP.
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Affiliation(s)
- Zhuodong Zhang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Jihua Zou
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
- Department of Rehabilitation Studies, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Pengcheng Lu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jinjing Hu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Yuxin Cai
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Chongwu Xiao
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Gege Li
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Qing Zeng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Manxu Zheng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - GuoZhi Huang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
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Liu R, Qian D, Chen Y, Zou J, Zheng S, Bai B, Lin Z, Zhang Y, Chen Y. Investigation of normal knees kinematics in walking and running at different speeds using a portable motion analysis system. Sports Biomech 2024; 23:417-430. [PMID: 33586617 DOI: 10.1080/14763141.2020.1864015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Walking and running at different speeds are common in daily life. This study investigated 6 degrees of freedom (DOF) kinematics of normal knees of Chinese during walking and running. Forty healthy participants were investigated in 4 conditions: comfortable walking, normal walking, slow running and ordinary running. The range of motion (ROM) and peak values in 6 DOF kinematics were analysed. As the speed increased, a general increase in flexion, lateral and proximal translations occurred. Significant increases of ROM in flexion/extension, axial rotation and medial/lateral translations were observed. The ROM of adduction/abduction, anterior/posterior and proximal/distal translations were greatest during normal walking. The maximum and minimum flexion/extension, maximum internal rotation and tibial lateral translations increased with the increase of speed. The maximum and minimum tibial proximal translations in running were found being greater than walking. A phenomenon between walking and running was observed: both tibial proximal/distal and medial/lateral translations increased when changed from walking to running. Non-linear transition exists in 6 DOF kinematics during walking to running. Discoveries in this study may have potential clinical values to serve as references of normal walking and running in the management of knee injury and knee rehabilitation.
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Affiliation(s)
- Rixu Liu
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou, China
- Institute of Orthopaedic Diseases, Jinan University, Guangzhou, China
| | - Dongyang Qian
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou, China
| | - Yushu Chen
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou, China
| | - Jianyu Zou
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou, China
| | - Shicong Zheng
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou, China
| | - Bo Bai
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou, China
| | - Zefeng Lin
- Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou, China
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China
| | - Yu Zhang
- Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou, China
- Department of Orthopaedic Surgery, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China
| | - Yi Chen
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangdong Key Laboratory of Orthopaedic Technology and Implant Materials, Guangzhou, China
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Kendell M, Smith A, O'Sullivan P, Beales D, Chan J, Li KM, McMullan M, Smith K, Rabey M. How do people with chronic low back pain pick a pencil off the floor? Physiother Theory Pract 2024; 40:576-593. [PMID: 36066194 DOI: 10.1080/09593985.2022.2120374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Picking objects off the floor is provocative for people with chronic low back pain (CLBP). There are no clinically applicable methods evaluating movement strategies for this task. The relationship between strategy and multidimensional profiles is unknown. OBJECTIVE Develop a movement evaluation tool (MET) to examine movement strategies in people with CLBP (n = 289) picking a pencil off the floor. Describe those movement strategies, and determine reliability of the MET. Explore differences across multidimensional profiles and movement strategies. METHODS An MET was developed using literature and iterative processes, and its inter-rater agreement determined. Latent class analysis (LCA) derived classes demonstrating different strategies using six movement parameters as indicator variables. Differences between classes across multidimensional profiles were investigated using analysis of variance, Kruskal-Wallis, or chi-squared tests. RESULTS Six movement parameters were evaluated. There was substantial inter-rater agreement (Cohen's Kappa = 0.39-0.79) across parameters. LCA derived three classes with different strategies: Class 1 (71.8%) intermediate trunk inclination/knee flexion; Class 2 (24.5%) greater forward trunk inclination, lower knee flexion; Class 3 (3.7%) lower forward trunk inclination, greater knee flexion. Pain duration differed across all classes (p ≤ .001). Time taken to complete forward bends differed between Class 3 and other classes (p = .024). CONCLUSIONS Movement strategies can be reliably assessed using the MET. Three strategies for picking lightweight objects off the floor were derived, which differed across pain duration and speed of movement.
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Affiliation(s)
- Michelle Kendell
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Anne Smith
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Peter O'Sullivan
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Darren Beales
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Jonathan Chan
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Kun Man Li
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Matthew McMullan
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Kelby Smith
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Martin Rabey
- Curtin enAble Institute, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
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García-Luna MA, Jimenez-Olmedo JM, Pueo B, Manchado C, Cortell-Tormo JM. Concurrent Validity of the Ergotex Device for Measuring Low Back Posture. Bioengineering (Basel) 2024; 11:98. [PMID: 38275578 PMCID: PMC10812927 DOI: 10.3390/bioengineering11010098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Highlighting the crucial role of monitoring and quantifying lumbopelvic rhythm for spinal curvature, the Ergotex IMU, a portable, lightweight, cost-effective, and energy-efficient technology, has been specifically designed for the pelvic and lumbar area. This study investigates the concurrent validity of the Ergotex device in measuring sagittal pelvic tilt angle. We utilized an observational, repeated measures design with healthy adult males (mean age: 39.3 ± 7.6 y, body mass: 82.2 ± 13.0 kg, body height: 179 ± 8 cm), comparing Ergotex with a 3D optical tracking system. Participants performed pelvic tilt movements in anterior, neutral, and posterior conditions. Statistical analysis included paired samples t-tests, Bland-Altman plots, and regression analysis. The findings show minimal systematic error (0.08° overall) and high agreement between the Ergotex and optical tracking, with most data points falling within limits of agreement of Bland-Altman plots (around ±2°). Significant differences were observed only in the anterior condition (0.35°, p < 0.05), with trivial effect sizes (ES = 0.08), indicating that these differences may not be clinically meaningful. The high Pearson's correlation coefficients across conditions underscore a robust linear relationship between devices (r > 0.9 for all conditions). Regression analysis showed a standard error of estimate (SEE) of 1.1° with small effect (standardized SEE < 0.26 for all conditions), meaning that the expected average deviation from the true value is around 1°. These findings validate the Ergotex as an effective, portable, and cost-efficient tool for assessing sagittal pelvic tilt, with practical implications in clinical and sports settings where traditional methods might be impractical or costly.
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Affiliation(s)
- Marco A. García-Luna
- Health, Physical Activity, and Sports Technology Research Group, Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain; (M.A.G.-L.); (B.P.), (J.M.C.-T.)
| | - Jose M. Jimenez-Olmedo
- Health, Physical Activity, and Sports Technology Research Group, Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain; (M.A.G.-L.); (B.P.), (J.M.C.-T.)
| | - Basilio Pueo
- Health, Physical Activity, and Sports Technology Research Group, Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain; (M.A.G.-L.); (B.P.), (J.M.C.-T.)
| | - Carmen Manchado
- Sports Coaching and Performance Research Group, Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain;
| | - Juan M. Cortell-Tormo
- Health, Physical Activity, and Sports Technology Research Group, Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain; (M.A.G.-L.); (B.P.), (J.M.C.-T.)
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Zhu C, Luo L, Li R, Guo J, Wang Q. Wearable Motion Analysis System for Thoracic Spine Mobility With Inertial Sensors. IEEE Trans Neural Syst Rehabil Eng 2024; 32:1884-1895. [PMID: 38753470 DOI: 10.1109/tnsre.2024.3384926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
This study presents a wireless wearable portable system designed for the automatic quantitative spatio-temporal analysis of continuous thoracic spine motion across various planes and degrees of freedom (DOF). This includes automatic motion segmentation, computation of the range of motion (ROM) for six distinct thoracic spine movements across three planes, tracking of motion completion cycles, and visualization of both primary and coupled thoracic spine motions. To validate the system, this study employed an Inter-days experimental setting to conduct experiments involving a total of 957 thoracic spine movements, with participation from two representatives of varying age and gender. The reliability of the proposed system was assessed using the Intraclass Correlation Coefficient (ICC) and Standard Error of Measurement (SEM). The experimental results demonstrated strong ICC values for various thoracic spine movements across different planes, ranging from 0.774 to 0.918, with an average of 0.85. The SEM values ranged from 0.64° to 4.03°, with an average of 1.93°. Additionally, we successfully conducted an assessment of thoracic spine mobility in a stroke rehabilitation patient using the system. This illustrates the feasibility of the system for actively analyzing thoracic spine mobility, offering an effective technological means for non-invasive research on thoracic spine activity during continuous movement states.
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Yousufy U, Chimera NJ. Is There an Association Between Injury History and Lower Extremity Joint Injury During Canada Games Competition? Int J Sports Phys Ther 2023; 18:1308-1319. [PMID: 38050547 PMCID: PMC10693481 DOI: 10.26603/001c.89273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/12/2023] [Indexed: 12/06/2023] Open
Abstract
Background Injuries during elite level competition like the Canada Games, occur frequently and injury history is one of the strongest predictors of future injury; however, this association is unknown in the Canada Games. Purpose To determine the association between injury history and incidence of lower extremity joint injury during Canada Games competition. Methods Data from the 2009 - 2019 Canada Games (8710 male and 8391 female athletes) competitions were de-identified by the Canada Games Council for analysis. Injury data were cleaned and categorized for previous injury and injury type and location. Injury history was self-reported and included concussion, major surgical procedure, neck and back, trauma to joint or bone, and trauma to ligament or tendon. Injury from the Canada Games competitions were categorized to include ankle, knee, hip, and patellofemoral joint injuries. Chi-Square (χ2 ) test of independence determined association between injury history and incidence of lower extremity joint injury during Canada Games competition. IBM SPSS (Version 26) was used for statistical analysis (p-value < 0.05). Results Four hundred and seventy-five ankle, 503 knee, 253 hip, and 106 patellofemoral joint injuries were reported during 10 years of Canada Games competitions. There were significant associations between history of neck and back injuries with ankle injuries and knee injuries, history of trauma and overuse of ligament or tendon with hip injuries and history of trauma or overuse of joint or bone with patellofemoral joint injuries. Conclusion These findings support previous literature suggesting that injury history is associated with future injury. Level of Evidence 3.
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Affiliation(s)
- Umar Yousufy
- Faculty of Applied Health Science Brock University
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Moissenet F, Armand S, Genevay S. Measurement properties of 72 movement biomarkers aiming to discriminate non‑specific chronic low back pain patients from an asymptomatic population. Sci Rep 2023; 13:6483. [PMID: 37081110 PMCID: PMC10119171 DOI: 10.1038/s41598-023-33504-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 04/13/2023] [Indexed: 04/22/2023] Open
Abstract
The identification of relevant and valid biomarkers to distinguish patients with non-specific chronic low back pain (NSCLBP) from an asymptomatic population in terms of musculoskeletal factors could contribute to patient follow-up and to evaluate therapeutic strategies. Several parameters related to movement impairments have been proposed in the literature in that respect. However, most of them were assessed in only one study, and only 8% were evaluated in terms of reliability, validity and interpretability. The aim of this study was to consolidate the current knowledge about movement biomarkers to discriminate NSCLBP patients from an asymptomatic population. For that, an experimental protocol was established to assess the reliability, validity and interpretability of a set of 72 movement biomarkers on 30 asymptomatic participants and 30 NSCLBP patients. Correlations between the biomarkers and common patient reported outcome measures were also analysed. Four biomarkers reached at least a good level in reliability (ICC ≥ 0.75) and validity (significant difference between asymptomatic participants and NSCLBP patients, p ≤ 0.01) domains and could thus be possibly considered as valuable biomarkers: maximal lumbar sagittal angle, lumbar sagittal angle range of motion, mean lumbar sagittal angular velocity, and maximal upper lumbar sagittal angle during trunk sagittal bending. These four biomarkers demonstrated typically larger values in asymptomatic participants than in NSCLBP patients. They are in general weakly correlated with patient reported outcome measures, arguing for a potential interest in including related musculoskeletal factors in the establishment of a valuable diagnosis and in guiding treatment response.
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Affiliation(s)
- Florent Moissenet
- Kinesiology Laboratory, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
| | - Stéphane Armand
- Kinesiology Laboratory, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Stéphane Genevay
- Department of Rheumatology, Geneva University Hospitals, Geneva, Switzerland
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Lin J, Halaki M, Leaver A. Limited evidence of altered gait parameters in people with chronic nonspecific low back pain. Gait Posture 2023; 99:98-103. [PMID: 36368242 DOI: 10.1016/j.gaitpost.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 10/29/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Differences in gait parameters have been shown between people with and without low back pain (LBP). However, previous studies did not well control factors such as sex, age, height and walking speed known to influence gait parameters. RESEARCH QUESTION Is gait altered in people with LBP when sex, age, height and walking speed are controlled? METHODS A series of gait parameters were measured in 16 participants with LBP and 16 age, sex and height matched healthy controls while walking on an instrumented treadmill. LBP group walked at a comfortable speed whilst control group walked at their own comfortable speed and at the comfortable speed of their matched participants with LBP. Pain and disability were measured for the LBP group. The between-group differences in mean, standard deviation (SD) and coefficient of variation (CV) of gait parameters were tested using paired samples t-test, Wilcoxon signed-rank test or two-factor repeated measures analyses of variance. RESULTS The median (interquartile range) of pain intensity was 2 (1, 3.5). From 102 tests of between-group difference in mean, SD and CV of 17 gait parameters at both comfortable speed and matched speed walking, only the mean of stride length (p = 0.037) during matched speed walking and SD of single support phase (p = 0.040) during comfortable speed walking showed significant between-group differences. There was no significant between-group difference in the rest means (comfortable walking: p ≥ 0.116; matched speed walking: p ≥ 0.069), SDs (comfortable walking: p ≥ 0.066; matched speed walking: p ≥ 0.098) and CVs of gait parameters (comfortable walking: p ≥ 0.110; matched speed walking: p ≥ 0.121). SIGNIFICANCE The lack of significant between-group difference in gait parameters may suggest that the gait of people with low level of LBP were not altered when sex, age and height were controlled.
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Affiliation(s)
- Jianhua Lin
- Department of Rehabilitation Therapy, YangZhi Rehabilitation Hospital, Tongji University, Shanghai, China; Sydney School of Health Sciences, The University of Sydney, New South Wales, Australia.
| | - Mark Halaki
- Sydney School of Health Sciences, The University of Sydney, New South Wales, Australia
| | - Andrew Leaver
- Sydney School of Health Sciences, The University of Sydney, New South Wales, Australia
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Abd Rahman NA, Li S, Schmid S, Shaharudin S. Biomechanical factors associated with non-specific low back pain in adults: A systematic review. Phys Ther Sport 2023; 59:60-72. [PMID: 36516512 DOI: 10.1016/j.ptsp.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Low back pain (LBP) can result in increased direct medical and non-medical costs to patients, employers, and health care providers. This systematic review aimed to provide a better understanding of the biomechanical factors associated with chronic non-specific LBP in adults. SCOPUS, ScienceDirect, MEDLINE, and Web of Science databases were searched. In total, 26 studies were included and significant differences were noted between healthy controls and LBP patients in various motion. Biomechanical factors among adults with non-specific LBP were altered and differed as compared to healthy controls in various motion might be to compensate the pain during those motions. This review highlighted the biomechanical differences across those with non-specific LBP and healthy adults. Both groups showed a similar level of pain during functional tasks but LBP patients suffered from a moderate level of disability. Future studies should not rely on questionnaire-based pain scale only. The biomechanical factors summarized in this review can be used to diagnose non-specific LBP accurately, and as modifiable targets for exercise-based intervention.
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Affiliation(s)
- Nur Athirah Abd Rahman
- Exercise & Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, 16150, Kota Bharu, Malaysia
| | - Shuoqi Li
- Exercise & Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, 16150, Kota Bharu, Malaysia; School of Sports Science, Nantong University, 226019, Nantong, China
| | - Stefan Schmid
- Bern University of Applied Sciences, School of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, 3008, Bern, Switzerland; University of Basel, Faculty of Medicine, 4056, Basel, Switzerland
| | - Shazlin Shaharudin
- Exercise & Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, 16150, Kota Bharu, Malaysia.
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Impact of Urinary Incontinence on Physical Function and Respiratory Muscle Strength in Incontinent Women: A Comparative Study between Urinary Incontinent and Apparently Healthy Women. J Clin Med 2022; 11:jcm11247344. [PMID: 36555959 PMCID: PMC9788047 DOI: 10.3390/jcm11247344] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Patients with stress urinary incontinence (SUI) may be afraid to increase intra-abdominal pressure to avoid incontinence. This could lead to weak expiratory muscles. The aim of this study was to investigate the association between respiratory muscle strength, physical function, and SUI in patients with SUI. A cross-sectional study was conducted in the Physical Medicine and Functional Rehabilitation Department. Thirty-one incontinent women (IG) and twenty-nine women in a control group (CG) were enrolled in this study. Anthropometric data, respiratory muscle strength (maximal inspiratory pressure; maximal expiratory pressure), SUI (Urogenital Distress Inventory-6; Incontinence Impact Questionnaire-7; Pad test), and physical function (waist circumference; timed-up-and-go test; abdominal muscle strength) were assessed. Body fat, body mass index, body weight, and waist circumference were higher in IG than CG (p < 0.01), while postural gait and abdominal muscles were lower (p < 0.001). Respiratory muscle strength displayed moderate correlations with SUI severity, especially for maximal expiratory pressure (p < 0.01). Maximal expiratory pressure was moderately associated with physical function. Deterioration in respiratory muscle strength is a characteristic of women with SUI. In this population, pelvic floor muscle training may be prescribed to improve continence. By feeling more confident about increasing intra-abdominal pressure, women with SUI would strengthen their expiratory muscles and eventually improve their physical function.
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Smith JA, Stabbert H, Bagwell JJ, Teng HL, Wade V, Lee SP. Do people with low back pain walk differently? A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:450-465. [PMID: 35151908 PMCID: PMC9338341 DOI: 10.1016/j.jshs.2022.02.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/04/2021] [Accepted: 12/17/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls. METHODS A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included if they reported biomechanical characteristics of individuals with and without LBP during steady-state or perturbed walking and running. Biomechanical data included spatiotemporal, kinematic, kinetic, and electromyography variables. The reporting quality and potential for bias of each study was assessed. Data were pooled where possible to compare the standardized mean differences (SMD) between back pain and back-healthy control groups. RESULTS Ninety-seven studies were included and reviewed. Two studies investigated acute pain and the rest investigated persistent pain. Nine studies investigated running gait. Of the studies, 20% had high reporting quality/low risk of bias. In comparison with back-healthy controls, individuals with persistent LBP walked slower (SMD = -0.59, 95% confidence interval (95%CI): -0.77 to -0.42)) and with shorter stride length (SMD = -0.38, 95%CI: -0.60 to -0.16). There were no differences in the amplitude of motion in the thoracic or lumbar spine, pelvis, or hips in individuals with LBP. During walking, coordination of motion between the thorax and the lumbar spine/pelvis was significantly more in-phase in the persistent LBP groups (SMD = -0.60, 95%CI: -0.90 to -0.30), and individuals with persistent LBP exhibited greater amplitude of activation in the paraspinal muscles (SMD = 0.52, 95%CI: 0.23-0.80). There were no consistent differences in running biomechanics between groups. CONCLUSION There is moderate-to-strong evidence that individuals with persistent LBP demonstrate differences in walking gait compared to back-healthy controls.
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Affiliation(s)
- Jo Armour Smith
- Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA.
| | - Heidi Stabbert
- Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA
| | - Jennifer J Bagwell
- Department of Physical Therapy, California State University, Long Beach, CA 90840, USA
| | - Hsiang-Ling Teng
- Department of Physical Therapy, California State University, Long Beach, CA 90840, USA
| | - Vernie Wade
- Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA
| | - Szu-Ping Lee
- Department of Physical Therapy, University of Nevada, Las Vegas, NV 89154, USA
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15
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Acasio JC, Butowicz CM, Dearth CL, Bazrgari B, Hendershot BD. Trunk Muscle Forces and Spinal Loads while Walking in Persons with Lower Limb Amputation: Influences of Chronic Low Back Pain. J Biomech 2022; 135:111028. [DOI: 10.1016/j.jbiomech.2022.111028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 10/19/2022]
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Zheng X, Reneman MF, Echeita JA, Schiphorst Preuper RHR, Kruitbosch H, Otten E, Lamoth CJC. Association between central sensitization and gait in chronic low back pain: Insights from a machine learning approach. Comput Biol Med 2022; 144:105329. [DOI: 10.1016/j.compbiomed.2022.105329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/14/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
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17
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Cugusi L, Manca A, Fishback E, Secci C, Bergamin M, Gobbo S, DI Blasio A, Montella A, Bandiera P, Deriu F. Low back pain prevalence and risk factors in Italian adolescent male soccer players: results from an online survey. J Sports Med Phys Fitness 2021; 62:1088-1094. [PMID: 34498823 DOI: 10.23736/s0022-4707.21.12696-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The purpose of this retrospective survey was to analyse the prevalence of low back pain (LBP) among Italian adolescent soccer players, and to identify potential risk factors. METHODS Participants were requested to answer an online survey based on the standardized Nordic questionnaires for musculoskeletal symptoms. RESULTS Data were obtained from 204 male soccer players aged 14-17 years competing at the national and regional level. More than half of the players had experienced LBP in their lives. One-way ANOVA revealed that the players with LBP were taller, heavier and with a higher BMI (all p values<0.00001). When considering the playing position, ANOVA revealed that 14-15 years-old strikers displayed higher LBP scores than all other roles (all p values<0.05). Accordingly, strikers were exposed to a higher risk of LBP than midfielders (RR=1.48; 95%CI:1.10-2.01; p=0.01) and goalkeepers (RR=1.48; 95%CI:1.02-2.971; p=0.04), but not defenders (RR=1.23; 95%CI:0.93-1.63; p=0.15). Within the 14-15 age-class, strikers were, again, those most exposed to LBP risk (all p values<0.05). CONCLUSIONS Anthropometric and soccer-related features should be monitored to ensure early identification of potential risk factors for LBP. This information should be considered along with the specific playing position as strikers emerged as the roles most exposed to LBP risk.
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Affiliation(s)
- Lucia Cugusi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy -
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Ernest Fishback
- Bachelor Degree Course in Physiotherapy, University of Cagliari, Cagliari, Italy
| | - Claudio Secci
- Bachelor Degree Course in Physiotherapy, University of Cagliari, Cagliari, Italy
| | - Marco Bergamin
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Stefano Gobbo
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Andrea DI Blasio
- Endocrine Section, Department of Medicine and Sciences of Aging, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Andrea Montella
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Pasquale Bandiera
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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18
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Shih HJS, Van Dillen LR, Kutch JJ, Kulig K. Individuals with recurrent low back pain exhibit further altered frontal plane trunk control in remission than when in pain. Clin Biomech (Bristol, Avon) 2021; 87:105391. [PMID: 34118490 PMCID: PMC8392132 DOI: 10.1016/j.clinbiomech.2021.105391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 05/18/2021] [Accepted: 05/24/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Movement alterations due to low back pain (LBP) could lead to long-term adverse consequences if they do not resolve after symptoms subside. This study aims to determine if altered trunk control associated with recurrent low back pain persists beyond symptom duration. METHODS Twenty young adults with recurrent LBP were tested once during an LBP episode and once in symptom remission, and twenty matched back-healthy participants served as controls. Participants walked on a treadmill with five prescribed step widths (0.33, 0.67, 1, 1.33, 1.67 × preferred step width). Motion capture and surface electromyography were used to record trunk kinematics and muscle activation. Thorax-pelvis coordination was calculated using vector coding, and longissimus activation and co-activation were analyzed. FINDINGS Young adults with recurrent LBP exhibited a "looser" trunk control strategy in the frontal plane during gait that was persistent regardless of pain status across multiple step widths compared to controls. The looser trunk control was demonstrated by a greater pelvis-only, less thorax-only coordination pattern, and decreased bilateral longissimus co-activation in individuals with recurrent LBP compared to controls. The looser trunk control strategy was further amplified when individuals were in symptom remission and exhibited greater trunk excursion and reduced in-phase coordination in the frontal plane. INTERPRETATION The amplification of aberrant movement during symptom remission may suggest that movement patterns or anatomical factors existing prior to the tested painful episode underlie altered trunk control in individuals with recurrent LBP. The symptom remission period of recurrent LBP may be a critical window into clinical evaluation and treatment.
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Affiliation(s)
- Hai-Jung Steffi Shih
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
| | - Linda R Van Dillen
- Program in Physical Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Jason J Kutch
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Kornelia Kulig
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
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Meftahi N, Kamali F, Parnianpour M, Davoudi M. Biomechanical Analysis of the Pelvis Angular Excursion in Sagittal Plane in Response to Asymmetric Leg Loading Tasks in Females with and without Non-specific Chronic Low Back Pain. J Biomed Phys Eng 2021; 11:367-376. [PMID: 34189125 PMCID: PMC8236097 DOI: 10.31661/jbpe.v0i0.944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 06/20/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Controlling pelvic excursions is the focus of stabilization exercises such as legs loading tasks in rehabilitation of non-specific chronic low back pain (NSCLBP) patients. Progression of these exercises is based on the ability to perform tasks with minimal sagittal pelvic excursions. In spite of emphasis on minimizing pelvic motions, no previous studies have investigated kinematic analysis of the pelvic excursions during leg loading exercises in NSCLBP patients. OBJECTIVE This study aims to investigate the sagittal pelvis excursion during performing asymmetric leg loading tasks in individuals with and without NSCLBP. MATERIAL AND METHODS In this cross-sectional study, kinematic data were collected from 15 NSCLBP patients and 15 asymptomatic participants by a motion analysis system during right and left leg loading tasks with 2 levels of difficulty. Pelvis segments were modeled using Visual3D motion analysis software. Maximum pelvic excursion in the sagittal plane was calculated during each task. Mixed model analysis of variances (group, task difficulty level, side) was performed for statistical analysis. RESULTS The maximum sagittal pelvic excursion values of all tasks in NSCLBP were smaller than those in the control group; however, no significant main effects and interactions were found between two groups. CONCLUSION These results suggest that NSCLBP patients completed loading tasks without differences in sagittal pelvic excursions as compared to controls. Assessment of NSCLBP patients only based on pelvic angular excursion may not be sufficient for clinical decision making. Furthermore, asymptomatic individuals may need to practice for controlling pelvic excursion during leg loading exercises similar to the CLBP patients.
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Affiliation(s)
- Narges Meftahi
- PhD, Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- PhD, Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fahimeh Kamali
- PhD, Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- PhD, Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohamad Parnianpour
- PhD, Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Mehrdad Davoudi
- MSc, Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
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20
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Hornestam JF, Arantes PMM, Souza TR, Resende RA, Aquino CF, Fonseca ST, da Silva PLP. Foot pronation affects pelvic motion during the loading response phase of gait. Braz J Phys Ther 2021; 25:727-734. [PMID: 34020879 DOI: 10.1016/j.bjpt.2021.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 03/14/2021] [Accepted: 04/06/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Increased foot pronation during walking has been associated with low back pain. This association may be due to the impact of increased pronation on pelvic motion. OBJECTIVE To investigate the effects of increased bilateral foot pronation on pelvic kinematic in frontal and transverse planes during the loading response phase of gait. METHODS Pelvic, hip, and foot angular positions of 20 participants were collected while they walked at fast speed wearing flat and medially inclined insoles inserted in the shoes. Pelvic motion in frontal and transverse planes was analyzed during the loading response phase. Foot eversion-inversion was analyzed during the complete stance phase to verify the insoles effectiveness in inducing increased pronation and to exclude excessive pronators. RESULTS Inclined insoles were effective in inducing increased foot pronation. Pelvic and hip motion were altered in the increased pronation condition compared to the control condition. In the frontal plane, mean pelvic position was more inclined to the contralateral side (mean difference [MD]: 0.54°; 95%CI: 0.23, 0.86) and its range of motion (ROM) was reduced (MD: 0.50°; 95%CI: 0.20, 0.79). In the transverse plane, mean pelvic position was less rotated toward the contralateral leg (MD: 1.03°; 95%CI: 0.65, 1.60) without changes in ROM (MD: 0.04°; 95%CI: -0.17, 0.25). The hip was more internally rotated (MD: 1.37°; 95%CI: 0.76, 1.98) without changes in ROM (MD: 0.10°; 95%CI: -1.02, 1.23). CONCLUSION Increased bilateral foot pronation changes pelvic motion during walking and should be assessed, as a contributing factor to possible pelvic and lower back disorders.
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Affiliation(s)
- Joana Ferreira Hornestam
- School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Paula Maria Machado Arantes
- School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Thales Rezende Souza
- School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Renan Alves Resende
- School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Cecilia Ferreira Aquino
- Department of Physical Therapy, Universidade José do Rosário Vellano, Divinópolis, MG, Brazil; Department of Physical Therapy, Universidade do Estado de Minas Gerais, Divinópolis, MG, Brazil
| | - Sergio Teixeira Fonseca
- School of Physical Education, Physical Therapy and Occupational Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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A systematic review of movement and muscular activity biomarkers to discriminate non-specific chronic low back pain patients from an asymptomatic population. Sci Rep 2021; 11:5850. [PMID: 33712658 PMCID: PMC7955136 DOI: 10.1038/s41598-021-84034-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/18/2021] [Indexed: 12/19/2022] Open
Abstract
The identification of relevant and valid biomarkers to distinguish patients with non-specific chronic low back pain (NSCLBP) from an asymptomatic population in terms of musculoskeletal factors could contribute to patient follow-up and to evaluate therapeutic strategies. Several parameters related to movement and/or muscular activity impairments have been proposed in the literature in that respect. In this article, we propose a systematic and comprehensive review of these parameters (i.e. potential biomarkers) and related measurement properties. This systematic review (PROSPERO registration number: CRD42020144877) was conducted in Medline, Embase, and Web of Knowledge databases until July 2019. In the included studies, all movements or muscular activity parameters having demonstrated at least a moderate level of construct validity were defined as biomarkers, and their measurement properties were assessed. In total, 92 studies were included. This allowed to identify 121 movement and 150 muscular activity biomarkers. An extensive measurement properties assessment was found in 31 movement and 14 muscular activity biomarkers. On the whole, these biomarkers support the primary biomechanical concepts proposed for low back pain. However, a consensus concerning a robust and standardised biomechanical approach to assess low back pain is needed.
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22
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Non-specific chronic low back pain elicits kinematic and neuromuscular changes in walking and gait termination. Gait Posture 2021; 84:238-244. [PMID: 33383534 DOI: 10.1016/j.gaitpost.2020.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/24/2020] [Accepted: 12/07/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Chronic low back pain (CLBP) is associated with an increased trunk stiffness and muscle coactivation during walking. However, it is still unclear whether CLBP individuals are unable to control neuromechanically their upper body motion during a sudden termination of gait (GT), which involves a challenging balance transition from walking to standing. RESEARCH QUESTION Does CLBP elicit neuromuscular and kinematic changes which are specific to walking and GT?. METHODS Eleven individuals with non-specific CLBP and 11 healthy controls performed walking and sudden GT in response to an external visual cue. 3D kinematic characteristics of thorax, lumbar and pelvis were obtained, with measures of range of motion (ROM) and intra-subject variability of segmental movement being calculated. Electromyographic activity of lumbar and abdominal muscles was recorded to calculate bilateral as well as dorsoventral muscle coactivation. RESULTS CLBP group reported greater transverse ROM of the lumbar segment during walking and GT compared to healthy controls. Thorax sagittal ROM was higher in CLBP than healthy participants during GT. Greater overall movement variability in the transverse plane was observed in the CLBP group while walking, whereas GT produced greater variability of lumbar frontal motion. CLBP participants showed higher bilateral lumbar coactivation compared to healthy participants after the stopping stimulus delivery during GT. SIGNIFICANCE These results suggest that CLBP can elicit a wider and more variable movement of the upper body during walking and GT, especially in the transverse plane and at lumbar level. Alterations in upper body motor control appeared to depend on task, plane of motion and segmental level. Therefore, these findings should be considered by practitioners when screening before planning specific training interventions for recovery of motor control patterns in CLBP population.
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23
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Aguilar-Zafra S, Del Corral T, Montero-González N, de-Gabriel-Hierro A, López-de-Uralde-Villanueva I. Urinary incontinence and impaired physical function are associated with expiratory muscle weakness in patients with multiple sclerosis. Disabil Rehabil 2021; 44:3531-3539. [PMID: 33427502 DOI: 10.1080/09638288.2020.1867908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Patients with multiple sclerosis (MS) with respiratory muscle weakness could have physical function impairments, given the functional/biomechanical link of the trunk stabilising system. Thus, clinicians could employ new treatment strategies targeting respiratory muscles to improve their physical function. This study pretends to evaluate the relationship between respiratory muscle strength, pulmonary function and pelvic floor function, and also to correlate these variables with physical function (gait function, disability and quality of life) in patients with MS. METHODS 41 patients participated in this descriptive cross-sectional study. Respiratory muscle strength [maximal respiratory pressures (MIP/MEP)], pulmonary function (forced spirometry), pelvic floor function [urinary incontinence (UI)], physical function [Timed Up & Go (TUG) test, Barthel index and health status questionnaire (SF-12)] were evaluated. RESULTS Respiratory muscle strength and pulmonary function were moderately related to UI (MIP: rho = -0.312; MEP: rho = -0.559). MEP was moderately related to physical function (TUG: rho = -0.508; Barthel index: rho = 0.418). Patients with and without expiratory muscle weakness showed differences in UI, pulmonary and physical function. CONCLUSION Patients with MS with greater deterioration in pulmonary function and respiratory muscle strength, especially expiratory muscles, showed greater deterioration in UI and physical function. Expiratory muscle weakness had a negative impact on urinary, physical and pulmonary function.Implications for rehabilitationPulmonary function is associated with urinary incontinence and gait functionality in patients with multiple sclerosis (MS).Expiratory muscle weakness is associated with impaired urinary and physical function in patients with MS.The inclusion of respiratory muscle training to the rehabilitation programs of patients with MS could improve their pelvic floor disorders and physical function.
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Affiliation(s)
- Sandra Aguilar-Zafra
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud. Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Téxum S.L Physiotherapy Center, Coslada, Madrid, Spain
| | - Tamara Del Corral
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain
| | - Noelia Montero-González
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud. Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Almudena de-Gabriel-Hierro
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud. Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain
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Sung PS, Schalk B, Camp R, Park MS. Gender difference of hip-ankle compensations following a novel trip perturbation in young adults. Clin Biomech (Bristol, Avon) 2020; 80:105194. [PMID: 33086186 DOI: 10.1016/j.clinbiomech.2020.105194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/18/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Women have an increased likelihood of sustaining a fall-related injury compared to men; however, little is known about fall prevention strategies between genders. The purpose of this study was to compare the gender differences in lower limb reactions and three-dimensional recovery patterns following a treadmill-induced trip perturbation. METHODS Seventy-six participants who are right limb dominant enrolled in the study, which included 41 females (26.15 [9.92] years old) and 35 males (27.11 [9.15] years old). The outcome measures included a three-dimensional (3D) range of motion (ROM) analysis on the bilateral hip, knee, and ankle joints following the trip perturbation at a 0.89 m/s velocity for 0.12 m. This induced trip caused subjects to walk forward for a 0.26 s duration. FINDINGS The female group demonstrated significantly increased frontal plane ROM in the right hip (t = 2.71, p = 0.01) and left ankle (t = 2.16, p = 0.03) as well as increased sagittal plane ROM in the right (t = 2.07, p = 0.04) and left (t = 2.36, p = 0.02) ankles. There was a significant gender interaction on 3D body region (F = 6.84, p = 0.01) following the perturbation. INTERPRETATION There was a 3D gender difference on the lower limbs for balance control. The female group demonstrated increased sagittal motion in both ankles following a trip perturbation. In addition, their ROM increased on the dominant hip and non-dominant ankle in the frontal plane, which was compensated by step width for standing stability. Clinicians might want to consider the implications of gender differences on lower limb reaction patterns to help patients avoid potential injuries/falls.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy/Motion Analysis Center, Central Michigan University, Mount Pleasant, MI 48858, USA.
| | - Bradly Schalk
- Department of Physical Therapy/Motion Analysis Center, Central Michigan University, Mount Pleasant, MI 48858, USA
| | - Ryan Camp
- Department of Physical Therapy/Motion Analysis Center, Central Michigan University, Mount Pleasant, MI 48858, USA
| | - Moon Soo Park
- Department of Physical Therapy/Motion Analysis Center, Central Michigan University, Mount Pleasant, MI 48858, USA
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Oliva-Lozano JM, Maraver EF, Fortes V, Muyor JM. Kinematic Analysis of the Postural Demands in Professional Soccer Match Play Using Inertial Measurement Units. SENSORS (BASEL, SWITZERLAND) 2020; 20:E5971. [PMID: 33105576 PMCID: PMC7659945 DOI: 10.3390/s20215971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 12/13/2022]
Abstract
The development of wearable sensors has allowed the analysis of trunk kinematics in match play, which is necessary for a better understanding of the postural demands of the players. The aims of this study were to analyze the postural demands of professional soccer players by playing position. A longitudinal study for 13 consecutive microcycles, which included one match per microcycle, was conducted. Wearable sensors with inertial measurement units were used to collect the percentage (%) of playing time spent and G-forces experienced in different trunk inclinations and the inclination required for different speeds thresholds. The inclination zone had a significant effect on the time percentage spent on each zone (p < 0.001, partial eta-squared (ηp2 = 0.85) and the G-forces experienced by the players (p < 0.001, ηp2 = 0.24). Additionally, a significant effect of the speed variable on the trunk inclination zones was found, since trunk flexion increased with greater speeds (p < 0.001; ηp2 = 0.73), except for midfielders. The players spent most of the time in trunk flexion between 20° and 40°; the greatest G-forces were observed in trunk extension zones between 0° and 30°, and a linear relationship between trunk inclination and speed was found. This study presents a new approach for the analysis of players' performance. Given the large volumes of trunk flexion and the interaction of playing position, coaches are recommended to incorporate position-specific training drills aimed to properly prepare the players for the perception-action demands (i.e., visual exploration and decision-making) of the match, as well as trunk strength exercises and other compensatory strategies before and after the match.
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Affiliation(s)
| | - Elisa F. Maraver
- Faculty of Computer Science, Multimedia and Telecommunications, Universitat Oberta de Catalunya, 08018 Barcelona, Spain;
| | | | - José M. Muyor
- Health Research Centre, University of Almería, 04120 Almería, Spain;
- Laboratory of Kinesiology, Biomechanics and Ergonomics (KIBIOMER Lab.), Research Central Services, University of Almería, 04120 Almería, Spain
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Madić D, Obradović B, Golik-Perić D, Marinković D, Trajković N, Gojković Z. The isokinetic strength profile of semi-professional soccer players according to low back pain. J Back Musculoskelet Rehabil 2020; 33:501-506. [PMID: 31524139 DOI: 10.3233/bmr-171109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Soccer as a sport has a very high injury rate and low back pain (LBP) is considered to be the most common overuse injury typically occurring in the back and spine in elite soccer players. OBJECTIVE This study aimed to investigate differences in knee muscle strength and muscle imbalances in soccer players according to lower back pain. METHODS One hundred and thirty-six male professional soccer players (20.49 ± 3.73 years, 76.57 ± 8.24 kg, 182.63 ± 6.73 cm) volunteered for the study. The isokinetic dynamometer PrimaDOC (EASYTECH, Italy) was used to assess the hamstring and quadriceps strength at the selected speeds of 60∘/s, whereas the Roland-Morris Disability Questionnaire (RDQ) was used as a health status measure to assess physical disability caused by low back pain. RESULTS A univariate analysis of variance has shown that there is a statistically significant difference among the groups divided into Absolute peak torque right knee flexors, Absolute peak torque left knee flexors, Ratio between hamstrings and quadriceps strength right leg, and Ratio between hamstrings and quadriceps strength left leg based on the RDQ scores. On the other hand, no other significant differences among the groups were found in other parametersCONCLUSION: The current study indicates that knee muscle strength variables, resulting from an isokinetic testing, have the potential to discriminate between soccer players with and without a history of low back pain. However, low back pain is a multidimensional phenomenon and knee muscle strength or imbalance alone cannot be expected to explain low back pain.
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Affiliation(s)
- Dejan Madić
- University of Novi Sad, Faculty of Sport and Physical Education, Novi Sad, Serbia
| | - Borislav Obradović
- University of Novi Sad, Faculty of Sport and Physical Education, Novi Sad, Serbia
| | - Dragana Golik-Perić
- University of Novi Sad, Faculty of Sport and Physical Education, Novi Sad, Serbia
| | - Dragan Marinković
- University of Novi Sad, Faculty of Sport and Physical Education, Novi Sad, Serbia
| | - Nebojša Trajković
- University of Novi Sad, Faculty of Sport and Physical Education, Novi Sad, Serbia
| | - Zoran Gojković
- Government of the Autonomous Province of Vojvodina, Provincial Secretariat for Health Care, Novi Sad, Serbia
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Simonet E, Winteler B, Frangi J, Suter M, Meier ML, Eichelberger P, Baur H, Schmid S. Walking and running with non-specific chronic low back pain: What about the lumbar lordosis angle? J Biomech 2020; 108:109883. [PMID: 32635997 DOI: 10.1016/j.jbiomech.2020.109883] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/25/2020] [Accepted: 06/06/2020] [Indexed: 01/02/2023]
Abstract
Non-specific chronic low back pain (NSCLBP) is a major health problem, affecting about one fifth of the population worldwide. To avoid further pain or injury, patients with NSCLBP seem to adopt a stiffer movement pattern during everyday living activities. However, it remains unknown how NSCLBP affects the lumbar lordosis angle (LLA) during repetitive activities such as walking or running. This pilot study therefore aimed at exploring possible NSCLBP-related alterations in LLAs during walking and running by focusing on discrete parameters as well as continuous data. Thirteen patients with NSCLBP and 20 healthy pain-free controls were enrolled and underwent a full-body movement analysis involving various everyday living activities such as standing, walking and running. LLAs were derived from markers placed on the spinous processes of the vertebrae L1-L5 and S1. Possible group differences in discrete (average and range of motion (ROM)) and continuous LLAs were analyzed descriptively using mean differences with confidence intervals ranging from 95% to 75%. Patients with NSCLBP indicated reduced average LLAs during standing, walking and running and a tendency for lower LLA-ROM during walking. Analyses of continuous data indicated the largest group differences occurring around 25% and 70% of the walking and 25% and 75% of the running cycle. Furthermore, patients indicated a reversed movement pattern during running, with increasing instead of a decreasing LLAs after foot strike. This study provides preliminary evidence that NSCLBP might affect LLAs during walking and running. These results can be used as a basis for future large-scale investigations involving hypothesis testing.
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Affiliation(s)
- Edwige Simonet
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Balz Winteler
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland; Bern University Hospital, Inselspital, Department of Physiotherapy, Bern, Switzerland
| | - Jana Frangi
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Magdalena Suter
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland; Balgrist University Hospital, Department of Chiropractic Medicine, Integrative Spinal Research, Zurich, Switzerland
| | - Michael L Meier
- Balgrist University Hospital, Department of Chiropractic Medicine, Integrative Spinal Research, Zurich, Switzerland
| | - Patric Eichelberger
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Heiner Baur
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Stefan Schmid
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland.
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Yabe Y, Hagiwara Y, Sekiguchi T, Momma H, Tsuchiya M, Kanazawa K, Itaya N, Yoshida S, Sogi Y, Yano T, Onoki T, Itoi E, Nagatomi R. High prevalence of low back pain among young basketball players with lower extremity pain: a cross-sectional study. BMC Sports Sci Med Rehabil 2020; 12:40. [PMID: 32655870 PMCID: PMC7339456 DOI: 10.1186/s13102-020-00189-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 06/30/2020] [Indexed: 11/10/2022]
Abstract
Background Low back pain (LBP) is a common problem among young basketball players in addition to lower extremity injuries. However, studies that focus on LBP with lower extremity pain are limited. From the perspective of the kinematic chain, disrupted lower extremity function can lead to LBP. The association between these two symptoms in basketball players, however, has not been reported. Therefore, this study aimed to clarify the association between lower extremity pain and LBP among young basketball players. Methods This cross-sectional study was conducted on school-aged basketball players (n = 592). Information regarding their sporting activities was collected using a self-reported questionnaire. Musculoskeletal pain such as low back, knee, and ankle pain was assessed. The sports players with knee and/or ankle pain were defined as having lower extremity pain. Multivariate logistic regression analysis was used to assess the association between lower extremity pain and LBP. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. The associations of knee or ankle pain with LBP were similarly assessed. Results School-aged basketball players had a point prevalence of 12.8% for LBP. Compared with the players without lower extremity pain, the players with lower extremity pain had higher rates of LBP, with an adjusted OR (95% CI) of 6.21 (3.57-10.80). There was also a significant association of knee and ankle pain with LBP. Compared with the players without knee or ankle pain, the adjusted ORs (95% CI) for LBP were 4.25 (2.55-7.07) in the players with knee pain and 3.79 (2.26-6.36) in the players with ankle pain. Conclusions Lower extremity pain was associated with LBP among school-aged basketball players. Further research is needed to clarify the mechanism of this association, which will provide useful information for prevention and treatment of LBP among young basketball players.
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Affiliation(s)
- Yutaka Yabe
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Yoshihiro Hagiwara
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan.,Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575 Japan
| | - Takuya Sekiguchi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Haruki Momma
- Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575 Japan
| | - Masahiro Tsuchiya
- Department of Nursing, Faculty of Health Science, Tohoku Fukushi University, 1-8-1 Kunimi, Aoba-ku, Sendai, 981-8522 Japan
| | - Kenji Kanazawa
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Nobuyuki Itaya
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Shinichirou Yoshida
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Yasuhito Sogi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Toshihisa Yano
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Takahiro Onoki
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Eiji Itoi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 Japan
| | - Ryoichi Nagatomi
- Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575 Japan.,Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575 Japan
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Sung PS, Cavataio M, Sauve J. Adaptive trunk sway velocities following repeated perturbations in subjects with and without low back pain. J Electromyogr Kinesiol 2020; 52:102423. [PMID: 32416446 DOI: 10.1016/j.jelekin.2020.102423] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 04/09/2020] [Accepted: 04/17/2020] [Indexed: 10/24/2022] Open
Abstract
Faster trunk motions could be a strategy to prevent loss of balance and fall injuries due to unexpected perturbations. However, it is unclear how trunk sway velocities can be compensated during stepping in subjects with low back pain (LBP). The purpose of this study was to investigate lower limb reaction, swing, and step times, as well as trunk sway velocities at heel strike and toe-off, following repeated step perturbations between subjects with and without LBP. There were 30 subjects with LBP and 42 control subjects who were exposed to treadmill-induced perturbations at a velocity of 0.12 m/sec for 0.62 m. The treadmill-induced steps caused subjects to walk forward for 4.90 sec after the perturbation. The groups demonstrated significant interactions on the lower limb reaction times and on the number of repeated perturbations (F = 4.83, p = 0.03) due to a decreased step time at the first perturbation (t = 2.52, p = 0.01) in the LBP group. For the trunk sway velocities, the repeated perturbations demonstrated a significant interaction between groups (F = 4.65, p = 0.03). This adaptive trunk strategy for gait stability increased step times with repeated perturbations in the LBP group. The group interactions on the trunk sway velocities also indicated a possible somatosensory integration for step time adjustments to avoid potential fall hazards. This adaptive response with repeated step perturbations could result in compensatory trunk sway for gait stability.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy/Motion Analysis Center, Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University, Health Professions Building, 1220 Mt. Pleasant, MI 48859, United States.
| | - Michael Cavataio
- Department of Physical Therapy/Motion Analysis Center, Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University, Health Professions Building, 1220 Mt. Pleasant, MI 48859, United States
| | - Jake Sauve
- Department of Health Sciences, Central Michigan University, United States
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30
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Lower limb kinematics in individuals with chronic low back pain during walking. J Electromyogr Kinesiol 2020; 51:102404. [DOI: 10.1016/j.jelekin.2020.102404] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/08/2019] [Accepted: 02/12/2020] [Indexed: 11/20/2022] Open
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31
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Pelegrinelli AR, Silva MF, Guenka LC, Carrasco AC, Moura FA, Cardoso JR. Low back pain affects coordination between the trunk segments but not variability during running. J Biomech 2020; 101:109605. [DOI: 10.1016/j.jbiomech.2020.109605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 11/12/2019] [Accepted: 12/11/2019] [Indexed: 12/28/2022]
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Sudden gait perturbations elicit sex-specific neuromuscular trunk responses in persons with low back pain. J Biomech 2020; 102:109646. [DOI: 10.1016/j.jbiomech.2020.109646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/01/2020] [Accepted: 01/15/2020] [Indexed: 12/26/2022]
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Mettler JH, Shapiro R, Pohl MB. Effects of a Hip Flexor Stretching Program on Running Kinematics in Individuals With Limited Passive Hip Extension. J Strength Cond Res 2020; 33:3338-3344. [PMID: 29927892 DOI: 10.1519/jsc.0000000000002586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mettler, JH, Shapiro, R, and Pohl, MB. Effects of a hip flexor stretching program on running kinematics in individuals with limited passive hip extension. J Strength Cond Res 33(12): 3338-3344, 2019-Tightness of the hip flexor muscle group may theoretically contribute to altered kinematics of the lumbo-pelvic-hip (LPH) complex during dynamic movements. Therefore, the purpose of this study was to analyze the effects of a 3-week home-based stretching program on passive hip extension and sagittal plane kinematics of the LPH complex when running. Twenty healthy subjects with limited passive hip extension underwent a 3D gait analysis both before (PRE) and after (POST) a hip flexor stretching program. After the stretching program, passive hip extension increased significantly (p < 0.001), whereas no improvements during running were reported for active hip extension, anterior pelvic tilt, or lumbar spine extension (p ≥ 0.05). In addition, no relationship was found between the change in passive hip extension with either the change in active hip extension, anterior pelvic tilt, or lumbar spine extension. A 3-week static stretching program of the hip flexor muscle group resulted in an increase in passive hip extension, but the sagittal plane kinematics of the LPH complex during running remained unchanged. The results suggest that passive hip joint flexibility may be of limited importance in determining the kinematics of the LPH complex during submaximal running. However, it is possible that an increase in the range of motion at the hip may be beneficial when running at or near maximal speeds.
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Affiliation(s)
- Jeffrey H Mettler
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky
| | - Robert Shapiro
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky
| | - Michael B Pohl
- Department of Exercise Science, University of Puget Sound, Tacoma, Washington
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Yabe Y, Hagiwara Y, Sekiguchi T, Momma H, Tsuchiya M, Kanazawa K, Itaya N, Yoshida S, Sogi Y, Yano T, Onoki T, Itoi E, Nagatomi R. Association between lower back pain and lower extremity pain among young volleyball players: A cross-sectional study. Phys Ther Sport 2020; 43:65-69. [PMID: 32092669 DOI: 10.1016/j.ptsp.2020.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 02/15/2020] [Accepted: 02/16/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Lower back pain (LBP), as well as lower extremity injuries, are major problems among young volleyball players. Nevertheless, only few studies have focused on the relationship between lower extremity injuries and LBP. OBJECTIVE This study investigated the association between LBP and lower extremity pain, including knee and ankle pain, among young volleyball players. DESIGN Cross-sectional study. SETTING Amateur sports association. PARTICIPANTS Elementary and middle school-aged athletes (6-15 years of age). MAIN OUTCOME MEASURES LBP and lower extremity pain. RESULTS A total of 566 young volleyball players participated in this study. The point prevalence of LBP among young volleyball players was 9.5%. Using absence of lower extremity pain as a reference, the adjusted odds ratio (95% confidence interval) for LBP was 11.07 (5.64-21.71) in the presence of lower extremity pain. CONCLUSIONS LBP is associated with Lower extremity pain among young volleyball players. Careful attention should be paid to lower extremity complaints to prevent and treat LBP among young volleyball players.
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Affiliation(s)
- Yutaka Yabe
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Yoshihiro Hagiwara
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan; Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
| | - Takuya Sekiguchi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Haruki Momma
- Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan
| | - Masahiro Tsuchiya
- Department of Nursing, Faculty of Health Science, Tohoku Fukushi University, 1-8-1 Kunimi, Aoba-ku, Sendai, 981-8522, Japan
| | - Kenji Kanazawa
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Nobuyuki Itaya
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Shinichirou Yoshida
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Yasuhito Sogi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Toshihisa Yano
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Takahiro Onoki
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Eiji Itoi
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Ryoichi Nagatomi
- Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan; Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan
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The effect of low back pain and lower limb injury on lumbar multifidus muscle morphology and function in university soccer players. BMC Musculoskelet Disord 2020; 21:96. [PMID: 32050966 PMCID: PMC7017535 DOI: 10.1186/s12891-020-3119-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/05/2020] [Indexed: 01/05/2023] Open
Abstract
Background The lumbar multifidus muscle (LMM) plays a critical role to stabilize the spine. While low back pain (LBP) is a common complaint in soccer players, few studies have examined LMM characteristics in this athletic population and their possible associations with LBP and lower limb injury. Therefore, the purpose of this study was to 1) investigate LMM characteristics in university soccer players and their potential association with LBP and lower limb injury; 2) examine the relationship between LMM characteristics and body composition measurements; and 3) examine seasonal changes in LMM characteristics. Methods LMM ultrasound assessments were acquired in 27 soccer players (12 females, 15 males) from Concordia University during the preseason and assessments were repeated in 18 players at the end of the season. LMM cross-sectional area (CSA), echo-intensity and thickness at rest and during contraction (e.g. function) were assessed bilaterally in prone and standing positions, at the L5-S1 spinal level. A self-reported questionnaire was used to assess the history of LBP and lower limb injury. Dual-energy x-ray absorptiometry (DEXA) was used to acquire body composition measurements. Results Side-to-side asymmetry of the LMM was significantly greater in males (p = 0.02). LMM thickness when contracted in the prone position (p = 0.04) and LMM CSA in standing (p = 0.02) were also significantly greater on the left side in male players. The LMM % thickness change during contraction in the prone position was significantly greater in players who reported having LBP in the previous 3-months (p < 0.001). LMM CSA (r = − 0.41, p = 0.01) and echo-intensity (r = 0.69, p < 0.001) were positively correlated to total % body fat. There was a small decrease in LMM thickness at rest in the prone position over the course of the season (p = 0.03). Conclusions The greater LMM contraction in players with LBP may be a maladaptive strategy to splint and project the spine. LMM morphology measurements were correlated to body composition. The results provide new insights with regards to LMM morphology and activation in soccer players and their associations with injury and body composition measurements.
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Sung PS, Schalk BM, Latuszek N, Hosmer E. Compensatory spinopelvic motions with and without a handheld task following a perturbation in standing between subjects with and without chronic low back pain. Gait Posture 2020; 76:7-13. [PMID: 31707307 DOI: 10.1016/j.gaitpost.2019.10.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 10/01/2019] [Accepted: 10/29/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND A handheld task-related compensation strategy could be used to avoid injuries in subjects with chronic low back pain (LBP). Those who suffer with LBP demonstrate reduced spinopelvic motion; however, there is a lack of understanding on dynamic mobility with a handheld task. RESEARCH QUESTION Are there differences in three-dimensional spinopelvic motions following a treadmill-induced perturbation in subjects with LBP while considering a handheld task? METHODS Twenty-five subjects (11 female and 14 male) with LBP and 38 control subjects (15 female and 23 male) participated in the study. Each group was introduced to walking perturbations (0.86 m/sec, velocity in 0.1 sec) with and without a handheld tray in a standing position. The induced trip allowed subjects to recover by walking forward for a 5 second duration while the spinopelvic angles were measured during the trip and the subsequent recovery period. RESULTS There was no significant group difference in the three-dimensional (3D) spinopelvic motions while holding or not holding a tray. However, the groups demonstrated a significant interaction on tray usage with 3D motions in the spinopelvic regions (F = 13.46, p = 0.001). The sagittal plane motion was significantly minimized with a handheld task for both the lumbar spine and pelvis in the LBP group. SIGNIFICANCE The LBP group demonstrated minimized lumbar and pelvic motions in the sagittal plane, which underpins their concern to reduce motion while holding a tray. The significant interaction between groups on tray usage for spinopelvic compensation represents a strategy for avoiding injuries. Further studies are required to determine strategies to enhance lumbopelvic integration with handheld tasks in individuals with LBP.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy/ Motion Analysis Center, Central Michigan University, United States.
| | - Bradley M Schalk
- Department of Physical Therapy/ Motion Analysis Center, Central Michigan University, United States
| | - Nicholas Latuszek
- Department of Health Sciences, Central Michigan University, United States
| | - Emily Hosmer
- Department of Health Sciences, Central Michigan University, United States
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Papi E, Bull AMJ, McGregor AH. Alteration of movement patterns in low back pain assessed by Statistical Parametric Mapping. J Biomech 2019; 100:109597. [PMID: 31928738 PMCID: PMC7001037 DOI: 10.1016/j.jbiomech.2019.109597] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/16/2019] [Accepted: 12/21/2019] [Indexed: 11/25/2022]
Abstract
Changes in movement pattern in low back pain (LBP) groups have been analysed by reporting predefined discrete variables. However, this approach does not consider the full kinematic data waveform and its dynamic information, potentially exposing the analysis to bias. Statistical Parametric Mapping (SPM) has been introduced and applied to 1 dimensional (D) kinematic variables allowing the assessment of data over time. The aims of this study were to assess differences in 3D kinematics patterns in people with and without LBP during functional tasks by using SPM and to investigate if SPM analysis was consistent with standard 3D range of motion (RoM) assessments. 3D joints kinematics of the spine and lower limbs were compared between 20 healthy controls and 20 participants with non-specific LBP during walking, sit-to-stand and lifting. SPM analysis showed significant differences in the 3Dkinematics of the lower thoracic segment, upper and lower lumbar segment and knee joint during walking and lifting mostly observed at the beginning and/or towards the end of the tasks. ROMs differed between groups in the lower thoracic segment (walking/sit-to-stand), upper and lower lumbar segments (walking/sit-to-stand/lifting), hip and knee (sit-to-stand/lifting). Based on these results, the two approaches can yield different data interpretations. SPM analysis allows the identification of differences in movement that occur over time. This adds value to LBP movement analysis as it allows an understanding of the LBP strategies adopted during motion that may not be conveyed by simple discrete parameters such as ROMs.
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Affiliation(s)
- Enrica Papi
- Department of Surgery and Cancer, Imperial College London, London, UK; Department of Bioengineering, Imperial College London, London, UK.
| | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, London, UK
| | - Alison H McGregor
- Department of Surgery and Cancer, Imperial College London, London, UK
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Yazdani F, Razeghi M, Karimi MT, Salimi Bani M, Bahreinizad H. Foot hyperpronation alters lumbopelvic muscle function during the stance phase of gait. Gait Posture 2019; 74:102-107. [PMID: 31499403 DOI: 10.1016/j.gaitpost.2019.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/19/2019] [Accepted: 08/30/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although altered muscular control of the lumbopelvic region is one of the main risk factors for the development of low back pain and dysfunction, the influence of abnormal foot posture on lumbopelvic muscular function has not been investigated. RESEARCH QUESTION To determine possible functional changes due to hyperpronation in the main muscles that control the lumbopelvic segment. METHODS Kinematic and kinetic data were collected from 15 persons with hyperpronated feet and compared to a control group of 15 persons with normally aligned feet during the stance phase of gait. A generic OpenSim musculoskeletal model was scaled for each participant. A computed muscle control approach was used to produce a forward dynamic simulation of walking to determine muscle function. RESULTS In the hyperpronation group significantly greater peak forces were observed in the erector spinae, iliopsoas and abdominals compared to controls. The former group showed peak latencies for abdominal muscles during early stance, and for erector spinae muscles during both early and late stance. No significant between-group differences were found in gluteus maximus muscle activation in the stance phase of gait. SIGNIFICANCE Abnormal foot pronation can change the timing and intensity of lumbopelvic muscle activation. These changes may predispose people to develop secondary dysfunctions.
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Affiliation(s)
- Farzaneh Yazdani
- Department of Physiotherapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohsen Razeghi
- Department of Physiotherapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Taghi Karimi
- Department of Physiotherapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Milad Salimi Bani
- School of Biomedical Engineering, Isfahan University of Technology, Isfahan, Iran.
| | - Hossein Bahreinizad
- Mechanical Engineering Department, Sahand University of Technology, Tabriz, Iran.
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Convergence and Divergence of Exercise-Based Approaches That Incorporate Motor Control for the Management of Low Back Pain. J Orthop Sports Phys Ther 2019; 49:437-452. [PMID: 31092126 DOI: 10.2519/jospt.2019.8451] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many approaches for low back pain (LBP) management focus on modifying motor control, which refers to motor, sensory, and central processes for control of posture and movement. A common assumption across approaches is that the way an individual loads the spine by typical postures, movements, and muscle activation strategies contributes to LBP symptom onset, persistence, and recovery. However, there are also divergent features from one approach to another. This commentary presents key principles of 4 clinical physical therapy approaches, including how each incorporates motor control in LBP management, the convergence and divergence of these approaches, and how they interface with medical LBP management. The approaches considered are movement system impairment syndromes of the lumbar spine, Mechanical Diagnosis and Therapy, motor control training, and the integrated systems model. These were selected to represent the diversity of applications, including approaches using motor control as a central or an adjunct feature, and approaches that are evidence based or evidence informed. This identification of areas of convergence and divergence of approaches is designed to clarify the key aspects of each approach and thereby serve as a guide for the clinician and to provide a platform for considering a hybrid approach tailored to the individual patient. J Orthop Sports Phys Ther 2019;49(6):437-452. Epub 15 May 2019. doi:10.2519/jospt.2019.8451.
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Fortin M, Rizk A, Frenette S, Boily M, Rivaz H. Ultrasonography of multifidus muscle morphology and function in ice hockey players with and without low back pain. Phys Ther Sport 2019; 37:77-85. [PMID: 30897493 DOI: 10.1016/j.ptsp.2019.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 02/11/2019] [Accepted: 03/10/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To examine the relationship between lumbar multifidus (LM) morphology, function, echo-intensity (EI) and body composition among a group of university level ice hockey players with and without low back pain (LBP). DESIGN Cross-sectional study. SETTING University Research Centre. PARTICIPANTS Thirty-two hockey players (18 females, 14 males) participated in this study. MAIN OUTCOME MEASURES Resting LM cross-sectional area (CSA) was assessed bilaterally at the L5 level in prone and standing using ultrasound imaging. The LM thickness at rest and during contraction was evaluated in addition to LM EI. Body composition measures were acquired using dual-energy X-ray absorptiometry (DEXA) and LBP history was acquired using a self-reported questionnaire. RESULTS LM muscle CSA was significantly associated with body composition measurements. LM EI was strongly associated with total % body fat and significantly greater in females. Resting LM muscle CSA and thickness (prone) was significantly smaller in players with LBP 4-weeks prior. LM side-to-side asymmetry (standing) was also significantly greater in players with LBP 3-months prior. CONCLUSION The results provide new insights with regards to LM morphology and activation in ice hockey players and revealed specific deficits in LM morphology in athletes with LBP. LM morphology was strongly associated with body composition measurements.
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Affiliation(s)
- Maryse Fortin
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada; Concordia University, Department of Health, Kinesiology and Applied Physiology, Montreal, Quebec, Canada.
| | - Amanda Rizk
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
| | | | - Mathieu Boily
- McGill University Health Center, Department of Diagnostic Radiology, Montreal, Quebec, Canada
| | - Hassan Rivaz
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada; Concordia University, Department of Electrical & Computer Engineering, Montreal, Quebec, Canada
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Knee pain is associated with lower back pain in young baseball players: a cross-sectional study. Knee Surg Sports Traumatol Arthrosc 2019; 27:985-990. [PMID: 30194468 DOI: 10.1007/s00167-018-5129-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/05/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Considerable research has focused on shoulder and elbow injuries among baseball players; however, although lumbar spine and knee injuries are commonly experienced, they are less frequently studied. During common motions in baseball, such as throwing, hitting, and running, energy is transferred from the lower extremities through the lower back to the upper body. Lower extremity pain, as well as lower back pain (LBP), can disrupt the kinematic chain, and it is important to understand the association between lower extremity complaints and LBP. The purpose of this study was to elucidate the association between knee pain and LBP among young baseball players. METHODS A cross-sectional study was conducted with young baseball players (aged 6-15 years, n = 1,609) using a self-reported questionnaire. Multivariate logistic regression models were used for analyses. Variables considered in the models were sex, age, body mass index, team levels, number of days of training per week, number of hours in practice per day on weekdays and weekend, frequency of participation in games, practice intensity, and player position. RESULTS The point prevalence of LBP and knee pain was 8.4% and 13.1%, respectively. Knee pain was significantly associated with LBP. Using the absence of knee pain as a reference, the adjusted odds ratio (95% confidence interval) for LBP was 5.83 (3.93-8.65) (p < 0.001) in the presence of knee pain. CONCLUSIONS Knee pain was associated with LBP among young baseball players. Clinicians should pay attention to knee complaints to prevent and treat LBP among young baseball players. LEVEL OF EVIDENCE III.
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Axial Thorax-Pelvis Coordination During Gait is not Predictive of Apparent Trunk Stiffness. Sci Rep 2019; 9:1066. [PMID: 30705368 PMCID: PMC6355803 DOI: 10.1038/s41598-018-37549-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 12/10/2018] [Indexed: 12/26/2022] Open
Abstract
The coordination of axial thorax and pelvis rotations during gait has been shown to be affected by several pathologies. This has been interpreted as an indication of increased apparent axial trunk stiffness, but arm swing may also affect these rotations. The objectives of this study were to assess the effect of trunk stiffness and arm swing on the relative timing (‘coordination’) between thorax and pelvis rotations, and to assess if apparent trunk stiffness can be inferred from thorax-pelvis kinematics. A forward dynamic model was constructed to estimate apparent trunk stiffness from observed thorax and pelvis rotations and arm swing moment around the longitudinal axis of the trunk of 30 subjects. The effect of independent manipulations of trunk stiffness and arm swing moment on thorax-pelvis coordination and gain of axial thorax-pelvis rotations were assessed using the same forward dynamic model. A linear regression model was constructed to evaluate whether forward dynamic model-based estimates of axial trunk stiffness could be inferred directly from thorax-pelvis rotations. The forward dynamic model revealed that axial trunk stiffness and arm swing moment have opposite effects on axial thorax-pelvis coordination. Apparent axial trunk stiffness could not be predicted from observed thorax-pelvis rotations.
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Spinal segments do not move together predictably during daily activities. Gait Posture 2019; 67:277-283. [PMID: 30391750 PMCID: PMC6249993 DOI: 10.1016/j.gaitpost.2018.10.031] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/25/2018] [Accepted: 10/26/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Considering the thoracic, lumbar spine or whole spine as rigid segments has been the norm until recent studies highlighted the importance of more detailed modelling. A better understanding of the requirement for spine multi-segmental analysis could guide planning of future studies and avoid missing clinically-relevant information. RESEARCH QUESTION This study aims to assess the correlation between adjacent spine segments movement thereby evaluating segmental redundancy in both healthy and participants with low back pain (LBP). METHODS A 3D motion capture system tracked the movement of upper and lower thoracic and lumbar spine segments in twenty healthy and twenty participants with LBP. Tasks performed included walking, sit-to-stand and lifting, repeated 3 times. 3D angular kinematics were calculated for each spine segment. Segmental redundancy was evaluated through cross-correlation (Rxy) analysis of kinematics time series and correlation of range of motion (RROM) of adjacent spine segments. RESULTS The upper/lower lumbar pairing showed weak correlations in the LBP group for all tasks and anatomical planes (Rxyrange:0.02-0.36) but moderate and strong correlations during walking (Rxy _frontalplane:0.4) and lifting (Rxy _sagittalplane:0.64) in the healthy group. The lower thoracic/upper lumbar pairing had weak correlations for both groups during lifting and sit-to-stand in the frontal plane and for walking (Rxy:0.01) in the sagittal plane only. The upper/lower thoracic pairing had moderate correlations during sit-to-stand in sagittal and transverse plane in patients with LBP (Rxy _sagittalplane:0.41; Rxy _transverse plane:-0.42) but weak in healthy (Rxy _sagittalplane:0.23; Rxy _transverseplane:-0.34); the contrary was observed during lifting. The majority of RROM values (55/72) demonstrated weak correlations. SIGNIFICANCE The results suggest that multi-segmental analysis of the spine is necessary if spine movement characteristics are to be fully understood. We cannot establish a priori where redundancy occurs based on healthy data, therefore extra consideration should be made when planning studies with pathological cohorts.
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AminiAghdam S, Müller R, Blickhan R. Locomotor stability in able-bodied trunk-flexed gait across uneven ground. Hum Mov Sci 2018; 62:176-183. [DOI: 10.1016/j.humov.2018.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/24/2018] [Accepted: 10/25/2018] [Indexed: 11/16/2022]
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Hines MG, Tillin NA, Luo J, Lee RYW. Passive elastic contribution of hip extensors to joint moments during walking in people with low back pain. Clin Biomech (Bristol, Avon) 2018; 60:134-140. [PMID: 30355537 DOI: 10.1016/j.clinbiomech.2018.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 05/21/2018] [Accepted: 10/10/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND It has been found that alterations in passive muscle properties may be associated with low back pain, and these may be responsible for the altered gait parameters often observed in subjects with back pain. The purpose of the present study was to assess total hip and passive hip extensor moments in people with or without low back pain during the hip flexion component of walking. METHODS 52 subjects volunteered for this study (low back pain group, n = 25 (male n = 13, female n = 12), control group, n = 27 (male n = 15, female n = 12)). Passive hip moments were calculated using an adapted force transducer during supine testing. A biomechanical model and predictive equation were used to calculate passive hip moments during walking. Total hip moments were calculated with the use of a 9 camera, 3-D motion-capture system. FINDINGS Independent samples t-tests demonstrated no significant differences between groups for gait parameters or hip or knee angles. Results of the ANOVAs demonstrated significant differences in passive hip flexor moments during the second half of hip flexion (P < 0.05).There were also significant differences in hip power and work done during peaks of power absorption and the second peak of power generation (P < 0.05). INTERPRETATION The present data demonstrates that subjects with low back pain have altered passive hip extensor and total power and work done during walking compared with healthy controls. Biomechanical models should include individual measurements of passive joint moments.
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Affiliation(s)
- Mark G Hines
- London South Bank University, School of Applied Sciences, 103 Borough Road, London SE1 0AA, UK; British College of Osteopathic Medicine, 3 Sumpter Close, London NW3 5HR, UK.
| | - Neale A Tillin
- University of Roehampton, School of Life Sciences, Whiteland's College, Holybourne Avenue, London SW15 4JD, UK
| | - Jin Luo
- London South Bank University, School of Applied Sciences, 103 Borough Road, London SE1 0AA, UK
| | - Raymond Y W Lee
- University of Portsmouth, Faculty of Technology, Winston Churchill Avenue, Portsmouth PO1 2UP, UK
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Koch C, Hänsel F. Chronic Non-specific Low Back Pain and Motor Control During Gait. Front Psychol 2018; 9:2236. [PMID: 30532718 PMCID: PMC6265306 DOI: 10.3389/fpsyg.2018.02236] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 10/29/2018] [Indexed: 12/18/2022] Open
Abstract
Background: Chronic non-specific low back pain (LBP) poses a major socioeconomic problem, although the mechanisms are not yet clear. Impaired motor control is one of the mechanisms being discussed. Objectives: The purpose of this review is to provide an overview of motor control parameter differences between individuals with and without non-specific LBP during gait. Methods: A literature search on Medline, SportDiscus, PsychInfo, PsychArticels, EMBASE, and Scopus was performed. Twenty-nine articles comparing healthy adults and adults with chronic non-specific LBP in neuromuscular and/or biomechanical parameters during walking or running were examined. Data extraction and quality assessment were independently performed by two persons. Among others, we extracted population, conditions, outcome measures, and results. Results: The results showed that persons with and without non-specific LBP differed in several parameters of motor control, which was indicated by a lower movement amplitude of the pelvis, more in-phase coordination, lower ground reaction forces, higher stride-to-stride variability and a higher activity in ES in the LBP group. Conclusion: Despite no strong evidence for any of the parameters, a combination of biomechanical and neuromuscular parameters provides a conclusive explanation. Impaired motor control during walking is reflected in higher activity of the erector spinae, which leads to a stiffened lumbar-pelvic region. Different acquisition and processing of data renders making comparisons difficult, whereby standards for future research are necessary.
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Affiliation(s)
- Cathrin Koch
- Institute of Sport Sciences, Technische Universität Darmstadt, Darmstadt, Germany
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Yazdani S, Dizji E, Alizadeh F, Hassanlouei H. Effect of chronic idiopathic low back pain on the kinetic gait characteristics in different foot masks. J Biomech 2018; 79:243-247. [DOI: 10.1016/j.jbiomech.2018.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 07/18/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022]
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Reproducibility of Static and Dynamic Postural Control Measurement in Adolescent Athletes with Back Pain. Rehabil Res Pract 2018; 2018:8438350. [PMID: 30057819 PMCID: PMC6051024 DOI: 10.1155/2018/8438350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/05/2018] [Indexed: 12/26/2022] Open
Abstract
Static (one-legged stance) and dynamic (star excursion balance) postural control tests were performed by 14 adolescent athletes with and 17 without back pain to determine reproducibility. The total displacement, mediolateral and anterior-posterior displacements of the centre of pressure in mm for the static, and the normalized and composite reach distances for the dynamic tests were analysed. Intraclass correlation coefficients, 95% confidence intervals, and a Bland-Altman analysis were calculated for reproducibility. Intraclass correlation coefficients for subjects with (0.54 to 0.65), (0.61 to 0.69) and without (0.45 to 0.49), (0.52 to 0.60) back pain were obtained on the static test for right and left legs, respectively. Likewise, (0.79 to 0.88), (0.75 to 0.93) for subjects with and (0.61 to 0.82), (0.60 to 0.85) for those without back pain were obtained on the dynamic test for the right and left legs, respectively. Systematic bias was not observed between test and retest of subjects on both static and dynamic tests. The one-legged stance and star excursion balance tests have fair to excellent reliabilities on measures of postural control in adolescent athletes with and without back pain. They can be used as measures of postural control in adolescent athletes with and without back pain.
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Rossi MK, Pasanen K, Heinonen A, Myklebust G, Kannus P, Kujala UM, Tokola K, Parkkari J. Incidence and risk factors for back pain in young floorball and basketball players: A Prospective study. Scand J Med Sci Sports 2018; 28:2407-2415. [DOI: 10.1111/sms.13237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2018] [Indexed: 12/31/2022]
Affiliation(s)
- M. K. Rossi
- Tampere Research Center of Sports Medicine; Tampere Finland
- Faculty of Sport and Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | - K. Pasanen
- Tampere Research Center of Sports Medicine; Tampere Finland
- UKK Institute for Health Promotion Research; Tampere Finland
- Faculty of Kinesiology; Sport Injury Prevention Research Centre; University of Calgary; Calgary Canada
| | - A. Heinonen
- Faculty of Sport and Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | - G. Myklebust
- Department of Sports Sciences; Oslo Sports Trauma Research Center; Norwegian School of Sport Sciences; Oslo Norway
| | - P. Kannus
- Injury and Osteoporosis Research Center; UKK Institute; Tampere Finland
| | - U. M. Kujala
- Faculty of Sport and Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | - K. Tokola
- Tampere Research Center of Sports Medicine; Tampere Finland
| | - J. Parkkari
- Tampere Research Center of Sports Medicine; Tampere Finland
- UKK Institute for Health Promotion Research; Tampere Finland
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Papi E, Bull AM, McGregor AH. Is there evidence to use kinematic/kinetic measures clinically in low back pain patients? A systematic review. Clin Biomech (Bristol, Avon) 2018; 55:53-64. [PMID: 29684790 PMCID: PMC6161016 DOI: 10.1016/j.clinbiomech.2018.04.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 03/06/2018] [Accepted: 04/10/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Currently, there is a widespread reliance on self-reported questionnaires to assess low back pain patients. However, it has been suggested that objective measures of low back pain patients' functional status should be used to aid clinical assessment. The aim of this study is to systematically review which kinematic /kinetic parameters have been used to assess low back pain patients against healthy controls and to propose clinical kinematic/kinetic measures. METHODS PubMed, Embase and Scopus databases were searched for relevant studies. Reference lists of selected studies and hand searches were performed. Studies had to compare people with and without non-specific low back pain while performing functional tasks and report body segment/joint kinematic and/or kinetic data. Two reviewers independently identified relevant papers. FINDINGS Sixty-two studies were included. Common biases identified were lack of assessor blinding and sample size calculation, use of samples of convenience, and poor experimental protocol standardization. Studies had small sample sizes. Range of motion maneuvers were the main task performed (33/62). Kinematic/kinetic data of different individual or combination of body segments/joints were reported among the studies, commonest was to assess the hip joint and lumbar segment motion (13/62). Only one study described full body movement. The most commonly reported outcome was range of motion. Statistically significant differences between controls and low back pain groups were reported for different outcomes among the studies. Moreover, when the same outcome was reported disagreements were noted. INTERPRETATION The literature to date offers limited and inconsistent evidence of kinematic/kinetic measures in low back pain patients that could be used clinically.
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Affiliation(s)
- Enrica Papi
- Department of Surgery and Cancer, Imperial College London, London, UK,Department of Bioengineering, Imperial College London, London, UK,Corresponding author at: Department of Surgery and Cancer, Imperial College London, Room 7L16, Floor 7, Laboratory Block, Charing Cross Hospital, London, W6 8RF, UK.
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