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Zhang T, Firouzabadi A, Yang D, Liu S, Schmidt H. Age-dependent flexion relaxation phenomenon in chronic low back pain patients. Front Bioeng Biotechnol 2024; 12:1388229. [PMID: 39295844 PMCID: PMC11408191 DOI: 10.3389/fbioe.2024.1388229] [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: 02/19/2024] [Accepted: 08/26/2024] [Indexed: 09/21/2024] Open
Abstract
Background The flexion relaxation phenomenon (FRP) is characterized by suddenly reduced paraspinal muscle activity during full flexion. Previous studies showed significant differences in FRP and flexion angles in chronic low back pain (cLBP) patients compared to individuals without back pain (no-BP). However, the relationship between FRP and flexion angles remains insufficiently understood in older populations. Thus, this study investigated the relationship between FRP and flexion angles concerning to the age and presence of cLBP. Methods Forty no-BP subjects (20m/20f; mean age 41.5 years) and thirty-eight cLBP patients (19m/19f; mean age 43.52 years) performed maximum full upper body flexion task. Electromyographic (EMG) measurements were conducted to assess the activity of lumbar erector spinae (ESL), thoracic erector spinae (EST), and multifidus (MF). Lumbar, thoracic, and pelvic angles at the onset (OnsetL/T/P) and offset of the FRP (OffsetL/T/P) and maximum trunk inclination (MaxL/T/P) were calculated. The FRP was evaluated using a flexion relaxation ratio (FRR). Results cLBP patients showed smaller FRR in MF and right ESL compared to no-BP individuals (p < 0.05), while no differences were found in flexion angles between two groups. Subjects over 40 showed smaller FRR in MF and ESL, and smaller flexion angles on OffsetL and MaxL (p < 0.05). Age-related analysis in the cLBP group revealed that patients over 40, compared to younger ones, had smaller FRR in MF and ESL, and smaller values in all thoracic and lumbar flexion angles (p < 0.05). While in no-BP group, significant larger flexion angles in OnsetL and OffsetT (p < 0.05) were observed in participants over 40. Pain-related analysis in the older group revealed that the cLBP patients, compared to no-BP individuals, had smaller FRR in right MF and right ESL, and smaller values in all lumbar and thoracic flexion angles (p < 0.05), while in younger group, there were no significant pain-related differences in FRR, with larger values in all lumbar flexion angles (p < 0.05). Conclusion Our findings indicate a reduction or absence of FRP in cLBP patients compared to no-BP individuals, with age being a significant factor as those over 40 showed smaller FRP and flexion angles compared to younger individuals.
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Affiliation(s)
- Tianwei Zhang
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ali Firouzabadi
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Daishui Yang
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sihai Liu
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Hendrik Schmidt
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
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Higgins S, Dutta S, Kakar RS. Machine learning for lumbar and pelvis kinematics clustering. Comput Methods Biomech Biomed Engin 2024; 27:1332-1345. [PMID: 37548432 DOI: 10.1080/10255842.2023.2241593] [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: 04/17/2023] [Revised: 07/07/2023] [Accepted: 07/20/2023] [Indexed: 08/08/2023]
Abstract
Clustering algorithms such as k-means and agglomerative hierarchical clustering (HCA) may provide a unique opportunity to analyze time-series kinematic data. Here we present an approach for determining number of clusters and which clustering algorithm to use on time-series lumbar and pelvis kinematic data. Cluster evaluation measures such as silhouette coefficient, elbow method, Dunn Index, and gap statistic were used to evaluate the quality of decision making. The result show that multiple clustering evaluation methods should be used to determine the ideal number of clusters and algorithm suitable for clustering time-series data for each dataset being analyzed.
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Affiliation(s)
- Seth Higgins
- Human Movement Science, Oakland University, Rochester Hills, MI, USA
| | - Sandipan Dutta
- Mathematics and Statistics, Old Dominion University, Norfolk, VA, USA
| | - Rumit Singh Kakar
- Human Movement Science, Oakland University, Rochester Hills, MI, USA
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Evans DW, Wong IT, Leung HK, Yang H, Liew BX. Quantifying lumbar mobility using a single tri-axial accelerometer. Heliyon 2024; 10:e32544. [PMID: 38961956 PMCID: PMC11219489 DOI: 10.1016/j.heliyon.2024.e32544] [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: 07/14/2023] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 07/05/2024] Open
Abstract
Background Lumbar mobility is regarded as important for assessing and managing low back pain (LBP). Inertial Measurement Units (IMUs) are currently the most feasible technology for quantifying lumbar mobility in clinical and research settings. However, their gyroscopes are susceptible to drift errors, limiting their use for long-term remote monitoring. Research question Can a single tri-axial accelerometer provide an accurate and feasible alternative to a multi-sensor IMU for quantifying lumbar flexion mobility and velocity? Methods In this cross-sectional study, 18 healthy adults performed nine repetitions of full spinal flexion movements. Lumbar flexion mobility and velocity were quantified using a multi-sensor IMU and just the tri-axial accelerometer within the IMU. Correlations between the two methods were assessed for each percentile of the lumbar flexion movement cycle, and differences in measurements were modelled using a Generalised Additive Model (GAM). Results Very high correlations (r > 0.90) in flexion angles and velocities were found between the two methods for most of the movement cycle. However, the accelerometer overestimated lumbar flexion angle at the start (-4.7° [95 % CI -7.6° to -1.8°]) and end (-4.8° [95 % CI -7.7° to -1.9°]) of movement cycles, but underestimated angles (maximal difference of 4.3° [95 % CI 1.4° to 7.2°]) between 7 % and 92 % of the movement cycle. For flexion velocity, the accelerometer underestimated at the start (16.6°/s [95%CI 16.0 to 17.2°/s]) and overestimated (-12.3°/s [95%CI -12.9 to -11.7°/s]) at the end of the movement, compared to the IMU. Significance Despite the observed differences, the study suggests that a single tri-axial accelerometer could be a feasible tool for continuous remote monitoring of lumbar mobility and velocity. This finding has potential implications for the management of LBP, enabling more accessible and cost-effective monitoring of lumbar mobility in both clinical and research settings.
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Affiliation(s)
- David W. Evans
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Ian T.Y. Wong
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, United Kingdom
| | - Hoi Kam Leung
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, United Kingdom
| | - Hanyun Yang
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, United Kingdom
| | - Bernard X.W. Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, United Kingdom
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García-Jaén M, Sebastia-Amat S, Sanchis-Soler G, Cortell-Tormo JM. Lumbo-Pelvic Rhythm Monitoring Using Wearable Technology with Sensory Biofeedback: A Systematic Review. Healthcare (Basel) 2024; 12:758. [PMID: 38610180 PMCID: PMC11012179 DOI: 10.3390/healthcare12070758] [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: 02/19/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
As an essential lower-back movement pattern, lumbo-pelvic rhythm (LPR) during forward trunk flexion and backward return has been investigated on a large scale. It has been suggested that abnormalities in lumbo-pelvic coordination are related to the risk of developing low back disorders. However, considerable differences in the approaches used to monitor LPR make it challenging to integrate findings from those investigations for future research. Therefore, the aim of this systematic review was to summarize the use of wearable technology for kinematic measurement with sensory biofeedback for LPR monitoring by assessing these technologies' specific capabilities and biofeedback capacities and exploring their practical viability based on sensor outcomes. The review was developed following the PRISMA guidelines, and the risk of bias was analyzed using the PREDro and STROBE scales. PubMed, Web of Science, Scopus, and IEEEXPLORE databases were searched for relevant studies, initially returning a total of 528 articles. Finally, we included eight articles featuring wearable devices with audio or vibration biofeedback. Differences in protocols and limitations were also observed. This novel study presents a review of wearable tracking devices for LPR motion-mediated biofeedback for the purpose of correcting lower back posture. More research is needed to determine the long-term effectiveness of these devices, as well as their most appropriate corresponding methodologies.
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Affiliation(s)
- Miguel García-Jaén
- Department of General and Specific Didactics, University of Alicante, 03690 San Vicente del Raspeig, Spain; (M.G.-J.); (S.S.-A.); (J.M.C.-T.)
- Health, Physical Activity and Sports Technology (HEALTH-TECH), University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Sergio Sebastia-Amat
- Department of General and Specific Didactics, University of Alicante, 03690 San Vicente del Raspeig, Spain; (M.G.-J.); (S.S.-A.); (J.M.C.-T.)
- Health, Physical Activity and Sports Technology (HEALTH-TECH), University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Gema Sanchis-Soler
- Department of General and Specific Didactics, University of Alicante, 03690 San Vicente del Raspeig, Spain; (M.G.-J.); (S.S.-A.); (J.M.C.-T.)
- Health, Physical Activity and Sports Technology (HEALTH-TECH), University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Juan Manuel Cortell-Tormo
- Department of General and Specific Didactics, University of Alicante, 03690 San Vicente del Raspeig, Spain; (M.G.-J.); (S.S.-A.); (J.M.C.-T.)
- Health, Physical Activity and Sports Technology (HEALTH-TECH), University of Alicante, 03690 San Vicente del Raspeig, Spain
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Sheeran L, Al-Amri M, Sparkes V, Davies JL. Assessment of Spinal and Pelvic Kinematics Using Inertial Measurement Units in Clinical Subgroups of Persistent Non-Specific Low Back Pain. SENSORS (BASEL, SWITZERLAND) 2024; 24:2127. [PMID: 38610338 PMCID: PMC11013962 DOI: 10.3390/s24072127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/14/2024]
Abstract
Inertial measurement units (IMUs) offer a portable and quantitative solution for clinical movement analysis. However, their application in non-specific low back pain (NSLBP) remains underexplored. This study compared the spine and pelvis kinematics obtained from IMUs between individuals with and without NSLBP and across clinical subgroups of NSLBP. A total of 81 participants with NSLBP with flexion (FP; n = 38) and extension (EP; n = 43) motor control impairment and 26 controls (No-NSLBP) completed 10 repetitions of spine movements (flexion, extension, lateral flexion). IMUs were placed on the sacrum, fourth and second lumbar vertebrae, and seventh cervical vertebra to measure inclination at the pelvis, lower (LLx) and upper (ULx) lumbar spine, and lower cervical spine (LCx), respectively. At each location, the range of movement (ROM) was quantified as the range of IMU orientation in the primary plane of movement. The ROM was compared between NSLBP and No-NSLBP using unpaired t-tests and across FP-NSLBP, EP-NSLBP, and No-NSLBP subgroups using one-way ANOVA. Individuals with NSLBP exhibited a smaller ROM at the ULx (p = 0.005), LLx (p = 0.003) and LCx (p = 0.01) during forward flexion, smaller ROM at the LLx during extension (p = 0.03), and a smaller ROM at the pelvis during lateral flexion (p = 0.003). Those in the EP-NSLBP group had smaller ROM than those in the No-NSLBP group at LLx during forward flexion (Bonferroni-corrected p = 0.005), extension (p = 0.013), and lateral flexion (p = 0.038), and a smaller ROM at the pelvis during lateral flexion (p = 0.005). Those in the FP-NSLBP subgroup had smaller ROM than those in the No-NSLBP group at the ULx during forward flexion (p = 0.024). IMUs detected variations in kinematics at the trunk, lumbar spine, and pelvis among individuals with and without NSLBP and across clinical NSLBP subgroups during flexion, extension, and lateral flexion. These findings consistently point to reduced ROM in NSLBP. The identified subgroup differences highlight the potential of IMU for assessing spinal and pelvic kinematics in these clinically verified subgroups of NSLBP.
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Affiliation(s)
- Liba Sheeran
- School of Healthcare Sciences, Cardiff University, Cardiff CF14 4XN, UK; (M.A.-A.); (V.S.); (J.L.D.)
- Biomechanics and Bioengineering Research Centre Versus Arthritis, Cardiff University, Cardiff CF10 3AT, UK
| | - Mohammad Al-Amri
- School of Healthcare Sciences, Cardiff University, Cardiff CF14 4XN, UK; (M.A.-A.); (V.S.); (J.L.D.)
- Biomechanics and Bioengineering Research Centre Versus Arthritis, Cardiff University, Cardiff CF10 3AT, UK
| | - Valerie Sparkes
- School of Healthcare Sciences, Cardiff University, Cardiff CF14 4XN, UK; (M.A.-A.); (V.S.); (J.L.D.)
- Biomechanics and Bioengineering Research Centre Versus Arthritis, Cardiff University, Cardiff CF10 3AT, UK
| | - Jennifer L. Davies
- School of Healthcare Sciences, Cardiff University, Cardiff CF14 4XN, UK; (M.A.-A.); (V.S.); (J.L.D.)
- Biomechanics and Bioengineering Research Centre Versus Arthritis, Cardiff University, Cardiff CF10 3AT, UK
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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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Firouzabadi A, Arjmand N, Zhang T, Pumberger M, Schmidt H. Effect of low back pain on the kinetics and kinematics of the lumbar spine - a combined in vivo and in silico investigation. J Biomech 2024; 164:111954. [PMID: 38310006 DOI: 10.1016/j.jbiomech.2024.111954] [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: 09/15/2023] [Revised: 01/03/2024] [Accepted: 01/12/2024] [Indexed: 02/05/2024]
Abstract
Lifting is a significant risk factor for low back pain (LBP). Different biomechanical factors including spinal loads, kinematics, and muscle electromyography (EMG) activities have previously been investigated during lifting activities in LBP patients and asymptomatic individuals to identify their association with LBP. However, the findings were contradictory and inconclusive. Accurate and subject-specific prediction of spinal loads is crucial for understanding, diagnosing, planning tailored treatments, and preventing recurrent pain in LBP patients. Therefore, the present study aimed to estimate the L5-S1 compressive and resultant shear loads in 19 healthy and 17 non-specific chronic LBP individuals during various static load-holding tasks (holding a 10 kg box at hip, chest, and head height) using full-body and personalized musculoskeletal models driven by subject-specific in vivo kinematic/kinetic, EMG, and physiological cross-sectional areas (PCSAs) data. These biomechanical characteristics were concurrently analyzed to identify potential differences between the two groups. Statistical analyses showed that LBP had almost no significant effect on the range of motion (trunk, lumbar, pelvis), PCSA, and EMG. There were no significant differences (p > 0.05) in the predicted L5-S1 loads. However, as the task became more demanding, by elevating the hand-load from hip to head, LBP patients experienced significant increases in both compressive (33 %, p = 0.00) and shear (25 %, p = 0.02) loads, while asymptomatic individuals showed significant increases only in compressive loads (30 %, p = 0.01). This suggests that engaging in more challenging activities could potentially magnify the effect of LBP on the biomechanical factors and increase their discrimination capacity between LBP and asymptomatic individuals.
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Affiliation(s)
- Ali Firouzabadi
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Navid Arjmand
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Tianwei Zhang
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Pumberger
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Hendrik Schmidt
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany.
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Gombatto SP, Bailey B, Bari M, Bouchekara J, Holmes A, Lenz S, Simmonds K, Vonarb A, Whelehon K, Batalla CR, Monroe KS. Identifying Clinical Phenotypes in People Who Are Hispanic/Latino With Chronic Low Back Pain: Use of Sensor-Based Measures of Posture and Movement, Pain, and Psychological Factors. Phys Ther 2024; 104:pzad185. [PMID: 38169435 PMCID: PMC10851858 DOI: 10.1093/ptj/pzad185] [Citation(s) in RCA: 1] [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: 01/15/2023] [Revised: 08/22/2023] [Accepted: 11/15/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE The aim of this study was to identify clinical phenotypes using sensor-based measures of posture and movement, pain behavior, and psychological factors in Hispanic/Latino people with chronic low back pain (CLBP). METHODS Baseline measures from an ongoing clinical trial were analyzed for 81 Hispanic/Latino people with CLBP. Low back posture and movement were measured using commercial sensors during in-person testing and 8 hours of ecological monitoring. Magnitude, frequency, and duration of lumbar movements, sitting and standing postures were measured. Movement-evoked pain was assessed during in-person movement testing. Psychological measures included the Pain Catastrophizing Scale and the Fear Avoidance Beliefs Questionnaire. Random forest analysis was conducted to generate 2 groups and identify important variables that distinguish groups. Group differences in demographics, pain, psychological, and posture and movement variables were examined using t-tests and chi-square analyses. RESULTS Two subgroups of Hispanic/Latino people with CLBP were identified with minimal error (7.4% misclassification ["out-of-bag" error]). Ecological posture and movement measures best distinguished groups, although most movement-evoked pain and psychological measures did not. Group 1 had greater height and weight, lower movement frequency, more time in sitting, and less time in standing. Group 2 had a greater proportion of women than men, longer low back pain duration, higher movement frequency, more time in standing, and less time in sitting. CONCLUSION Two distinct clinical phenotypes of Hispanic/Latino people with CLBP were identified. One group was distinguished by greater height and weight and more sedentary posture and movement behavior; the second group had more women, longer duration of low back pain, higher lumbar spine movement frequency, and longer duration of standing postures. IMPACT Ecological measures of posture and movement are important for identifying 2 clinical phenotypes in Hispanic/Latino people with CLBP and may provide a basis for a more personalized plan of care. LAY SUMMARY Wearable sensors were used to measure low back posture and movement in Hispanic/Latino people with chronic low back pain. These posture and movement measures helped to identify 2 different clinical subgroups that will give physical therapists more information to better personalize treatment for chronic low back pain in Hispanic/Latino patients.
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Affiliation(s)
- Sara P Gombatto
- Doctor of Physical Therapy Program, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
- SDSU HealthLINK Center for Transdisciplinary Health Disparities Research, San Diego, California, USA
| | - Barbara Bailey
- Department of Mathematics and Statistics, San Diego State University, San Diego, California, USA
| | - Monica Bari
- Doctor of Physical Therapy Program, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
| | - Juna Bouchekara
- Doctor of Physical Therapy Program, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
| | - Alyssa Holmes
- Doctor of Physical Therapy Program, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
| | - Stephanie Lenz
- Doctor of Physical Therapy Program, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
| | - Kerry Simmonds
- Doctor of Physical Therapy Program, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
| | - Alexandra Vonarb
- Doctor of Physical Therapy Program, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
| | - Kim Whelehon
- Doctor of Physical Therapy Program, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
| | - Cristina Rangel Batalla
- SDSU HealthLINK Center for Transdisciplinary Health Disparities Research, San Diego, California, USA
| | - Katrina S Monroe
- Doctor of Physical Therapy Program, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
- SDSU HealthLINK Center for Transdisciplinary Health Disparities Research, San Diego, California, USA
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Hemming R, du Rose A, Sheeran L, van Deursen R, Sparkes V. Relationships between trunk muscle activation and thoraco-lumbar kinematics in non-specific chronic low back pain subgroups during a forward bending task. Gait Posture 2024; 107:96-103. [PMID: 37797443 DOI: 10.1016/j.gaitpost.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 09/06/2023] [Accepted: 09/28/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Trunk muscle activity and thoraco-lumbar kinematics can discriminate between non-specific chronic low back pain (NSCLBP) subgroups and healthy controls. However, research commonly focuses on lumbar kinematics, with limited understanding of relationships between kinematics and muscle activity across clinical subgroups. Similarly, the thoracic spine, whilst intuitively associated with NSCLBP, has received less attention and potential relationships between spinal regions and muscle activity requires exploration. RESEARCH QUESTION Is there a relationship between trunk muscle activation and regional thoracic and lumbar kinematics in NSCLBP subgroups during a forward bending task? METHODS Observational, case-control study. Fifty subgrouped NSCLBP motor control impairment participants (27 Flexion Pattern (FP-MCI), 23 Active Extension Pattern (AEP-MCI)) and 28 pain-free controls were evaluated using 3D motion analysis (Vicon™) and surface electromyography during a forward bending and return to upright task. Mean sagittal angles for the upper-thoracic (UTx), lower-thoracic (LTx), upper-lumbar (ULx) and lower-lumbar (LLx) regions were compared with normalised (% sub-maximal voluntary contraction) mean amplitude electromyography of bilateral transversus abdominis/internal oblique, external oblique, superficial lumbar multifidus and erector spinae (longissimus thoracis) muscles between groups. Pearson correlations were computed to assess relationships (significance p < 0.01). RESULTS AEP-MCI individuals demonstrated statistically significant relationships between superficial lumbar multifidus and ULx and LLx kinematics (-.812 to.659). FP-MCI individuals exhibited statistically significant relationships between erector spinae and superficial lumbar multifidus and LLx and LTx kinematics (-.686 to.664) in both task phases, and between external oblique and LTx during forward bending) (-.459 to.572). Correlations were moderate to strong for all significant relationships (-.812 to .664). SIGNIFICANCE Relationships between muscle activity and regional spinal kinematics varied between NSCLBP subgroups, suggesting that those with flexion- or extension-related LBP adopt different motor control strategies when performing a bending task. As effectively mechanical biomarkers, these findings may inform treatment by improving understanding of varied motor strategies in subgroups.
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Affiliation(s)
- Rebecca Hemming
- Biomechanics and Bioengineering Research Centre Versus Arthritis, School of Healthcare Sciences, Cardiff University, Cardiff CF24 0AB, Wales, UK.
| | | | - Liba Sheeran
- Biomechanics and Bioengineering Research Centre Versus Arthritis, School of Healthcare Sciences, Cardiff University, Cardiff CF24 0AB, Wales, UK.
| | - Robert van Deursen
- Biomechanics and Bioengineering Research Centre Versus Arthritis, School of Healthcare Sciences, Cardiff University, Cardiff CF24 0AB, Wales, UK.
| | - Valerie Sparkes
- Biomechanics and Bioengineering Research Centre Versus Arthritis, School of Healthcare Sciences, Cardiff University, Cardiff CF24 0AB, Wales, UK.
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Ratajczak M, Waszak M, Śliwicka E, Wendt M, Skrypnik D, Zieliński J, Krutki P. In search of biomarkers for low back pain: can traction therapy effectiveness be prognosed by surface electromyography or blood parameters? Front Physiol 2023; 14:1290409. [PMID: 38143914 PMCID: PMC10739392 DOI: 10.3389/fphys.2023.1290409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/17/2023] [Indexed: 12/26/2023] Open
Abstract
Background: Lumbar traction therapy is a common method to reduce low back pain (LBP) but is not always effective. The search for biomarkers that would prognose the effectiveness of LBP management is one priority for improving patients' quality of life. Objectives: 1) To determine the phenotype of patients benefiting most from lumbar traction therapy. 2) To correlate systemic and electromyographic biomarkers with pain and pain-related disability. Methods: Data on muscle bioelectrical activity (surface electromyography [SEMG]) in the flexion-extension task, the concentrations of twelve systemic biochemical factors, LBP intensity (Visual Analog Scale), the Oswestry Disability Index, and the Roland-Morris Disability Questionnaire (RMDQ) were collected before and 72 h after 20 sessions of lumbar traction therapy. Patients were divided into responders and nonresponders based on the criterion of a 50% reduction in maximal pain. Results: The responders had lower maximal muscle bioactivity in the extension phase on the left side (p < 0.01) and higher flexion-extension ratios on both sides of the body in the SEMG (left: p < 0.05; right: p < 0.01), and higher adipsin, interleukin-2, interleukin-4, and interleukin-10 concentrations (p < 0.05) than nonresponders. Patients with higher interleukin-4 concentrations before therapy achieved greater reductions in maximal pain in the sitting position, bioelectrical muscle activity in flexion, and flexion-relaxation ratio on the left side of the body. Changes in adipsin and interleukin-4 concentrations correlated with changes in LBP intensity (r = 0.68; r = -0.77). Changes in stem cell growth factor and interleukin-17A correlated with changes in RMDQ (R = 0.53) and bioelectrical muscle activity in extension (left: R = -0.67; right: R = -0.76), respectively. Conclusion: Responders to traction therapy had SEMG indices of less favorable muscle activity in the flexion-extension task and elevated indices of inflammation before the study. For the first time, interleukin-4 was indicated as a potential biomarker for prognosing post-therapy changes in pain intensity and muscle activity.
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Affiliation(s)
- Marzena Ratajczak
- Department of Medical Biology, Poznan University of Physical Education, Poznan, Poland
| | - Małgorzata Waszak
- Department of Medical Biology, Poznan University of Physical Education, Poznan, Poland
| | - Ewa Śliwicka
- Department of Physiology and Biochemistry, Poznan University of Physical Education, Poznan, Poland
| | - Michał Wendt
- Department of Medical Biology, Poznan University of Physical Education, Poznan, Poland
| | - Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Zieliński
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, Poznan, Poland
| | - Piotr Krutki
- Department of Medical Biology, Poznan University of Physical Education, Poznan, Poland
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11
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Chen BJ, Liu TY, Wu HC, Tsai MW, Wei SH, Chou LW. Effects of sling exercises on pain, function, and corticomuscular functional connectivity in individuals with chronic low back pain- preliminary study. PLoS One 2023; 18:e0288405. [PMID: 38032998 PMCID: PMC10688743 DOI: 10.1371/journal.pone.0288405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/21/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Individuals with chronic low back pain (CLBP) exhibit altered brain function and trunk muscle activation. AIM This study examined the effects of sling exercises on pain, function, and corticomuscular coherence (CMC) in healthy adults and individuals with CLBP. METHODS Eight individuals with CLBP and 15 healthy adults received sling exercise training for 6 weeks. Before and after training, participants performed two motor tasks: rapid arm lifts and repeated trunk flexion-extension tasks, and electromyography of the trunk muscles and electroencephalography of the sensorimotor cortex were recorded. Chi-squared test and Mann-Whitney U tests were used for between group comparison, and Wilcoxon signed-rank tests were used for pre- and post-training comparison. Spearman's Rank Correlation Coefficient (Rs) was used to identify for the relationship between motor performance and Corticomuscular coherence. RESULTS Sling exercises significantly improved pain (median from 3 to 1, p = .01) and Oswestry Disability Index scores (median from 2.5 to 2, p = .03) in the CLBP group. During rapid arm lifts, individuals with CLBP showed lower beta CMC of the transverse abdominis and internal oblique (Tra/IO) (0.8 vs. 0.49, p = .01) and lumbar erector spinae (0.70 vs. 0.38, p = .04) than the control group at baseline. During trunk flexion-extension, the CLBP group showed higher gamma CMC of the left Tra/IO than the control group at baseline (0.28 vs. 0.16 , p = .001). After training, all CMC became statistically non-significant between groups. The training induced improvement in anticipatory activation of the Tra/IO was positively correlated with the beta CMC (rs = 0.7851, p = .02). CONCLUSION A 6-week sling exercises diminished pain and disability in patients with CLBP and improved the anticipatory activation and CMC in some trunk muscles. These improvements were associated with training induced changes in corticomuscular connectivity in individuals with CLBP.
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Affiliation(s)
- Bo-Jhen Chen
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan (R.O.C.)
| | - Tzu-Ying Liu
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chao Tung University, Hsinchu, Taiwan (R.O.C.)
| | - Hsin-Chi Wu
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan (R.O.C.)
- Department of Medicine, Tzu Chi University, Hualien, Taiwan (R.O.C.)
| | - Mei-Wun Tsai
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chao Tung University, Hsinchu, Taiwan (R.O.C.)
| | - Shun-Hwa Wei
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chao Tung University, Hsinchu, Taiwan (R.O.C.)
| | - Li-Wei Chou
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chao Tung University, Hsinchu, Taiwan (R.O.C.)
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12
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Quirk DA, Chung J, Schiller G, Cherin JM, Arens P, Sherman DA, Zeligson ER, Dalton DM, Awad LN, Walsh CJ. Reducing Back Exertion and Improving Confidence of Individuals with Low Back Pain with a Back Exosuit: A Feasibility Study for Use in BACPAC. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:S175-S186. [PMID: 36794907 PMCID: PMC10403307 DOI: 10.1093/pm/pnad003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Low back pain (LBP) is hallmarked by activity limitations, especially for tasks involving bending. Back exosuit technology reduces low back discomfort and improves self-efficacy of individuals with LBP during bending and lifting tasks. However, the biomechanical efficacy of these devices in individuals with LBP is unknown. This study sought to determine biomechanical and perceptual effects of a soft active back exosuit designed to assist individuals with LBP sagittal plane bending. To understand patient-reported usability and use cases for this device. METHODS Fifteen individuals with LBP performed two experimental lifting blocks once with and without an exosuit. Trunk biomechanics were measured by muscle activation amplitudes, and whole-body kinematics and kinetics. To evaluate device perception, participants rated task effort, low back discomfort, and their level of concern completing daily activities. RESULTS The back exosuit reduced peak back extensor: moments by 9%, and muscle amplitudes by 16% when lifting. There were no changes in abdominal co-activation and small reductions maximum trunk flexion compared to lifting without an exosuit. Participants reported lower task effort, back discomfort, and concern about bending and lifting with an exosuit compared to without. CONCLUSIONS This study demonstrates a back exosuit not only imparts perceptual benefits of reduced task effort, discomfort, and increased confidence in individuals with LBP but that it achieves these benefits through measurable biomechanical reductions in back extensor effort. The combined effect of these benefits implies back exosuits might be a potential therapeutic aid to augment physical therapy, exercises, or daily activities.
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Affiliation(s)
- D Adam Quirk
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
| | - Jinwon Chung
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
| | - Gregory Schiller
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Jason M Cherin
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
| | - Philipp Arens
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
| | - David A Sherman
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Emma R Zeligson
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Diane M Dalton
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Lou N Awad
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Conor J Walsh
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
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13
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Quirk DA, Johnson ME, Anderson DE, Smuck M, Sun R, Matthew R, Bailey J, Marras WS, Bell KM, Darwin J, Bowden AE. Biomechanical Phenotyping of Chronic Low Back Pain: Protocol for BACPAC. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:S48-S60. [PMID: 36315101 PMCID: PMC10403313 DOI: 10.1093/pm/pnac163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/12/2022] [Accepted: 10/21/2022] [Indexed: 04/27/2023]
Abstract
OBJECTIVE Biomechanics represents the common final output through which all biopsychosocial constructs of back pain must pass, making it a rich target for phenotyping. To exploit this feature, several sites within the NIH Back Pain Consortium (BACPAC) have developed biomechanics measurement and phenotyping tools. The overall aims of this article were to: 1) provide a narrative review of biomechanics as a phenotyping tool; 2) describe the diverse array of tools and outcome measures that exist within BACPAC; and 3) highlight how leveraging these technologies with the other data collected within BACPAC could elucidate the relationship between biomechanics and other metrics used to characterize low back pain (LBP). METHODS The narrative review highlights how biomechanical outcomes can discriminate between those with and without LBP, as well as among levels of severity of LBP. It also addresses how biomechanical outcomes track with functional improvements in LBP. Additionally, we present the clinical use case for biomechanical outcome measures that can be met via emerging technologies. RESULTS To answer the need for measuring biomechanical performance, our "Results" section describes the spectrum of technologies that have been developed and are being used within BACPAC. CONCLUSION AND FUTURE DIRECTIONS The outcome measures collected by these technologies will be an integral part of longitudinal and cross-sectional studies conducted in BACPAC. Linking these measures with other biopsychosocial data collected within BACPAC increases our potential to use biomechanics as a tool for understanding the mechanisms of LBP, phenotyping unique LBP subgroups, and matching these individuals with an appropriate treatment paradigm.
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Affiliation(s)
- D Adam Quirk
- Harvard School of Engineering and Applied Science, Harvard University, Cambridge, Massachusetts
| | - Marit E Johnson
- Department of Orthopaedic Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Dennis E Anderson
- Center for Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Matthew Smuck
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Ruopeng Sun
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Robert Matthew
- Department of Physical Therapy and Rehabilitation Sciences, University of California, San Francisco, California
| | - Jeannie Bailey
- Department of Orthopaedic Surgery, University of California, San Francisco, California
| | - William S Marras
- Department of Integrated Systems Engineering, The Ohio State University, Columbus, Ohio
| | - Kevin M Bell
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jessa Darwin
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anton E Bowden
- Department of Mechanical Engineering, Brigham Young University, Provo, Utah, USA
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14
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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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15
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Larivière C, Preuss R, Gagnon DH, Mecheri H, Driscoll M, Henry SM. The relationship between clinical examination measures and ultrasound measures of fascia thickness surrounding trunk muscles or lumbar multifidus fatty infiltrations: An exploratory study. J Anat 2023; 242:666-682. [PMID: 36521728 PMCID: PMC10008298 DOI: 10.1111/joa.13807] [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: 08/25/2022] [Revised: 10/28/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Patients with chronic low back pain (CLBP) exhibit remodelling of the lumbar soft tissues such as muscle fatty infiltrations (MFI) and fibrosis of the lumbar multifidus (LuM) muscles, thickness changes of the thoracolumbar fascia (TLF) and perimuscular connective tissues (PMCT) surrounding the abdominal lateral wall muscles. Rehabilitative ultrasound imaging (RUSI) parameters such as thickness and echogenicity are sensitive to this remodelling. This experimental laboratory study aimed to explore whether these RUSI parameters (LuM echogenicity and fascia thicknesses), hereafter called dependent variables (DV) were linked to independent variables (IV) such as (1) other RUSI parameters (trunk muscle thickness and activation) and (2) physical and psychological measures. RUSI measures, as well as a clinical examination comprising physical tests and psychological questionnaires, were collected from 70 participants with LBP. The following RUSI dependent variables (RUSI-DV), measures of passive tissues were performed bilaterally: (1) LuM echogenicity (MFI/fibrosis) at three vertebral levels (L3/L4, L4/L5 and L5/S1); (2) TLF posterior layer thickness, and (3) PMCT thickness of the fasciae between subcutaneous tissue thickness (STT) and external oblique (PMCTSTT/EO ), between external and internal oblique (PMCTEO/IO ), between IO and transversus abdominis (PMCTIO/TrA ) and between TrA and intra-abdominal content (PMCTTrA/IA ). RUSI measures of trunk muscle's function (thickness and activation), also called measures of active muscle tissues, were considered as independent variables (RUSI-IV), along with physical tests related to lumbar stability (n = 6), motor control deficits (n = 7), trunk muscle endurance (n = 4), physical performance (n = 4), lumbar posture (n = 2), and range of motion (ROM) tests (n = 6). Psychosocial measures included pain catastrophizing, fear-avoidance beliefs, psychological distress, illness perceptions and concepts related to adherence to a home-based exercise programme (physical activity level, self-efficacy, social support, outcome expectations). Six multivariate regression models (forward stepwise selection) were generated, using RUSI-DV measures as dependent variables and RUSI-IV/physical/psychosocial measures as independent variables (predictors). The six multivariate models included three to five predictors, explaining 63% of total LuM echogenicity variance, between 41% and 46% of trunk superficial fasciae variance (TLF, PMCTSTT/EO ) and between 28% and 37% of deeper abdominal wall fasciae variance (PMCTEO/IO , PMCTIO/TrA and PMCTTrA/IA ). These variables were from RUSI-IV (LuM thickness at rest, activation of IO and TrA), body composition (percent fat) and clinical physical examination (lumbar and pelvis flexion ROM, aberrant movements, passive and active straight-leg raise, loaded-reach test) from the biological domain, as well as from the lifestyle (physical activity level during sports), psychological (psychological distress-cognitive subscale, fear-avoidance beliefs during physical activities, self-efficacy to exercise) and social (family support to exercise) domains. Biological, psychological, social and lifestyle factors each accounted for substantial variance in RUSI-passive parameters. These findings are in keeping with a conceptual link between tissue remodelling and factors such as local and systemic inflammation. Possible explanations are discussed, in keeping with the hypothesis-generating nature of this study (exploratory). However, to impact clinical practice, further research is needed to determine if the most plausible predictors of trunk fasciae thickness and LuM fatty infiltrations have an effect on these parameters.
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Affiliation(s)
- Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
| | - Richard Preuss
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada.,School of Physical & Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Dany H Gagnon
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada.,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Hakim Mecheri
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
| | - Mark Driscoll
- Department of Mechanical Engineering, McGill University, Montréal, Québec, Canada
| | - Sharon M Henry
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont, USA
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Exercise Therapy in Nonspecific Low Back Pain among Individuals with Lower-Limb Amputation: A Systematic Review. Life (Basel) 2023; 13:life13030772. [PMID: 36983927 PMCID: PMC10059211 DOI: 10.3390/life13030772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/14/2023] Open
Abstract
Low back pain is very common condition that often becomes a long-lasting problem in prostheses users after lower limb amputation. The presented study aims to decide the potential benefits of exercise therapy on low back pain among lower limb amputees by using a systematic review. The PICO technique was used to answer the primary issue of this review: Does exercise treatment lessen the prevalence of low back pain in the population of lower limb amputees? Systematic review was conducted in the following databases: Medline-PubMed, EMBASE, Scopus, and Web of Science. Studies up to September 2010 published in English are included. Aim, target population, development and execution strategies, and treatment suggestions were among the data gathered. The primary outcomes of interest were exercise interventions as a therapy for low back pain but only two articles met including criteria. The search was broadened and 21 studies describing biomechanical changes in gait and pelvic-spine posture were analysed. This review indicates that movement therapy is a potential treatment strategy in low back pain among amputees. The major limitation of the study is the very heterogenous group of subjects in terms of amputation level, baseline activity level and comorbidities. We used a procedure that was registered in PROSPERO (CRD42022345556) to perform this systematic review of systematic reviews. There is a necessity of good quality research for concluding a consensus of exercise intervention.
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Prat-Luri A, de Los Rios-Calonge J, Moreno-Navarro P, Manresa-Rocamora A, Vera-Garcia FJ, Barbado D. Effect of Trunk-Focused Exercises on Pain, Disability, Quality of Life, and Trunk Physical Fitness in Low Back Pain and How Potential Effect Modifiers Modulate Their Effects: A Systematic Review With Meta-analyses. J Orthop Sports Phys Ther 2023; 53:64-93. [PMID: 36645193 DOI: 10.2519/jospt.2023.11091] [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] [Indexed: 01/17/2023]
Abstract
OBJECTIVE: To analyze the effect of trunkfocused exercise programs (TEPs) and moderator factors on chronic nonspecific low back pain (LBP). DESIGN: Systematic review with meta-analyses. LITERATURE SEARCH: We searched the PubMed, Scopus, Embase, SPORTDiscus, and CENTRAL databases from their inception to June 2022. STUDY SELECTION CRITERIA: We included randomized controlled trials comparing TEPs to control or general exercises. DATA SYNTHESIS: We used random-effects models to calculate the standardized mean difference (SMD) plus confidence interval (CI) and heterogeneity (I2) for pain, disability, quality of life, and trunk performance. The impact of moderator factors was analyzed through meta-regression. RESULTS: Forty randomized controlled trials (n = 2391) were included. TEPs showed positive effects for all outcomes versus control (SMD 0.90-2.46; 95% CI, -0.04 to 4.96; I2 61%-98%). There were small effects in favor of TEPs versus general exercises for pain (SMD = 0.20; 95% CI, 0.03-0.37; I2 = 13.4%) and disability (SMD = 0.20; 95% CI, 0.02-0.38; I2 = 0%). Trunk and/or hip range-of-motion improvements were associated with greater reductions in pain (P<.01; β = 0.56; 95% CI, 0.25-0.87) and disability (P<.01; β = 0.66; 95% CI, 0.27-1.05). Low body mass was associated with higher pain reduction (P = .03; β = -0.17; 95% CI, -0.32 to -0.02). CONCLUSIONS: Trunk-focused exercise programs had positive effects on pain, disability, quality of life, and trunk performance compared to control groups, and on pain and disability compared to general exercises. Increasing trunk and/or hip range of motion was associated with greater pain and disability reduction, and lower body mass with higher pain reduction. J Orthop Sports Phys Ther 2023;53(2):64-93. Epub: 16 January 2023. doi:10.2519/jospt.2023.11091.
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Zawadka M, Smolka J, Skublewska-Paszkowska M, Lukasik E, Jablonski M, Gawda P. The influence of sedentary behaviour on lumbar-pelvic kinematics during squatting and forward bending among physically active students. ERGONOMICS 2023; 66:101-112. [PMID: 35361072 DOI: 10.1080/00140139.2022.2061051] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Prolonged sitting may involve several mechanisms that make it a risk factor for low back pain. The aim of this study was to investigate lumbar-pelvic kinematics and multifidus muscle (MF) activity during squatting and forward bending in relation to the sedentary behaviour of physically active students. Sixty-three students were divided into two groups according to the time spent in a sitting position during the day: 'high' (>7 h/day); 'low' (≤7 h/day). Lumbar-pelvic ratios, ranges of motion, angular velocities, and MF flexion-relaxation phenomenon were investigated. Data were obtained using the optical motion analysis system, and surface electromyography. The results indicated that lumbar-pelvic ratios during both tasks and velocity of lumbar spine during squatting were significantly greater in the 'high' than in the 'low' sitting group. Muscle activity showed no differences between groups. Prolonged sitting can be considered a factor that slightly, but statistically significantly influences the lumbar-pelvic kinematics in physically active people.Practitioner summary: Lumbar-pelvic kinematics can be altered by prolonged sitting in physically active students. Lumbar-pelvic ratios during squatting and forward bending and lumbar spine velocity during squatting were significantly greater in the 'high' than in the 'low' sitting group. Sedentary behaviour should be considered during an assessment of movement patterns.Abbreviations: BMI: body mass index; ERR: extension-relaxation ratio; FRP: flexion-relaxation phenomenon; FRR: flexion-relaxation ratio; IPAQ: International Physical Activity Questionnaire; LBP: low back pain; METs: metabolic equivalent of tasks; MF: multifidus muscle; PA: physical activity; ROM: range of motion; sEMG: surface electromyography.
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Affiliation(s)
- Magdalena Zawadka
- Department of Sports Medicine, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Jakub Smolka
- Department of Computer Science, Faculty of Electrical Engineering and Computer Science, Lublin University of Technology, Lublin, Poland
| | - Maria Skublewska-Paszkowska
- Department of Computer Science, Faculty of Electrical Engineering and Computer Science, Lublin University of Technology, Lublin, Poland
| | - Edyta Lukasik
- Department of Computer Science, Faculty of Electrical Engineering and Computer Science, Lublin University of Technology, Lublin, Poland
| | - Mirosław Jablonski
- Department of Rehabilitation and Orthopedics, Faculty of Medicine, Medical University of Lublin, Lublin, Poland
| | - Piotr Gawda
- Department of Sports Medicine, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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Moon KS, Gombatto SP, Phan K, Ozturk Y. Extraction of Lumbar Spine Motion Using a 3-IMU Wearable Cluster. SENSORS (BASEL, SWITZERLAND) 2022; 23:182. [PMID: 36616780 PMCID: PMC9823955 DOI: 10.3390/s23010182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Spine movement is a daily activity that can indicate health status changes, including low back pain (LBP) problems. Repetitious and continuous movement on the spine and incorrect postures during daily functional activities may lead to the potential development and persistence of LBP problems. Therefore, monitoring of posture and movement is essential when designing LBP interventions. Typically, LBP diagnosis is facilitated by monitoring upper body posture and movement impairments, particularly during functional activities using body motion sensors. This study presents a fully wireless multi-sensor cluster system to monitor spine movements. The study suggests an attempt to develop a new method to monitor the lumbopelvic movements of interest selectively. In addition, the research employs a custom-designed robotic lumbar spine simulator to generate the ideal lumbopelvic posture and movements for reference sensor data. The mechanical motion templates provide an automated sensor pattern recognition mechanism for diagnosing the LBP.
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Affiliation(s)
- Kee S. Moon
- Mechanical Engineering, College of Engineering, San Diego State University, San Diego, CA 92182, USA
| | - Sara P. Gombatto
- Doctor of Physical Therapy Program, School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA 92182, USA
| | - Kim Phan
- Electrical and Computer Engineering, College of Engineering, San Diego State University, San Diego, CA 92182, USA
| | - Yusuf Ozturk
- Electrical and Computer Engineering, College of Engineering, San Diego State University, San Diego, CA 92182, USA
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Abbott E, Campbell A, Wise E, Tidman SJ, Lay BS, Kent P. Physiotherapists could detect changes of 12 degrees or more in single-plane movement when observing forward bending, squat or hand-over-head: A cross-sectional experiment. Musculoskelet Sci Pract 2022; 61:102594. [PMID: 35667319 DOI: 10.1016/j.msksp.2022.102594] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/29/2022] [Accepted: 05/29/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The visual accuracy of physiotherapists to detect changes in dynamic joint angles is currently unknown. OBJECTIVE To investigate (i) the smallest detectable change in movement that physiotherapists could visually observe, and (ii) whether visual accuracy was associated with the functional activity observed or characteristics of the physiotherapist. METHODS Thirty-four physiotherapists viewed and rated videos of squat, hand-over-head, forward bend functional activities and an artificial test condition (a reference movement followed by subsequent movements showing random differences in peak angle from 0° to 15°, so 18 sets of paired videos per functional activity). They rated each range of movement (same/more/less) relative to the reference movement, while their visual tracking was continuously monitored. Accuracy was calculated (multilevel regression) using two thresholds - two correct out of three viewings (2/3) and three correct out of three viewings (3/3). RESULTS More than 80% of physiotherapists were able to detect 9° difference using the 2/3 threshold and 12° using the 3/3 threshold. There was no association (p > 0.05) between visual accuracy and experience, sex, or movement type, except when viewing shoulder abduction compared with knee flexion using the 3/3 threshold. The only association between accuracy and visual tracking characteristics was for assessing lumbar flexion, where use of more visual fixation areas and a shorter fixation time per area were more accurate. CONCLUSION Physiotherapists were consistently accurate at detecting changes of ≥12° in single-plane, low-speed functional activities. Visual accuracy was not explained by experience or sex, and rarely associated with functional activity type or visual fixation.
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Affiliation(s)
- Emily Abbott
- Curtin School of Allied Health, Curtin University, Kent Street, Bentley, Western Australia, 6102, Perth, Australia.
| | - Amity Campbell
- Curtin School of Allied Health, Curtin University, Kent Street, Bentley, Western Australia, 6102, Perth, Australia.
| | - Emma Wise
- Curtin School of Allied Health, Curtin University, Kent Street, Bentley, Western Australia, 6102, Perth, Australia.
| | - Stephen J Tidman
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Perth, Australia.
| | - Brendan S Lay
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Perth, Australia.
| | - Peter Kent
- Curtin School of Allied Health, Curtin University, Kent Street, Bentley, Western Australia, 6102, Perth, Australia.
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21
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Effects of dynamic lumbar motor control training on lumbar proprioception: A randomized controlled trial. J Bodyw Mov Ther 2022; 30:132-139. [DOI: 10.1016/j.jbmt.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 10/17/2021] [Accepted: 02/04/2022] [Indexed: 11/20/2022]
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22
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Alcaraz-Clariana S, García-Luque L, Garrido-Castro JL, Aranda-Valera IC, Ladehesa-Pineda L, Puche-Larrubia MÁ, Carmona-Pérez C, Rodrigues-de-Souza DP, Alburquerque-Sendín F. Paravertebral Muscle Mechanical Properties in Patients with Axial Spondyloarthritis or Low Back Pain: A Case-Control Study. Diagnostics (Basel) 2021; 11:1898. [PMID: 34679595 PMCID: PMC8535094 DOI: 10.3390/diagnostics11101898] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/06/2021] [Accepted: 10/12/2021] [Indexed: 12/29/2022] Open
Abstract
Different musculoskeletal disorders are a source of pain in the spinal region; most of them can be divided into mechanical, such as low back pain (LBP), or inflammatory origins, as is the case of axial spondyloarthritis (axSpA). Nevertheless, insufficient information is available about the muscle negative consequences of these conditions. Thus, the objective of this study was to identify whether mechanical muscle properties (MMPs) of cervical and lumbar muscles are different between patients with axSpA, subacute LBP (sLBP), and healthy controls. Furthermore, we aimed identify whether MMPs were related to sociodemographic and clinical variables in various study groups. The MMPs, sociodemographic, and clinical variables were obtained in 43 patients with axSpA, 43 subjects with sLBP, and 43 healthy controls. One-way ANOVAs and ROC curves were applied to identify whether the MMPs could differentiate between the study groups. Intra-group Pearson r coefficients to test the associations between MMPs and the rest of the variables were calculated. The results showed that axSpA subjects have a higher tone and stiffness and a lower relaxation and creep than sLBP and healthy ones (p < 0.05). All lumbar and cervical MMPs, except for decrement, could correctly classify axSpA and healthy subjects and axSpA and sLBP patients (in both cases, Area Under the Curve > 0.8). However, no MMP could differentiate between sLBP and healthy subjects. Each group had a different pattern of bivariate correlations between MMPs and sociodemographic and clinical data, with a worse state and progression of the axSpA group associated with a higher tone and stiffness in both spinal regions. This study supports that MMPs are different and show different patterns of correlations depending on the type of spinal pain.
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Affiliation(s)
- Sandra Alcaraz-Clariana
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
| | - Lourdes García-Luque
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
| | - Juan Luis Garrido-Castro
- Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Cordoba, 14071 Cordoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
| | - I. Concepción Aranda-Valera
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
- Department of Rheumatology, University Hospital Reina Sofía, 14004 Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, 14004 Cordoba, Spain
| | - Lourdes Ladehesa-Pineda
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
- Department of Rheumatology, University Hospital Reina Sofía, 14004 Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, 14004 Cordoba, Spain
| | - María Ángeles Puche-Larrubia
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
- Department of Rheumatology, University Hospital Reina Sofía, 14004 Cordoba, Spain
- Department of Medical and Surgical Sciences, University of Cordoba, 14004 Cordoba, Spain
| | - Cristina Carmona-Pérez
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
| | - Daiana Priscila Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Cordoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (F.A.-S.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain; (I.C.A.-V.); (L.L.-P.); (M.Á.P.-L.)
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Gouteron A, Tabard-Fougère A, Bourredjem A, Casillas JM, Armand S, Genevay S. The flexion relaxation phenomenon in nonspecific chronic low back pain: prevalence, reproducibility and flexion-extension ratios. A systematic review and meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 31:136-151. [PMID: 34553264 DOI: 10.1007/s00586-021-06992-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 08/26/2021] [Accepted: 09/07/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The flexion relaxation phenomenon (FRP) is characterized by the reduction of paraspinal muscle activity at maximum trunk flexion. The FRP is reported to be altered (persistence of spinal muscle activity) in nonspecific chronic low back pain (NSCLBP) and is considered a promising biomarker. The aim of this systematic review was to synthetize current knowledge on FRP in the NSCLBP population regarding prevalence, the reliability of FRP measurement using surface electromyography (sEMG), the average value, and variation of the relaxation ratios (RR). METHODS Five databases were searched (PubMed, EMBASE, Web of Sciences, Cochrane Library, Pedro). A qualitative analysis was done for all included studies and meta-analysis studying prevalence, mean value of flexion relaxation ratio (FRR) and extension relaxation ratio (ERR), and difference between asymptomatic and NSCLBP FRR. RESULTS Twenty-seven studies were included for qualitative analysis and 21 studies for meta-analysis. The prevalence of the altered FRP was 55% (95%CI [32-79%]) in the NSCLBP population. The studies on reliability reported good within-session and between-session reproducibility. In the NSLBP population, the mean FRR was 2.96 (95%CI [2.02; 3.90]) and the mean ERR was 4.07 (95%CI [2.08; 6.07]). The difference between asymptomatic and NSCLBP FRR was - 1.19 (95%CI [- 1.92, - 0.45]). In all meta-analysis, the I2 index was > 80%. CONCLUSION An altered FRP is frequently found in NSCLBP population using sEMG and the test has a good reproducibility. The difference between asymptomatic and NSCLBP FRR was significant. Nevertheless, considering the high heterogeneity observed, additional research is required to confirm the value of RR.
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Affiliation(s)
- Anaïs Gouteron
- Inserm UMR 1093, Cognition, Action, Plasticité sensori-motrice, Dijon, France. .,University Hospital Dijon-Burgundy Franche-Comté, France, Pôle Rééducation-Réadaptation, CHU de Dijon, 23, Rue Gaffarel, 21078, Dijon, France.
| | - Anne Tabard-Fougère
- Geneva University Hospitals and University of Geneva, Willy Taillard Laboratory of Kinesiology, Geneva, Switzerland
| | - Abderrahmane Bourredjem
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon, Burgundy, Dijon, France
| | - Jean-Marie Casillas
- Inserm UMR 1093, Cognition, Action, Plasticité sensori-motrice, Dijon, France.,Inserm CIC 1432, Module P, Plateforme d'investigation Technologique, CHU de Dijon, Dijon, France.,University Hospital Dijon-Burgundy Franche-Comté, France, Pôle Rééducation-Réadaptation, CHU de Dijon, 23, Rue Gaffarel, 21078, Dijon, France
| | - Stéphane Armand
- Geneva University Hospitals and University of Geneva, Willy Taillard Laboratory of Kinesiology, Geneva, Switzerland
| | - Stéphane Genevay
- Division of Rheumatology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
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24
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Kinematic changes in goal-directed movements in a fear-conditioning paradigm. Sci Rep 2021; 11:11162. [PMID: 34045515 PMCID: PMC8159940 DOI: 10.1038/s41598-021-90518-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/10/2021] [Indexed: 11/08/2022] Open
Abstract
In individuals with a musculoskeletal disorder, goal-directed reaching movements of the hand are distorted. Here, we investigated a pain-related fear-conditioning effect on motor control. Twenty healthy participants (11 women and 9 men, 21.7 ± 2.7 years) performed a hand-reaching movement task. In the acquisition phase, a painful electrocutaneous stimulus was applied on the reaching hand simultaneous with the completion of reaching. In the subsequent extinction phase, the task context was the same but the painful stimulus was omitted. We divided the kinematic data of the hand-reaching movements into acceleration and deceleration periods based on the movement-velocity characteristics, and the duration of each period indicated the degree of impairment in the feedforward and feedback motor controls. We assessed the wavelet coherence between electromyograms of the triceps and biceps brachii muscles. In the acquisition phase, the durations of painful movements were significantly longer in both the acceleration and deceleration periods. In the extinction phase, painful movements were longer only in the acceleration period and higher pain expectation and fear were maintained. Similarly, the wavelet coherence of muscles in both periods were decreased in both the acquisition and extinction phases. These results indicate that negative emotional modulations might explain the altered motor functions observed in pain patients.
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25
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Quantifying Lumbar Movement Patterns of Allied Health Professionals in an Australian Health Care Facility. J Appl Biomech 2021; 37:304-310. [PMID: 33906160 DOI: 10.1123/jab.2020-0268] [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: 08/21/2020] [Revised: 01/04/2021] [Accepted: 02/09/2021] [Indexed: 11/18/2022]
Abstract
Health professionals responsible for return to work plans have little data about allied health movement to guide recommendations following lower back injury. This study aimed to quantify the lumbar movement patterns of allied health professionals within a health care facility throughout a normal workday. An observational case study was undertaken at a public health care facility with 122 allied health professionals. The lumbar movements were recorded with the ViMove together with pain scale measurement. The mean (SD) recording time for allied health was 7.7 (0.7) hours. A mean (SD) 3 (1.4) hours total were spent in standing, 3.8 (1.7) hours in sitting, and 0.8 (0.4) hours in locomotion. Forty-nine flexions were recorded on average per session, most identified as short term (<30 s) within low range (0°-20°). Lumbar movement patterns differed among professions. Thirty-seven (31%) participants reported a history of lower back injury, and 57 (47%) reported low back pain at the end of their workday. This study provides an insight into allied health professionals' back movement in a hospital or community-based health care setting. These data may inform those who make return to work recommendations or provide rehabilitation services for allied health professionals working with a lower back injury.
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26
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Paravertebral Muscle Mechanical Properties and Spinal Range of Motion in Patients with Acute Neck or Low Back Pain: A Case-Control Study. Diagnostics (Basel) 2021; 11:diagnostics11020352. [PMID: 33672470 PMCID: PMC7923441 DOI: 10.3390/diagnostics11020352] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 12/26/2022] Open
Abstract
Our aims were to identify potential differences in muscle mechanical properties (MMPs) of cervical and lumbar tissues and in spinal range of motion (ROM) between patients with acute low back pain (LBP) or acute neck pain (NP) and healthy controls, and to identify if ROMs and MMPs are able to identify subjects among the three groups. Clinical variables (pain, disability, fear of movement, kinesiophobia, quality of life), MMPs and ROMs were obtained in 33 subjects with acute LBP, 33 with acute NP, and 33 healthy control subjects. Between-groups differences and explanatory models to discriminate groups depending on MMPs and ROMs were calculated. The results showed that cervical tone was higher in patients with acute NP than in controls, while cervical decrement was higher in both spinal pain groups. Patients with acute NP showed reduced cervical flexion when compared to acute LBP and control groups, and also cervical rotation, but just against controls. Furthermore, lumbar flexion was reduced in patients with acute LBP when compared to those with acute NP. Cervical decrement was able to discriminate spinal pain individuals from controls in a multinominal regression (R2: Cox–Snell estimation = 0.533; Nagelkerke estimation = 0.600). Lumbar flexion differentiated patients with acute LBP and controls, whereas cervical flexion differentiated patients with acute NP and controls. This study supports a tendency of the affectation of other spinal regions when only one is affected.
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27
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Alsubaie AM, Martinez-Valdes E, De Nunzio AM, Falla D. Trunk control during repetitive sagittal movements following a real-time tracking task in people with chronic low back pain. J Electromyogr Kinesiol 2021; 57:102533. [PMID: 33621756 DOI: 10.1016/j.jelekin.2021.102533] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/15/2021] [Accepted: 02/11/2021] [Indexed: 11/26/2022] Open
Abstract
Precision of trunk movement has commonly been examined by testing relocation accuracy rather than evaluating accuracy of tracking dynamic movement. In this study we used a 3-D motion capture system to provide a novel real-time tracking task to assess trunk motor control at varying movement speeds between people with and without chronic non-specific low back pain (LBP). Eleven asymptomatic volunteers and 15 participants with chronic non-specific LBP performed 12 continuous cycles of trunk flexion-extension following real time visual feedback, during which, trunk motion was measured using eight optoelectronic infrared cameras. Significant time differences between the feedback and actual trunk motion were found between groups (P = 0.001). Both groups had similar variability of tracking accuracy when following the feedback (P > 0.05). However, tracking variability at a slow speed correlated (P = 0.03; r = 0.55) with the Fear-Avoidance Beliefs Questionnaire (FABQ) scores in those with LBP. This study shows that both asymptomatic people and individuals with LBP displayed anticipatory behaviour, however, the response of those with LBP was consistently delayed in tracking the visual feedback compared to the asymptomatic group. Additionally, the extent of variability of tracking accuracy over repeated tracking cycles was associated with the degree of fear of movement in people with LBP.
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Affiliation(s)
- A M Alsubaie
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK; Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - E Martinez-Valdes
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - A M De Nunzio
- LUNEX International University of Health, Exercise and Sports, 50, Avenue du Parc des Sports, 4671, Differdange, Luxembourg
| | - D Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK.
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Shigetoh H, Nishi Y, Osumi M, Morioka S. Combined abnormal muscle activity and pain-related factors affect disability in patients with chronic low back pain: An association rule analysis. PLoS One 2020; 15:e0244111. [PMID: 33332431 PMCID: PMC7746291 DOI: 10.1371/journal.pone.0244111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 12/02/2020] [Indexed: 12/27/2022] Open
Abstract
Objectives In patients with chronic low back pain (CLBP), reduced lumbar flexion-relaxation and reduced variability of muscle activity distribution are reported as abnormal muscle activity. It is not known how abnormal muscle activity and pain-related factors are related to CLBP-based disability. Here, we performed an association rule analysis to investigated how CLBP disability, muscle activity, and pain-related factors in CLBP patients are related. Methods Surface electromyographic signals were recorded from over the bilateral lumbar erector spinae muscle with four-channel electrodes from 24 CLBP patients while they performed a trunk flexion re-extension task. We calculated the average value of muscle activities of all channels and then calculated the flexion relaxation ratio (FRR) and the spatial variability of muscle activities. We also assessed the pain-related factors and CLBP disability by a questionnaire method. A clustering association rules analysis was performed to determine the relationships among pain-related factors, the FRR, and the variability of muscle activity distribution. Results The association rules of severe CLBP disability were divisible into five classes, including ‘low FRR-related rules.’ The rules of the mild CLBP disability were divisible into four classes, including ‘high FRR-related rules’ and ‘high muscle variability-related rules.’ When we combined pain-related factors with the FRR and muscle variability, the relationship between abnormal FRR/muscle variability and CLBP disability became stronger. Discussion Our findings thus highlight the importance of focusing on not only the patients’ pain-related factors but also the abnormal motor control associated with CLBP, which causes CLBP disability.
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Affiliation(s)
- Hayato Shigetoh
- Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, Koryo-cho, Nara, Japan
- Miura Internal Medicine Michiko Pediatrics Clinic, Marugame-shi, Kagawa, Japan
- * E-mail:
| | - Yuki Nishi
- Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, Koryo-cho, Nara, Japan
| | - Michihiro Osumi
- Neuro Rehabilitation Research Center, Kio University, Koryo-cho, Nara, Japan
| | - Shu Morioka
- Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, Koryo-cho, Nara, Japan
- Neuro Rehabilitation Research Center, Kio University, Koryo-cho, Nara, Japan
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Abstract
OBJECTIVE To investigate the relationship between changes in volitional spinal movement (including muscle activity) and changes in pain or activity limitation at the individual level in people with nonspecific low back pain. DESIGN Etiology systematic review. LITERATURE SEARCH MEDLINE, Embase, CINAHL, and AMED were searched from inception to January 2020. STUDY SELECTION CRITERIA The study included peer-reviewed articles that reported the relationship between changes in volitional spinal movement and changes in pain or activity limitation at the individual level in people with nonspecific low back pain. DATA SYNTHESIS The data were descriptively synthesized to identify a relationship between change in movement and improved pain or activity limitation. RESULTS We included 27 studies involving 2739 participants. There was low-quality evidence of a relationship between change in movement and change in pain or activity limitation at the individual level 31% of the time (20 of the 65 times investigated within the 27 studies). Increases in spinal range of motion, velocity, and flexion relaxation of the back extensors were consistently related to improved pain or activity limitation (93%, 18.5/20 relationships observed). CONCLUSION A relationship between changes in movement and changes in pain or activity limitation was infrequently observed at the individual level; however, a paucity of high-quality evidence precludes a definitive understanding of this relationship. J Orthop Sports Phys Ther 2020;50(12):664-680. Epub 28 Oct 2020. doi:10.2519/jospt.2020.9635.
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30
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Crasto C, Montes AM, Carvalho P, Carral JC. Abdominal muscle activity and pelvic motion according to active straight leg raising test results in adults with and without chronic low back pain. Musculoskelet Sci Pract 2020; 50:102245. [PMID: 32919292 DOI: 10.1016/j.msksp.2020.102245] [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: 04/26/2019] [Revised: 06/29/2020] [Accepted: 08/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Active Straight Leg Raise (ASLR) is a clinical test that challenges lumbopelvic stability and have been used in low back pain patients. There are reports of positive tests in asymptomatic individuals, however, it is not clear if they are false positives or a consequence of performing the test differently. OBJECTIVES To compare abdominal muscles activity and pelvic motion during an ASLR between adults with chronic low back pain and asymptomatic participants with a positive and negative ASLR test. DESIGN Cross-sectional study design. METHOD Nineteen volunteers with chronic nonspecific low back pain (LBP) and 19 asymptomatic, 12 with a negative ASLR (AG-) and 7 with a positive ASLR test (AG+) were assessed while performing an ASLR (dynamic postural challenge). Pelvic rotation and medio-lateral center of pressure displacement (COPml), as well as bilateral EMG abdominal muscles activity were assessed. Muscles asymmetry index were also analyzed. Kruskal-wallis test was used to compare groups (α = 0.05). RESULTS Both LBP and AG + displayed significantly less contralateral internal oblique/transversus abdominis (IO/TrA) muscle activation than AG- (p = 0.003 and p = 0.005, respectively) and also more asymmetry between sides in the IO/TrA than AG- (p = 0.022 and p = 0.004, respectively). No significant differences between LBP and AG+ were found (p > 0.05). CONCLUSION A positive ASLR test in an asymptomatic person could be more than a false positive, since IO/TrA muscle activation appears to be lower and more asymmetrical in people with a positive ASLR test, both with and without low back pain. Future studies may consider removing asymptomatic individuals with a positive ASLR.
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Affiliation(s)
- Carlos Crasto
- Department of Physiotherapy and Activity and Human Movement Study Center (CEMAH), School of Allied Health Technologies, Polytechnic Institute of Porto, Portugal; Department of Physiotherapy, Santa Maria Health School, Porto, Portugal.
| | - António Mesquita Montes
- Department of Physiotherapy and Activity and Human Movement Study Center (CEMAH), School of Allied Health Technologies, Polytechnic Institute of Porto, Portugal; Department of Physiotherapy, Santa Maria Health School, Porto, Portugal.
| | - Paulo Carvalho
- Department of Physiotherapy and Activity and Human Movement Study Center (CEMAH), School of Allied Health Technologies, Polytechnic Institute of Porto, Portugal.
| | - Jm Cancela Carral
- Faculty of Education and Sports Science, University of Vigo, Pontevedra, Spain.
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Arampatzis A, Laube G, Schroll A, Frank J, Bohm S, Mersmann F. Perturbation‐based exercise for prevention of low‐back pain in adolescent athletes. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.191] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Adamantios Arampatzis
- Department of Training and Movement Sciences Humboldt‐Universität zu Berlin Berlin Germany
- Berlin School of Movement Science Berlin Germany
| | - Gunnar Laube
- Department of Training and Movement Sciences Humboldt‐Universität zu Berlin Berlin Germany
- Berlin School of Movement Science Berlin Germany
| | - Arno Schroll
- Department of Training and Movement Sciences Humboldt‐Universität zu Berlin Berlin Germany
- Berlin School of Movement Science Berlin Germany
| | - Johannes Frank
- Department of Training and Movement Sciences Humboldt‐Universität zu Berlin Berlin Germany
| | - Sebastian Bohm
- Department of Training and Movement Sciences Humboldt‐Universität zu Berlin Berlin Germany
- Berlin School of Movement Science Berlin Germany
| | - Falk Mersmann
- Department of Training and Movement Sciences Humboldt‐Universität zu Berlin Berlin Germany
- Berlin School of Movement Science Berlin Germany
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Wernli K, O'Sullivan P, Smith A, Campbell A, Kent P. Movement, posture and low back pain. How do they relate? A replicated single-case design in 12 people with persistent, disabling low back pain. Eur J Pain 2020; 24:1831-1849. [PMID: 32621351 DOI: 10.1002/ejp.1631] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/11/2020] [Accepted: 06/28/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Movement and posture are commonly believed to relate to non-specific low back pain (NSLBP). While people with NSLBP appear to move and posture themselves differently from those without NSLBP, changes in movement and posture infrequently relate to improvements in NSLBP when analysed at a group-level. Additionally, little is known about how movement or posture change when clinical outcome improves. METHODS Within-person relationships were investigated using a replicated, repeated measures, single-case design in 12 people with persistent, disabling NSLBP. Individually relevant movement and posture were captured using wearable sensors on up to 20 occasions over a 22-week period (5-week baseline, 12-week physiotherapy-led intervention, 5-week follow-up), while pain and activity limitation were collected concomitantly. A series of cross-correlation analyses estimated the presence, strength, and direction of relationships. RESULTS Many participants (n = 10/12) had strong (e.g. r = 0.91, p = <0.001) relationships between changes in movement or posture and changes in pain and activity limitation, while some showed no strong association. Where relationships were observed, clinical improvement predominantly (93% or 57/61 relationships) related to increased spinal movement range and velocity during forward bending and lifting, reduced lumbar muscle EMG activity at maximum voluntary flexion, and increased posterior-pelvic-tilt during sitting and standing. CONCLUSION Within-person changes to individually relevant movement and posture appear to often relate to clinical outcome, but not always. When changes were related, movement and posture appear to return towards being 'less protective', however causal directions remain unknown. Important activities, movements, and postural parameters varied across the participants, highlighting the potential importance of individualized management. SIGNIFICANCE Changes to individually relevant movement and posture appear to often relate to clinical outcome, but not always. Patient-specific activities, and movement or postural parameters that related to improved pain and activity limitation, varied across the 12 participants, highlighting the potential importance of individualised management. Where clinical improvements were related to changes in movement or posture, participants consistently returned towards being 'less protective' (increased range and speed of movement, increased posterior-pelvic-tilt during sitting and standing). Mechanisms and generalizability remain unclear.
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Affiliation(s)
- Kevin Wernli
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
- Body Logic Physiotherapy, Perth, Western Australia, Australia
| | - Peter O'Sullivan
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
- Body Logic Physiotherapy, Perth, Western Australia, Australia
| | - Anne Smith
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Amity Campbell
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Peter Kent
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Presta V, Galuppo L, Mirandola P, Galli D, Pozzi G, Zoni R, Capici S, Colucci ME, Veronesi L, Ambrosini L, Gobbi G, Vitale M, Pasquarella C. One-shoulder carrying school backpack strongly affects gait swing phase and pelvic tilt: a case study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:168-170. [PMID: 32275285 PMCID: PMC7975905 DOI: 10.23750/abm.v91i3-s.9435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 11/27/2022]
Abstract
The use of backpacks is common to both adults and children and often leads to the onset of musculoskeletal discomforts. Although a large number of studies have focused on the optimal load for children schoolbags, there is no general consensus. Here we report a 13-yr old girl case study, showing the impact of weight and wearing the school backpack on gait parameters. The variation of gait parameters and pelvis angles in different conditions were studied: without backpack (CTRL), or with backpack at 10% Body Weight (10BW), 15% BW (15BW) and 20% BW (20BW), carried “on both shoulders” (2S), “on one shoulder” (1S), or “with one hand” (1H). Swing phase was comparably modified by 2S/20BW and 1S/10BW conditions, suggesting that a lower backpack weight was sufficient to induce gait alterations when carried in asymmetrical conditions. Pelvic tilt, which was preserved by a two-shoulders distributed 10% BW load (2S/10BW), was strongly reduced in asymmetrical condition (1S/10BW), suggesting that a low weight carried on a single shoulder generates postural modifications including reduction of pelvic tilting, which is known to be associated to low back pain.
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Affiliation(s)
| | - Laura Galuppo
- Dipartimento di Medicina e Chirurgia, Università di Parma.
| | | | - Daniela Galli
- Dipartimento di Medicina e Chirurgia, Università di Parma.
| | - Giulia Pozzi
- Dipartimento di Medicina e Chirurgia, Università di Parma.
| | - Roberta Zoni
- Dipartimento di Medicina e Chirurgia, Università di Parma.
| | - Silvia Capici
- Presidio di Riabilitazione Specialistica Ambulatoriale "terapia fisica e riabilitazione", Roma.
| | | | - Licia Veronesi
- Dipartimento di Medicina e Chirurgia, Università di Parma.
| | - Luca Ambrosini
- Dipartimento di Medicina e Chirurgia, Università di Parma.
| | - Giuliana Gobbi
- Dipartimento di Medicina e Chirugia, Università di Parma.
| | - Marco Vitale
- Dipartimento di Medicina e Chirurgia, Università di Parma; Laboratorio Analisi del Movimento (LAM), AOU Parma.
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Rodriguez-Perea A, Chirosa Ríos LJ, Martinez-Garcia D, Ulloa-Díaz D, Guede Rojas F, Jerez-Mayorga D, Chirosa Rios IJ. Reliability of isometric and isokinetic trunk flexor strength using a functional electromechanical dynamometer. PeerJ 2019; 7:e7883. [PMID: 31695965 PMCID: PMC6827544 DOI: 10.7717/peerj.7883] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 09/12/2019] [Indexed: 01/13/2023] Open
Abstract
Aim To determine the absolute and relative reliability of functional trunk tests, using a functional electromechanical dynamometer to evaluate the isokinetic strength of trunk flexors and to determine the most reliable assessment condition, in order to compare the absolute and relative reliability of mean force and peak force of trunk flexors and to determine which isokinetic condition of evaluation is best related to the maximum isometric. Methods Test-retest of thirty-seven physically active male student volunteers who performed the different protocols, isometric contraction and the combination of three velocities (V1 = 015 m s−1 , V2 = 0.30 m s−1, V3 = 0.45 m s−1) and two range of movement (R1 = 25% cm ; R2 = 50% cm) protocols. Results All protocols to evaluate trunk flexors showed an absolute reliability provided a stable repeatability for isometric and dynamic protocols with a coefficient of variation (CV) being below 10% and a high or very high relative reliability (0.69 < intraclass correlation coefficient [ICC] > 0.86). The more reliable strength manifestation (CV = 6.82%) to evaluate the concentric contraction of trunk flexors was mean force, with 0.15 m s−1 and short range of movement (V1R1) condition. The most reliable strength manifestation to evaluate the eccentric contraction of trunk flexors was peak force, with 0.15 m s−1 and a large range of movement (V1R2; CV = 5.07%), and the most reliable way to evaluate isometric trunk flexors was by peak force (CV = 7.72%). The mean force of eccentric trunk flexor strength with 0.45 m s−1 and short range of movement (V3R1) condition (r = 0.73) was best related to the maximum isometric contraction. Conclusion Functional electromechanical dynamometry is a reliable evaluation system for assessment of trunk flexor strength.
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Affiliation(s)
- Angela Rodriguez-Perea
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Granada, Spain
| | - Luis J Chirosa Ríos
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Granada, Spain
| | - Dario Martinez-Garcia
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Granada, Spain
| | - David Ulloa-Díaz
- Department of Sports Sciences and Physical Conditioning, Faculty of Education, CIEDE, Catholic University of Most Holy Conception, Concepcion, Concepcion, Chile
| | | | | | - Ignacio J Chirosa Rios
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Granada, Spain
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Desai MJ, Jonely H, Blackburn M, Wanasinghage S, Sheikh S, Taylor RS. The Back Pain and Movement (B-PAM) registry; a study protocol. BMC Musculoskelet Disord 2019; 20:249. [PMID: 31122221 PMCID: PMC6533756 DOI: 10.1186/s12891-019-2625-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 05/14/2019] [Indexed: 11/25/2022] Open
Abstract
Background Low back pain (LBP) is a ubiquitous, heterogeneous disorder that affects most people at some point in their lives. The efficient management of LBP remains elusive, with direct and indirect costs attributed to LBP surpassing many other common conditions. An emphasis on a structural basis of LBP often fails to recognize movement, specifically patterns of movement that may provide biomechanical signatures of painful conditions. The primary objective of this registry is to understand the differences in movement patterns among those with LBP and those without pain in a U.S. population sample. Methods This ongoing, non-randomized, prospective post-market registry will consist of two groups: patients with LBP, and age and sex-matched controls without LBP. We will seek to recruit 132 subjects in each group. Data collection will take place in two phases: (1) baseline assessment of LBP patients and matched controls; (2) assessment of LBP patients at 6 and 12-months follow up. The primary outcome measure will be differences in movement patterns between those with LBP and those without LBP. Secondary outcomes will include differences in patient reported outcomes including pain, disability and quality of life. Discussion The findings will help determine if there are meaningful differences in movement patterns between those with and those without LBP. Further, an initial understanding of movement signatures specific to certain subtypes of patients with LBP may be achieved. Trial registration The study was registered on the clinicaltrials.gov portal: NCT03001037. Trial retrospectively registered 12/22/2016.
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Affiliation(s)
- Mehul J Desai
- International Spine, Pain & Performance Center, 2141 K Street NW, Suite 600, Washington, DC, 20037, USA.,The George Washington University, School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA
| | - Holly Jonely
- The George Washington University, School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA
| | | | | | - Sidrah Sheikh
- International Spine, Pain & Performance Center, 2141 K Street NW, Suite 600, Washington, DC, 20037, USA
| | - Rod S Taylor
- University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
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