Dataset Information

Mechanical Perturbations of the Walking Surface Reveal Unaltered Axial Trunk Stiffness in Chronic Low Back Pain Patients.

ABSTRACT: INTRODUCTION:Patients with chronic low back pain (CLBP) often demonstrate altered timing of thorax rotations in the transverse plane during gait. Increased axial trunk stiffness has been claimed to cause this movement pattern. OBJECTIVES:The objective of this study was to assess whether axial trunk stiffness is increased in gait in CLBP patients. METHODS:15 CLBP patients and 15 healthy controls walked on a treadmill that imposed rotational perturbations in the transverse plane. The effect of these perturbations on transverse pelvis, thorax and trunk (thorax relative to pelvis) rotations was evaluated in terms of residual rotations, i.e., the deviation of these movements from the unperturbed patterns. In view of the heterogeneity of the CLBP group, we additionally performed a subgroup comparison between seven patients and seven controls with maximal between-group contrast for timing of thorax rotations. RESULTS:Rotations of the walking surface had a clear effect on transverse pelvis, thorax and trunk rotations in all groups. No significant between-group differences on residual transverse pelvis, thorax and trunk rotations were observed. CONCLUSION:Axial trunk stiffness in gait does not appear to be increased in CLBP. Altered timing of thorax rotations in CLBP does not seem to be a result of increased axial trunk stiffness.

SUBMITTER: Prins MR

PROVIDER: S-EPMC4911008 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Mechanical Perturbations of the Walking Surface Reveal Unaltered Axial Trunk Stiffness in Chronic Low Back Pain Patients.

Prins Maarten R MR van der Wurff Peter P Meijer Onno G OG Bruijn Sjoerd M SM van Dieën Jaap H JH

PloS one 20160616 6

<h4>Introduction</h4>Patients with chronic low back pain (CLBP) often demonstrate altered timing of thorax rotations in the transverse plane during gait. Increased axial trunk stiffness has been claimed to cause this movement pattern.<h4>Objectives</h4>The objective of this study was to assess whether axial trunk stiffness is increased in gait in CLBP patients.<h4>Methods</h4>15 CLBP patients and 15 healthy controls walked on a treadmill that imposed rotational perturbations in the transverse pl ...[more]

PMID: 27310528

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Project description:Chronic low back pain (cLBP) rates among younger individuals are rising. Although pain and disability are often less severe, underlying changes in trunk behavior may be responsible for recurrence. We examine the biomarker capacity of a simple Trunk Compliance Index (TCI) to distinguish individuals with and without cLBP. A random subset (n = 49) of the RELIEF RCT were matched to healthy controls for sex, age, height and weight. We measured TCI (as displacement/ weight-normalized perturbation force) using anthropometrically-matched, suddenly-applied pulling perturbations to the trunk segment, randomized across three planes of motion (antero-posterior, medio-lateral, and rotational). Mean differences between cLBP, sex and perturbation direction were assessed with repeated-measures analysis of variance. Discriminatory accuracy of TCI was assessed using Receiver Operator Characteristic (ROC) analysis. Baseline characteristics between groups were equivalent (x̅ [range]): sex (57% female / group), age (23.0 [18-45], 22.8 [18-45]), height, cm (173.0 [156.5-205], 171.3 [121.2-197], weight, kg (71.8 [44.5-116.6], 71.7 [46.8-117.5]) with cLBP associated with significantly lower TCI for 5 of 6 directions (range mean difference, - 5.35: - 1.49, range 95% CI [- 6.46: - 2.18 to - 4.35: - 0.30]. Classification via ROC showed that composite TCI had high discriminatory potential (area under curve [95% CI], 0.90 [0.84-0.96]), driven by TCI from antero-posterior perturbations (area under curve [95% CI], 0.99 [0.97-1.00]). Consistent reductions in TCI suggests global changes in trunk mechanics that may go undetected in classic clinical examination. Evaluation of TCI in younger adults with mild pain and disability may serve as a biomarker for chronicity, leading to improved preventative measures in cLBP.Trial Registration and Funding RELIEF is registered with clinicaltrials.gov (NCT01854892) and funded by the NIH National Center for Complementary & Integrative Health (R01AT006978).

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Dataset Information

Mechanical Perturbations of the Walking Surface Reveal Unaltered Axial Trunk Stiffness in Chronic Low Back Pain Patients.

Publications

Mechanical Perturbations of the Walking Surface Reveal Unaltered Axial Trunk Stiffness in Chronic Low Back Pain Patients.

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