Assessment instruments of movement quality in patients with non-specific low back pain: A systematic review and selection of instruments

Dijk, Margriet J. H van; Smorenburg, Nienke; Heerkens, Yvonne; Mollema, Jürgen; Kiers, Henri; Sanden, Maria W. G. Nijhuis – van der; Visser, Bart

doi:10.1016/j.gaitpost.2019.12.027

Cited by 11 publications

(11 citation statements)

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“…To the best of our knowledge, a systematic review study has not yet examined the kinematic differences between lumbopelvic and lower limb joints between NS-LBP and healthy people. Observation and analysis of movement quality in patients with NS-LBP is important for physiotherapists to make clinical decisions and exercise program design [30].…”

Section: Systematic Review Registrationmentioning

confidence: 99%

Lumbo-Pelvic and Lower Limb Joint Kinematics in Subjects with and Without Low Back Pain: A Protocol for Systematic Review

Dehcheshme

Arab²,

Nourbakhsh

2021

Preprint

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Background Low back pain (LBP) is one of the leading causes of disability worldwide. While its main cause is mostly unknown, more than 80% of people experience this disorder during their lifetime .Some clinical evidence suggests that people with chronic LBP have various lower extremity movement disorders. This study aims to systematically review the literature on comparing the kinematics of the lumbopelvic region and lower limb joints in people with non-specific low back pain (NS-LBP) compared to healthy individuals. Methods/design: We will search main electronic databases (Medline/PubMed, Scopus, Embase, Web of Science, Pedro, ProQuest and Google Scholar) and two key journals (Journal of Electromyography and Kinesiology, Clinical Biomechanics). Also, the reference list of the previous systematic reviews would be hand-searched. Studies that have examined the kinematic differences in lumbopelvic or lower limbs between NS-LBP and healthy individuals will be included. We will examine the methodological quality and statistical reporting of each eligible trial using the Newcastle – Ottawa Scale (NOS). Discussion To our knowledge, this study will be the first systematic review to examine the kinematic differences of the lower limb joints and pelvic complex between healthy people and NS-LBP. Since the kinematic assessment of the lower extremities and pelvic joints during daily activities may help understand underlying factors causing LBP, it is important to evaluate the kinematic changes in these regions, during repetitive daily functions in these patients. Systematic review registration: PROSPERO (CRD42021230826)

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Section: Systematic Review Registrationmentioning

confidence: 99%

Lumbo-Pelvic and Lower Limb Joint Kinematics in Subjects with and Without Low Back Pain: A Protocol for Systematic Review

Dehcheshme

Arab²,

Nourbakhsh

2021

Preprint

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“…Movement characteristics between people with and without low back pain overlap but vary substantially (Knechtle et al., 2021; Laird et al., 2014; Laird et al., 2019) in speed, range, flexion‐relaxation response, and lumbo‐pelvic synchrony (Laird et al., 2018), inside and outside clinic settings (Gizzi et al., 2018; Roeser et al., 2019), but intervening to change them has produced mixed reports of change in pain and function (Farragher et al., 2019; Kent et al., 2015; Laird et al., 2012; van Dieën et al., 2019). Although physiotherapists routinely observe and interpret pain‐related movement quality (Van Dijk, Smorenburg, Visser, Heerkens, & Nijhuis‐van der Sanden, 2017), no adequate assessment instruments exist (Van Dijk et al., 2020).…”

Section: Introductionmentioning

confidence: 99%

Guarding and flow in the movements of people with chronic pain: A qualitative study of physiotherapists’ observations

Williams,

Buono,

Gold

et al. 2023

European Journal of Pain

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BackgroundAmong the adaptations of movement consistently associated with disability in chronic pain, guarding is common. Based on previous work, we sought to understand better the constituents of guarding; we also used the concept of flow to explore the description of un/naturalness that emerged from physiotherapists' descriptions of movement in chronic pain. The aim was to inform the design of technical systems to support people with chronic pain in everyday activities.MethodsSixteen physiotherapists, experts in chronic pain, were interviewed while repeatedly watching short video clips of people with chronic low back pain doing simple movements; physiotherapists described the movements, particularly in relation to guarding and flow. The transcribed interviews were analysed thematically to elaborate these constructs.ResultsModerate agreement emerged on the extent of guarding in the videos, with good agreement that guarding conveyed caution about movement, distinct from biomechanical variables of stiffness or slow speed. Physiotherapists' comments on flow showed slightly better agreement, and described the overall movement in terms of restriction (where there was no flow or only some flow), of tempo of the entire movement, and as naturalness (distinguished from normality of movement).ConclusionsThese qualities of movement may be useful in designing technical systems to support self‐management of chronic pain.SignificanceDrawing on the descriptions of movements of people with chronic low back pain provided by expert physiotherapists to standard stimuli, two key concepts were elaborated. Guarding was distinguished from stiffness (a physical limitation) or slowness as motivated by fear or worry about movement. Flow served to describe harmonious and continuous movement, even when adapted around restrictions of pain. Movement behaviours associated with pain are better understood in terms of their particular function than aggregated without reference to function.

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“…These questionnaires establish an overview of the perceived limitations in activities and restrictions in participation from a patient’s perspective. Currently, a standardized observational assessment of MQ during relevant problematic activities is lacking [ 10 , 20 , 24 ]. This hampers comparison of the therapeutic observations with the patient’s experience and the physical examination of for instance the mobility of the spine.…”

Section: Introductionmentioning

confidence: 99%

“…The Observable Movement Quality scale for patients with Low Back Pain (OMQ-LBP) for therapists’ aims to achieve a standardized observation and an uniform and objectified description and evaluation of how the patient performs activities. The development of the OMQ-LBP is based on two extended inventories in clinical practice [ 10 , 14 ] and a systematic review [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

The Observable Movement Quality scale for patients with low back pain (OMQ-LBP): validity and reliability in a primary care setting of physical therapy

van Dijk,

van der Wal,

Mollema†

et al. 2023

BMC Musculoskelet Disord

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Background The Observable Movement Quality scale for patients with low back pain (OMQ-LBP) is a newly developed measurement instrument for use in primary care settings of physical and exercise therapists to assess movement quality (MQ) of patients with low back pain (LBP). Objective This study aims to determine validity, reliability and feasibility of the OMQ-LBP. The OMQ-LBP consists of a standardized movement circuit (performed twice) consisting of five daily activities problematic for LBP patients, which are scored with an 11-item observation list. Methods Construct validity was determined by testing seven hypotheses on associations between constructs (n = 85 patients with LBP) and four hypotheses on known group differences (n = 85 patients with LBP and n = 63 healthy controls; n = 35 matched participant-patients having VAS-pain ≥ 20 mm during and/or after both circuits and healthy controls). Internal consistency was analyzed with Cronbach’s alpha (n = 85 patients with LBP). For inter- and intra-rater reliability Intraclass Correlation Coefficient (ICC) values were examined (n = 14 therapists: seven primary care physical therapists and seven exercise therapists). Additionally, content validity and feasibility were determined using thematic analysis of a brief interview with participants, patients (n = 38) and therapists (n = 14). Results After Bonferroni correction 2/7 associations between constructs and 2/4 significant group differences were confirmed. Cronbach’s alpha was 0,79. The ICC-values of interrater reliability of the OMQ-LBP total score and the duration score were 0.56 and 0.99 and intra-rater reliability 0.82 and 0,93, respectively. Thematic analysis revealed five themes. Three themes elucidate that both patients and therapists perceived the content of the OMQ-LBP as valid. The fourth theme exhibits that OMQ-LBP provides a clear and unambiguous language for MQ in patients with LBP. Theme 5 depicts that the OMQ-LBP seems feasible, but video recording is time-consuming. Conclusions The OMQ-LBP is a promising standardized observational assessment of MQ during the five most problematic daily activities in patients with LBP. It is expected that uniform and objective description and evaluation of MQ add value to clinical reasoning and facilitate uniform communication with patients and colleagues.

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Assessment instruments of movement quality in patients with non-specific low back pain: A systematic review and selection of instruments

Cited by 11 publications

References 59 publications

Lumbo-Pelvic and Lower Limb Joint Kinematics in Subjects with and Without Low Back Pain: A Protocol for Systematic Review

Lumbo-Pelvic and Lower Limb Joint Kinematics in Subjects with and Without Low Back Pain: A Protocol for Systematic Review

Guarding and flow in the movements of people with chronic pain: A qualitative study of physiotherapists’ observations

The Observable Movement Quality scale for patients with low back pain (OMQ-LBP): validity and reliability in a primary care setting of physical therapy

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