Determining Physiological and Psychological Predictors of Time to Task Failure on a Virtual Reality Sørensen Test in Participants With and Without Recurrent Low Back Pain: Exploratory Study

Abstract

BackgroundSørensen trunk extension endurance test performance predicts the development of low back pain and is a strong discriminator of those with and without low back pain. Performance may greatly depend on psychological factors, such as kinesiophobia, self-efficacy, and motivation. Virtual reality video games have been used in people with low back pain to encourage physical activity that would otherwise be avoided out of fear of pain or harm. Accordingly, we developed a virtual reality video game to assess the influence of immersive gaming on the Sørensen test performance.ObjectiveThe objective of our study was to determine the physiological and psychological predictors of time to task failure (TTF) on a virtual reality Sørensen test in participants with and without a history of recurrent low back pain.MethodsWe recruited 24 individuals with a history of recurrent low back pain and 24 sex-, age-, and body mass index–matched individuals without a history of low back pain. Participants completed a series of psychological measures, including the Center for Epidemiological Studies-Depression Scale, Pain Resilience Scale, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and a self-efficacy measure. The maximal isometric strength of trunk and hip extensors and TTF on a virtual reality Sørensen test were measured. Electromyography of the erector spinae, gluteus maximus, and biceps femoris was recorded during the strength and endurance trials.ResultsA two-way analysis of variance revealed no significant difference in TTF between groups (P=.99), but there was a trend for longer TTF in females on the virtual reality Sørensen test (P=.06). Linear regression analyses were performed to determine predictors of TTF in each group. In healthy participants, the normalized median power frequency slope of erector spinae (beta=.450, P=.01), biceps femoris (beta=.400, P=.01), and trunk mass (beta=−.32, P=.02) predicted TTF. In participants with recurrent low back pain, trunk mass (beta=−.67, P<.001), Tampa Scale for Kinesiophobia (beta=−.43, P=.01), and self-efficacy (beta=.35, P=.03) predicted TTF.ConclusionsTrunk mass appears to be a consistent predictor of performance. Kinesiophobia appears to negatively influence TTF for those with a history of recurrent low back pain, but does not influence healthy individuals. Self-efficacy is associated with better performance in individuals with a history of recurrent low back pain, whereas a less steep median power frequency slope of the trunk and hip extensors is associated with better performance in individuals without a history of low back pain.

No alteration of back muscle oxygenation during isometric exercise in individuals with non-specific low back pain

“…This points to two conclusions: First, BSME holding times are reduced in NSCLBP patients because of some other factor that was not measured in the present study, such as reduced motivation 17 , 44 or different recruitment of muscles beyond back extensors 10 , 45 . Second, it appears unlikely that altered back muscle oxygenation and subsequent accumulation of metabolites is a major source of pain in patients with CNSLBP.…”

Are neuromuscular adaptations present in people with recurrent spinal pain during a period of remission? a systematic review

“…The main findings of each study are summarised in S3 Table . From the results retrieved in individual studies, evidence of neuromuscular adaptations in people with rLBP were found for the following outcome domains: muscle activation amplitude [ 34 , 35 , 37 , 38 , 42 , 44 , 48 , 49 , 56 , 57 , 58 – 60 , 65 , 67 ] and timing [ 13 , 37 , 51 – 54 , 65 ], spine kinematics [ 34 , 43 , 47 , 50 , 62 – 64 , 66 ], sensorimotor control [ 61 , 62 ], muscle properties [ 45 , 46 , 58 , 68 ], and neuromuscular performance [ 39 – 41 , 46 , 47 , 55 , 69 ]. For people with rNP, sensorimotor control and neck muscle performance were assessed in the single study included [ 33 ].…”

A scoping review on the methods of assessment and role of resilience on function and movement-evoked pain when experiencing a musculoskeletal injury

“…This therefore did not assess grit in relation to a musculoskeletal injury and excluded the paper from the review. Similarly, a virtual reality Sørensen test was assessed in participants with and without recurrent low back pain [ 71 ]. Whilst the Sørensen test is a well-known test of muscle endurance, it is used to predict first time episodes and recurrence of back pain [ 71 ], rather than predict functional performance.…”

“…Similarly, a virtual reality Sørensen test was assessed in participants with and without recurrent low back pain [ 71 ]. Whilst the Sørensen test is a well-known test of muscle endurance, it is used to predict first time episodes and recurrence of back pain [ 71 ], rather than predict functional performance. Five further studies outwardly fit the brief of the scoping review, however upon deeper examination were excluded due to inclusion of presentations not of a musculoskeletal origin [ 72 ], lack of detail to confirm pain of a musculoskeletal origin [ 73 ], use of an optimism outcome measure to assess resilience [ 74 ], absence of results reflecting the assessment of resilience [ 75 ] or use of assessments which were the combination of cognitive and functional domains [ 76 ].…”