Discriminating Healthy Controls and Two Clinical Subgroups of Nonspecific Chronic Low Back Pain Patients Using Trunk Muscle Activation and Lumbosacral Kinematics of Postures and Movements

Dankaerts, Wim; O’Sullivan, Peter; Burnett, Angus; Straker, Leon; Davey, Paul; Gupta, Ritu

doi:10.1097/brs.0b013e3181aa6175

Cited by 161 publications

(147 citation statements)

References 37 publications

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“…16 In another study, we investigated sag ittal plane standing postures in 14year olds and identified 4 posture subgroups (neutral, sway back, flat back, and lordot ic). 58 A number of relationships between LBP and nonneutral spinal postures were identified.…”

Section: Multidimensional Factors and Adolescent Lbp: Physical Factorsmentioning

confidence: 99%

Understanding Adolescent Low Back Pain From a Multidimensional Perspective: Implications for Management

O’Sullivan¹,

Smith²,

Beales³

et al. 2017

J Orthop Sports Phys Ther

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Section: Multidimensional Factors and Adolescent Lbp: Physical Factorsmentioning

confidence: 99%

Understanding Adolescent Low Back Pain From a Multidimensional Perspective: Implications for Management

O’Sullivan¹,

Smith²,

Beales³

et al. 2017

J Orthop Sports Phys Ther

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“…4,8,22 Consideration of poor ability to dissociate movements between spine regions is common in these classification methods 10,22 and other assessments for LBP. 25 Poor movement dissociation is been reported previously.…”

Section: Relevance For Identification Of Lbp Subgroupsmentioning

confidence: 99%

“…4,5,19,29 Recovery from LBP does not ensure restoration of spine function or movement, and recurrent LBP involves persistent alterations of motor control, including modified coordination between short/deep (eg, multifidus) and long/ superficial (eg, thoracic erector spinae) paraspinal muscles, with a tendency to contract these muscles en masse rather than to activate …”

mentioning

confidence: 99%

Validation of a Clinical Test of Thoracolumbar Dissociation in Chronic Low Back Pain

Cancino

Schabrun²,

Danneels³

et al. 2015

J Orthop Sports Phys Ther

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Motor control deficits are common in chronic/recurrent low back pain (LBP) 3,13,19,24,33,34,36 and include altered paraspinal muscle function. 4,5,19,29 Recovery from LBP does not ensure restoration of spine function or movement, and recurrent LBP involves persistent alterations of motor control, including modified coordination between short/deep (eg, multifidus) and long/ superficial (eg, thoracic erector spinae) paraspinal muscles, with a tendency to contract these muscles en masse rather than to activate T T BACKGROUND:Control deficits of back muscles and trunk movement are common in chronic/recurrent low back pain (LBP). A reliable clinical test to rate an individual's ability to dissociate lumbopelvic movement from the thoracolumbar region has been described. This test rates the performance quality of 5 key aspects against criterion standards. T T METHODS: Concurrent validity was examinedby comparison of clinical test scores (overall score and each individual criterion) against spine kinematics. Discriminant validity was evaluated by comparison of scores between pain-free controls and participants with LBP. A receiver operating characteristic curve was calculated to determine the optimal cutoff or score to differentiate between good and poor performers. T T RESULTS:Concurrent validity was supported by the significant correlation between the total score and motion of the T5 vertebra relative to the S1 vertebra (P<.05). Scores for some (4 correlations of 14 measures) but not all individual criteria were correlated with the kinematic features that each criterion was expected to reflect. Discriminant validity was supported by higher test scores for pain-free controls than for participants with LBP after 2 minutes of training (P = .045). Scores of less than 5.5 were more prevalent in the LBP group (pretraining LBP versus control, 72% versus 35%; P = .008; posttraining LBP versus control, 48% versus 16%; P = .018). T T CONCLUSION:This preliminary study of concurrent and discriminant validity of the test provides a foundation to further investigate its utility to characterize thoracolumbar movement patterns in individuals with LBP.

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“…The laboratory tests analysed in Study IV (Dankaerts et al, 2009) involved commonly reported aggravating spinal postures and movements that form part of the basis of the clinical classification process. The results of Study IV demonstrated that a Statistical Classification Model identified five lumbo-sacral kinematics (lower lumbar spine kinematics in sitting and forward bending) and two trunk muscle activation (lack of flexion relaxation of the superficial fibres of lumbar multifidus in slump sitting and end range of forward bending) variables that were able to correctly classify 96.4% of cases and to discriminate the three groups (no-LBP, AEP and FP).…”

Section: Can Clinicians Agree On the Classification Of Nonspecific Chmentioning

confidence: 99%

The validity of O’Sullivan’s classification system (CS) for a sub-group of NS-CLBP with motor control impairment (MCI): Overview of a series of studies and review of the literature

Dankaerts

O’Sullivan

2011

Manual Therapy

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a b s t r a c tChronic Low Back Pain (LBP) remains a common, recalcitrant and costly problem for the individual sufferer and for society. Effective treatments that reduce the social and economic burden have yet to be established for the majority of chronic LBP cases. Lack of evidence for specific interventions has been blamed on the heterogeneity of the chronic LBP population as well as a lack of a patient centred biopsycho-social approach. This issue of heterogeneity has resulted in classification being considered the highest research priority in the area of chronic LBP. The potential for a 'wash-out effect' caused by the heterogeneity of the chronic LBP populations sampled for randomised controlled clinical trials (RCTs), has driven the need for classifying patients with nonspecific chronic LBP. A summary of a series of studies is outlined in this review paper. They represent a comprehensive investigation into the validity of O'Sullivan's proposed mechanism-based classification system (CS) for a sub-group of localized mechanically provoked nonspecific chronic LBP with motor control impairment (MCI). Further, the findings of these studies are discussed in relation to the relevant literature and the clinical implications arising are presented. Finally, the limitations of this research are outlined and recommendations for future research are made.

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Discriminating Healthy Controls and Two Clinical Subgroups of Nonspecific Chronic Low Back Pain Patients Using Trunk Muscle Activation and Lumbosacral Kinematics of Postures and Movements

Abstract: Selected biomechanical variables were predictors for subgroup membership and were able to discriminate the 3 subgroups. This study adds further support toward the validation of the proposed classification system.

Cited by 161 publications

References 37 publications

Understanding Adolescent Low Back Pain From a Multidimensional Perspective: Implications for Management

Understanding Adolescent Low Back Pain From a Multidimensional Perspective: Implications for Management

Validation of a Clinical Test of Thoracolumbar Dissociation in Chronic Low Back Pain

The validity of O’Sullivan’s classification system (CS) for a sub-group of NS-CLBP with motor control impairment (MCI): Overview of a series of studies and review of the literature

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