Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance

Abstract

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).

Relation between Physical Fitness Components and the Occurrence and Subjective Intensity of Back Pain in Secondary School Adolescents

“…The use of a 5-choice Likert scale was also made to reflect the school grading system, which participants were familiar with. Based on the risk-intensity association for back pain proposed in previous studies [ 27 , 28 , 29 ], and in accordance with Joergensen et el. [ 30 ], based on their responses participants were grouped into three main categories: no back pain (NBP: students who stated not to suffer from back pain; score = 1); mild-to-moderate back pain (MBP: participants with low to null health risk; scores = 2–3); and severe back pain (SBP: youth whose back pain may imply higher health risk; scores > 3).…”

Assessing the Effects of Aging on Muscle Stiffness Using Shear Wave Elastography and Myotonometer

“…When it comes to the human body, stiffness can be explained in a wide range of contexts, from a single muscle fiber to the whole body. Muscle stiffness is the muscle’s ability to maintain its initial structure against external forces to prevent deformities [ 17 ]. Several studies have investigated the alterations of muscle stiffness due to aging; however, the results are conflicting.…”

Mechanical Changes of the Lumbar Intervertebral Space and Lordotic Angle Caused by Posterior-to-Anterior Traction Using a Spinal Thermal Massage Device in Healthy People

“…Studies have reported that the lifetime prevalence of LBP is as high as 84% and known to cause massive individual and economic burdens in industrialized nations such as Korea [ 6 , 7 , 8 ]. In addition, numerous studies have shown that adolescent LBP is a strong predictor for chronic LBP problems in adulthood [ 6 , 9 , 10 , 11 ]. Most cases of LBP are due to herniated discs, 98% of which occur in the L4–5 disc [ 2 ].…”