Do people with low back pain walk differently? A systematic review and meta-analysis

Smith, Jo Armour; Stabbert, Heidi; Bagwell, Jennifer J.; Teng, Hsiang‐Ling; Wade, Vernie; Lee, Szu‐Ping

doi:10.1016/j.jshs.2022.02.001

Cited by 40 publications

(29 citation statements)

References 137 publications

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“…In recent years, increasing attention was given toward the role of paraspinal muscle in pathogenesis of spinal disorders. Multiple studies have showed correlation between PSM degeneration with back pain, radiculopathy, and spinal deformity ( 19 , 21 , 26 - 28 ). Similarly, Lee et al reported extensive degeneration of back muscle could be a causative factor in the pathogenesis of flat back syndrome ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

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The role of paraspinal muscle degeneration in coronal imbalance in patients with degenerative scoliosis

Kiram¹,

Hu²,

Man³

et al. 2022

Quant Imaging Med Surg

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Background Coronal imbalance in degenerative scoliosis is common and is highly correlated with health-related quality of life. Paraspinal muscle is critical to spine stability, but little is known about its contribution to coronal imbalance in degenerative scoliosis. This study aims to investigate the relationship between paraspinal muscle (PSM) degeneration and coronal imbalance in patients with degenerative scoliosis (DS). Methods This is a retrospective cohort study. A total of 117 patients with DS were retrospectively reviewed. Parameters of PSM (bilateral cross-sectional area, CSA; fat infiltration rate, FI%) at the apical disc and adjacent levels were quantitatively evaluated using MRI. Standing whole-spine radiograph was used to evaluate the coronal (Cobb angle, CA; coronal balance distance, CBD) and sagittal (thoracic kyphosis, TK; lumbar lordosis, LL; sagittal vertical axis, SVA) parameters. Patients were divided into 3 groups: coronal balanced (Type A), coronal imbalanced shifting to concavity (Type B), and coronal imbalanced shifting to convexity (Type C). Results Based on our criteria, 56 patients were assigned to Type A, 34 patients to Type B, and 27 patients to Type C. There was no significant difference on the sagittal profiles and CSA between the groups. However, Type A showed significantly lower FI% than Type B and Type C on both concavity and convexity (Concave side: Type A vs. Type B vs. Type C, 30.8±8.1 vs. 45.1±7.7 vs. 38.7±12.5, P=0.001; Convex side: Type A vs. Type B vs. Type C, 32.6±10.9 vs. 46.3±7.3 vs. 40.7±11.8, P=0.004). Specifically, Cobb angle was negatively correlated with CSA, mainly at convexity (R=−0.415, P=0.008). Similarly, the increase of CBD significantly correlated with FI% at concavity (R=0.491, P=0.001) and convexity (R=0.354, P=0.025). Conclusions DS patients with coronal imbalance demonstrated a worse PSM degeneration when compared with those without coronal imbalance. Besides, PSM degeneration strongly correlated with coronal imbalance, which implies that PSM degeneration may contribute to the coronal imbalance in patients with DS.

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Section: Discussionmentioning

confidence: 99%

“…The quality and quantity of paraspinal muscle were reported to be correlated with age and gender ( 20 , 21 ). To eliminate those confounding factors, this retrospective cohort study included female patients with DS that attended our hospital during the period from February 2017 to December 2020.…”

Section: Methodsmentioning

confidence: 99%

The role of paraspinal muscle degeneration in coronal imbalance in patients with degenerative scoliosis

Kiram¹,

Hu²,

Man³

et al. 2022

Quant Imaging Med Surg

View full text Add to dashboard Cite

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“…Low back pain, which refers to pain and discomfort in the lumbosacral region, is a highly prevalent condition with high burden worldwide ( Balagué et al, 2012 ; Smith et al, 2022 ). The point prevalence and lifetime prevalence of low back pain are 7.83% (95% confidence interval [CI]: 7.04–8.64) and 84% ( Balagué et al, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Non-invasive brain neuromodulation techniques for chronic low back pain

Chang

et al. 2022

Front. Mol. Neurosci.

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Structural and functional changes of the brain occur in many chronic pain conditions, including chronic low back pain (CLBP), and these brain abnormalities can be reversed by effective treatment. Research on the clinical applications of non-invasive brain neuromodulation (NIBS) techniques for chronic pain is increasing. Unfortunately, little is known about the effectiveness of NIBS on CLBP, which limits its application in clinical pain management. Therefore, we summarized the effectiveness and limitations of NIBS techniques on CLBP management and described the effects and mechanisms of NIBS approaches on CLBP in this review. Overall, NIBS may be effective for the treatment of CLBP. And the analgesic mechanisms of NIBS for CLBP may involve the regulation of pain signal pathway, synaptic plasticity, neuroprotective effect, neuroinflammation modulation, and variations in cerebral blood flow and metabolism. Current NIBS studies for CLBP have limitations, such as small sample size, relative low quality of evidence, and lack of mechanistic studies. Further studies on the effect of NIBS are needed, especially randomized controlled trials with high quality and large sample size.

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“…Therefore, over the past 30 years, many clinical guidelines have recommended that treatment of CLBP should focus on non-pharmacological treatments, such as exercise therapy and mind–body exercise ( Bernstein et al, 2017 ; Qaseem et al, 2017 ; Wong et al, 2017 ; Stochkendahl et al, 2018 ; Zhang et al, 2019 ; Peng et al, 2022 ; Xiong et al, 2022 ). Exercise therapy, which includes a variety of interventions ranging from aerobic exercise to muscle strength training, has been shown to be useful in alleviating pain ( Lawand et al, 2015 ; Wieland et al, 2017 ; Russo et al, 2018 ; Smith et al, 2022 ; Wu et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

The effect and mechanism of traditional Chinese exercise for chronic low back pain in middle-aged and elderly patients: A systematic review

Wang

Xiong

et al. 2022

Front. Aging Neurosci.

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BackgroundIncreasing lines of evidence indicate that traditional Chinese exercise (TCE) has potential benefits in improving chronic low back pain (CLBP) symptoms. To assess the clinical efficacy of TCE in the treatment of CLBP, we performed a systematic review of existing randomized controlled trials (RCTs) of CLBP and summarized the neural mechanisms underlying TCE in the treatment of CLBP.MethodsA systematic search was conducted in four electronic databases: PubMed, Embase, the Cochrane Library, and EBSCO from January 1991 to March 2022. The quality of all included RCTs was evaluated by the Physiotherapy Evidence Database Scale (PEDro). The primary outcomes included pain severity and pain-related disability.ResultsA total of 11 RCTs with 1,256 middle-aged and elderly patients with CLBP were included. The quality of all 11 included RCTs ranged from moderate to high according to PEDro. Results suggested that TCE could considerably reduce pain intensity in patients with CLBP. Overall, most studies did not find any difference in secondary outcomes (quality of life, depression, and sleep quality).ConclusionThe neurophysiological mechanism of TCE for treating CLBP could be linked to meditation and breathing, posture control, strength and flexibility training, and regulation of pain-related brain networks. Our systematic review showed that TCE appears to be effective in alleviating pain in patients with CLBP.

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Do people with low back pain walk differently? A systematic review and meta-analysis

Cited by 40 publications

References 137 publications

The role of paraspinal muscle degeneration in coronal imbalance in patients with degenerative scoliosis

The role of paraspinal muscle degeneration in coronal imbalance in patients with degenerative scoliosis

Non-invasive brain neuromodulation techniques for chronic low back pain

The effect and mechanism of traditional Chinese exercise for chronic low back pain in middle-aged and elderly patients: A systematic review

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