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

Smith, Jo Armour; Stabbert, Heidi; Bagwell, Jennifer; Teng, Hsiang‐Ling; Wade,; S, Lee

doi:10.1101/2021.05.08.21256890

Cited by 4 publications

(5 citation statements)

References 137 publications

(240 reference statements)

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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)(27)(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: 98%

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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: 98%

“…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: Patient Selectionmentioning

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

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“…CNLBP is a highly prevalent global public health issue ( Van et al, 2006), causing not only physical and psychological harm to patients but also incurring signi cant nancial costs that must be addressed [75]. Exercise treatment has been demonstrated to alleviate symptoms in individuals with CNLBP, according to several studies [76, 77,78].…”

Section: Discussionmentioning

confidence: 99%

Interventions of Exercise Therapy for Chronic Non-Specific Low Back Pain: A Comprehensive Systematic Review and Comparative Study of Effects

Liu,

Wang,

Dong

et al. 2024

Preprint

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Background: The cost of medical care for low back pain is a heavy financial burden for patients and has become a common social health issue that affects people of all ages and professions. Objective：To comprehensively evaluate the effectiveness of different types of exercise therapy in treating chronic non-specific low back pain, and provide decision support for patients, medical professionals, and decision-makers to choose the most suitable exercise therapy to reduce pain, improve function, and reduce medical expenses. Methods: Data was sourced from electronic databases including PubMed, China Knowledge Network (CNKI), China Biomedical Literature Database (CBM), and Wanfang Data (WD). The search targeted studies focused on exercise therapy as a treatment for chronic non-specific low back pain (CNLBP) conducted within the timeframe spanning five years, from 2018 to 2022. The selection process encompassed published literature, excluding studies deemed of low relevance, ultimately culminating in the inclusion of 26 pertinent papers. Results: Different exercise modalities have shown clinical effectiveness for lumbopelvic stability exercise、spinal stabilization exercise training, etc., with superior efficacy for increasing muscle strength, enhancing spinal or lumbar stability, and increasing the thickness of core stabilising muscles. However, exercise therapies like McKenzie therapy (MDT), Motor Control Exercise（MCE）, Sling Exercise Therapy（SET）, and physical education (PE) are more helpful in restoring posture and function, improving neuromuscular control, and correcting delayed muscle activation than they are in increasing muscle thickness. Second, yoga activities have been found to help with pain management, emotional regulation, psychological control, and sleep problems. Conclusions: Although there are differences in the clinical effectiveness of various exercise therapies for the management of CNLBP, yet all of these exercise interventions have significant efficacy for managing low back pain and are safe, simple to use, and affordable. This is crucial for reducing medical costs and warrants widespread promotion.The potential of exercise therapy in the treatment of CNLBP, healthcare professionals and patients choose appropriate exercise modalities based on individual needs to improve quality of life and reduce pain

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“…In terms of gait changes, patients with LBP demonstrated reduced gait speed and shorter stride length compared to painfree controls (Smith et al, 2022). To initiate walking, body weight should be voluntarily shifted to one side to facilitate the stride on the other.…”

Section: Introductionmentioning

confidence: 99%

“…When the ipsilateral side of the lower limb transitions from the support phase to the swing phase, effective weight shifting to the contralateral side can be beneficial for enhancing the gait cycle (Alcock et al, 2013). A systematic review showed that it may be challenging for patients with LBP to maintain normal gait and stable posture consecutively, possibly due to impaired control of lateral weight shifting (Smith et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Kinematic changes of the trunk and lower limbs during voluntary lateral sway postural control in adults with low back pain

Chen,

Tirosh,

Han

et al. 2024

Front. Bioeng. Biotechnol.

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Introduction: Voluntary lateral weight shifting is essential for gait initiation. However, kinematic changes during voluntary lateral weight shifting remain unknown in people with low back pain (LBP). This study aims to explore the differences in kinematics and muscle activation when performing a voluntary lateral weight shifting task between patients with LBP and asymptomatic controls without pain.Methods: Twenty-eight participants volunteered in this study (14 in both the LBP group and the control group). The Sway Discrimination Apparatus (SwayDA) was used to generate a postural sway control task, mimicking lateral weight shifting movements when initiating gait. Kinematic parameters, including range of motion (ROM) and standard deviation of ROM (Std-ROM) of the lumbar spine, pelvis, and lower limb joints, were recorded using a motion capture system during lateral weight shifting. The electroactivity of the trunk and lower limb muscles was measured through surface electromyography using root mean square (RMS). The significant level was 0.05. An independent t-test was employed to compare kinematic parameters, and muscle activation between the LBP group and the control group. A paired-sample t-test, adjusted with Bonferroni correction (significant level of 0.025), was utilized to examine differences between the ipsilateral weight shifting towards side (dominant side) and the contralateral side.Results: The results of kinematic parameters showed significantly decreased ROM and std-ROM of the ipsilateral hip in the transverse plane (tROM = −2.059, p = 0.050; tstd-ROM = −2.670, p = 0.013), as well as decreased ROM of the ipsilateral knee in the coronal plane (t = −2.148, p = 0.042), in the LBP group compared to the control group. For the asymptomatic controls, significantly larger ROM and ROM-std were observed in the hip and knee joints on the ipsilateral side in contrast to the contralateral side (3.287 ≤ t ≤ 4.500, 0.001 ≤ p≤ 0.006), but no significant differences were found between the two sides in the LBP group. In addition, the LBP group showed significantly lower RMS of the biceps femoris than the control group (tRMS = −2.186, p = 0.044).Discussion: Patients with LBP showed a conservative postural control pattern, characterized by reduced ROM of ipsilateral joints and diminished activation of the biceps femoris. These findings suggested the importance of voluntary postural control assessment and intervention to maximize recovery.

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

Cited by 4 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

Interventions of Exercise Therapy for Chronic Non-Specific Low Back Pain: A Comprehensive Systematic Review and Comparative Study of Effects

Kinematic changes of the trunk and lower limbs during voluntary lateral sway postural control in adults with low back pain

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