Low back pain affects trunk as well as lower limb movements during walking and running

Müller, Roy; Ertelt, Thomas; Blickhan, Reinhard

doi:10.1016/j.jbiomech.2015.01.042

Cited by 92 publications

(96 citation statements)

References 24 publications

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“…In addition, according to the research by Lamoth et al [7, 8], no significant difference was observed between the pelvic rotations of patients with LBP and control subjects. In level running, the amplitude of pelvis and trunk rotation decreased significantly in patients with LBP in Muller’s study [4], while Seay et al discovered only greater pelvic rotation in LBP than in the control group [9]. In [10], the range of motion (ROM) in the lumbar spine during stair climbing was determined to be significantly smaller in patients with LBP than in control subjects; no other reports related to lumbar motion during stair climbing have been found based on the authors’ knowledge.…”

Section: Introductionmentioning

confidence: 99%

“…The majority of the previous studies related to kinematic variability affected by LBP were mainly concerned about the region of trunk and pelvis [3, 8]; thorax, lumbar, and pelvis [10, 20]; or lumbar, pelvis, and hip [21–23]. However, Muller determined that there was a significant kinematic difference in knee joint angle during level walking and level running between patients with LBP and control subjects [4]. Therefore, lower extremities should be included.…”

Section: Introductionmentioning

confidence: 99%

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Influences of lumbar disc herniation on the kinematics in multi-segmental spine, pelvis, and lower extremities during five activities of daily living

Kuai¹,

Liao²,

Ji³

et al. 2017

BMC Musculoskelet Disord

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BackgroundLow back pain (LBP) is a common problem that can contribute to motor dysfunction. Previous studies reporting the changes in kinematic characteristics caused by LBP present conflicting results. This study aimed to apply the multisegmental spinal model to investigate the kinematic changes in patients with lumbar disc herniation (LDH) during five activities of daily living (ADLs).MethodsTwenty-six healthy subjects and 7 LDH patients participated in this study and performed level walking, stair climbing, trunk flexion, and ipsilateral and contralateral pickups. The angular displacement of the thorax, upper lumbar (ULx), lower lumbar (LLx), pelvis, hip, and knee was calculated using a modified full-gait-model in the AnyBody modeling system.ResultsIn the patient group, the ULx almost showed no sagittal angular displacement while the LLx remained part of the sagittal angular displacement during trunk flexion and the two pickups. In the two pickups, pelvic tilt and lower extremities’ flexion increased to compensate for the deficiency in lumbar motion. LDH patients exhibited significantly less pelvic rotation during stair climbing and greater pelvic rotation in other ADLs, except in contralateral pickup. In addition, LDH patients demonstrated more antiphase movement in the transverse plane between ULx and LLx, during level walking and stair climbing, between thorax and pelvis in the two pickups.ConclusionsLDH patients mainly restrict the motion of LLx and ULx in the spinal region during the five ADLs. Pelvic rotation is an important method to compensate for the limited lumbar motion. Furthermore, pelvic tilt and lower extremities’ flexion increased when ADLs were quite difficult for LDH patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influences of lumbar disc herniation on the kinematics in multi-segmental spine, pelvis, and lower extremities during five activities of daily living

Kuai¹,

Liao²,

Ji³

et al. 2017

BMC Musculoskelet Disord

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show abstract

“…As mentioned above, kinematic outcomes during walking and back pain are diverse [24,26,27,41]. Vogt et al [27] demonstrated that lumbar trunk motion patterns and displacement in patients while walking were equivalent to those of healthy controls.…”

Section: Discussionmentioning

confidence: 99%

Effects of sudden walking perturbations on neuromuscular reflex activity and three-dimensional motion of the trunk in healthy controls and back pain symptomatic subjects

et al. 2017

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BackgroundBack pain patients (BPP) show delayed muscle onset, increased co-contractions, and variability as response to quasi-static sudden trunk loading in comparison to healthy controls (H). However, it is unclear whether these results can validly be transferred to suddenly applied walking perturbations, an automated but more functional and complex movement pattern. There is an evident need to develop research-based strategies for the rehabilitation of back pain. Therefore, the investigation of differences in trunk stability between H and BPP in functional movements is of primary interest in order to define suitable intervention regimes. The purpose of this study was to analyse neuromuscular reflex activity as well as three-dimensional trunk kinematics between H and BPP during walking perturbations.MethodsEighty H (31m/49f;29±9yrs;174±10cm;71±13kg) and 14 BPP (6m/8f;30±8yrs;171±10cm;67±14kg) walked (1m/s) on a split-belt treadmill while 15 right-sided perturbations (belt decelerating, 40m/s2, 50ms duration; 200ms after heel contact) were randomly applied. Trunk muscle activity was assessed using a 12-lead EMG set-up. Trunk kinematics were measured using a 3-segment-model consisting of 12 markers (upper thoracic (UTA), lower thoracic (LTA), lumbar area (LA)). EMG-RMS ([%],0-200ms after perturbation) was calculated and normalized to the RMS of unperturbed gait. Latency (TON;ms) and time to maximum activity (TMAX;ms) were analysed. Total motion amplitude (ROM;[°]) and mean angle (Amean;[°]) for extension-flexion, lateral flexion and rotation were calculated (whole stride cycle; 0-200ms after perturbation) for each of the three segments during unperturbed and perturbed gait. For ROM only, perturbed was normalized to unperturbed step [%] for the whole stride as well as the 200ms after perturbation. Data were analysed descriptively followed by a student´s t-test to account for group differences. Co-contraction was analyzed between ventral and dorsal muscles (V:R) as well as side right:side left ratio (Sright:Sleft). The coefficient of variation (CV;%) was calculated (EMG-RMS;ROM) to evaluate variability between the 15 perturbations for all groups. With respect to unequal distribution of participants to groups, an additional matched-group analysis was conducted. Fourteen healthy controls out of group H were sex-, age- and anthropometrically matched (group Hmatched) to the BPP.ResultsNo group differences were observed for EMG-RMS or CV analysis (EMG/ROM) (p>0.025). Co-contraction analysis revealed no differences for V:R and Srigth:Sleft between the groups (p>0.025). BPP showed an increased TON and TMAX, being significant for Mm. rectus abdominus (p = 0.019) and erector spinae T9/L3 (p = 0.005/p = 0.015). ROM analysis over the unperturbed stride cycle revealed no differences between groups (p>0.025). Normalization of perturbed to unperturbed step lead to significant differences for the lumbar segment (LA) in lateral flexion with BPP showing higher normalized ROM compared to Hmatched (p = 0.02). BPP showed a significant ...

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“…However, most of the studies on low back pain concentrate on changes in trunk coordination and lower limb movements in kinematic and kinetic manners. [10,11,27] Lower limb disability received little attention in association with low back pain. Our study indicated that people with low back pain report more musculoskeletal complaints in the lower limbs and there is a significant correlation between low back disability/pain and lower limb disability/pain.…”

Section: Discussionmentioning

confidence: 99%

“…Up to now, most of the studies on LBP have concentrated on changes in trunk coordination and lower limb movements in kinematic and kinetic manners. [10,11] However, lower limb disability had received little attention in association with LBP. We hypothesized that even self-reported LBP can also be associated with lower limb disability such as self-reported neck pain is associated with upper limb disability.…”

Section: Introductionmentioning

confidence: 99%

The association between self-reported low back pain and lower limb disability as well as the association between neck pain and upper limb disability

Kahraman¹,

Göz²,

Genç

2016

Agri

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Low back pain affects trunk as well as lower limb movements during walking and running

Cited by 92 publications

References 24 publications

Influences of lumbar disc herniation on the kinematics in multi-segmental spine, pelvis, and lower extremities during five activities of daily living

Influences of lumbar disc herniation on the kinematics in multi-segmental spine, pelvis, and lower extremities during five activities of daily living

Effects of sudden walking perturbations on neuromuscular reflex activity and three-dimensional motion of the trunk in healthy controls and back pain symptomatic subjects

The association between self-reported low back pain and lower limb disability as well as the association between neck pain and upper limb disability

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