Lumbar spine kinematics during walking in people with and people without low back pain

Gombatto, Sara P.; Brock, Tricia; DeLork, Anthony; Jones, Glynis; Madden, Erin; Rinere, Chelsea

doi:10.1016/j.gaitpost.2015.08.010

Cited by 82 publications

(116 citation statements)

References 27 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…Figure 1 illustrates the marker placements. In spinal segments, the markers were placed on the spinous processes of the third and seventh thoracic vertebra (T3 and T7), and of the first, third, and fifth lumbar vertebra (L1, L3, and L5) [24]. The markers on the pelvis were placed on the left posterior superior iliac spine (LPSIS), right posterior superior iliac spine (RPSIS), and iliac crest (IC).…”

Section: Methodsmentioning

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

View full text Add to dashboard Cite

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.

show abstract

Section: Methodsmentioning

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

View full text Add to dashboard Cite

show abstract

“…Clinical biomechanical investigations have demonstrated kinematic differences in lumbar motion depending on the level examined with greater disturbances seen in the lower levels. 56,57 As previously discussed, facet joint arthritis was seen more commonly at the caudal spinal segments. 27,49 This stress likely concentrates to an even greater degree at the L4/L5 segment.…”

Section: Discussionmentioning

confidence: 65%

The Kinematics and Spondylosis of the Lumbar Spine Vary Depending on the Levels of Motion Segments in Individuals With Low Back Pain

Basques

Orías

Shifflett

et al. 2017

Spine

View full text Add to dashboard Cite

Study Design Prospective cohort study. Objective To identify associations of spondylotic and kinematic changes with low back pain (LBP). Summary of Background Data The ability to characterize and differentiate the biomechanics of both the symptomatic and asymptomatic lumbar spine is crucial to alleviate the sparse literature on the association of lumbar spine biomechanics and LBP. Methods Lumbar dynamic plain radiographs (flexion-extension), dynamic CT scanning (axial rotation, disc height) and MRI (disc and facet degeneration grades) were obtained for each subject. These parameters were compared between symptomatic and control groups using Student’s t-test and multivariate logistic regression, which controlled for patient age and sex and identified spinal parameters that were independently associated with symptomatic LBP. Disc grade and mean segmental motion by level were tested by one-way ANOVA. Results Ninety-nine volunteers (64 asymptomatic/35 LBP) were prospectively recruited. Mean age was 37.3±10.1 y.o. and 55% were male. LBP showed association with increased L5/S1 translation (odds ratio [OR] 1.63 per mm, p=0.005), decreased flexion-extension motion at L1/L2 (OR 0.87 per degree, p=0.036), L2/L3 (OR 0.88 per degree, p=0.036), and L4/L5 (OR 0.87 per degree, p=0.020), increased axial rotation at L4/L5 (OR 2.11 per degree, p=0.032), decreased disc height at L3/L4 (OR 0.52 per mm, p=0.008) and L4/L5 (OR 0.37 per mm, p<0.001), increased disc grade at all levels (ORs 2.01–12.33 per grade, p=0.001–0.026), and increased facet grade at L4/L5 (OR 4.99 per grade, p=0.001) and L5/S1 (OR 3.52 per grade, p=0.004). Significant associations were found between disc grade and kinematic parameters (flexion-extension motion, axial rotation, and translation) at L4/L5 (p=0.001) and L5/S1 (p<0.001), but not at other levels (p>0.05). Conclusions In symptomatic individuals, L4/L5 and L5/S1 levels were affected by spondylosis and kinematic changes. This study clarifies the relationships between kinematic alterations and LBP, mostly observed at the above-mentioned segments.

show abstract

“…Therefore, the transferability of these results to dynamic loading, daily life or sports situations applied by the lower limbs cannot be validated, and has to be discussed critically due to the quasi-static and limited functional load application. Sudden loading during gait, therefore, might be a more suitable situation in which to analyse differences between healthy controls (H) and back pain patients (BPP) [20–23]. The human gait is described as an automated and stable movement pattern (high intra-individual reproducibility) with more functional and complex demands on the neuromuscular system and kinematic chain of the trunk compared to the quick-release experiments.…”

Section: Introductionmentioning

confidence: 99%

“…The analysis of trunk kinematics and posture comparing patients and healthy participants has been discussed as beneficial for extracting the mechanical factors that may be associated with the development, persistence and recurrence of back pain [13,14,20]. However, inconsistent results regarding movement patterns and kinematic variability during gait have been found [24–27].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, Steel et al [26] reported a higher movement variability during gait in patients compared to healthy controls only in the sagittal and transverse planes. Moreover, some studies reported that symptomatic participants display reduced lumbar rotational movements [20], while others showed that lower BP increases spine or pelvis rotation [28]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

View full text Add to dashboard Cite

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 ...

show abstract

Lumbar spine kinematics during walking in people with and people without low back pain

Cited by 82 publications

References 27 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

The Kinematics and Spondylosis of the Lumbar Spine Vary Depending on the Levels of Motion Segments in Individuals With Low Back Pain

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

Contact Info

Product

Resources

About