Multi-segment analysis of spinal kinematics during sit-to-stand in patients with chronic low back pain

Christe, Guillaume; Redhead, Lucy; Legrand, Thomas; Jolles, Brigitte M.; Favre, Julien

doi:10.1016/j.jbiomech.2016.05.015

Cited by 66 publications

(93 citation statements)

References 37 publications

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“…Nevertheless, the literature is relatively inconsistent with respect to the nature of these motor control adaptions. For example, in chronic LBP, spine kinematic patterns during movement indicated a more rigid spine (Christe and others 2016), in line with clinical observations of a stronger coupling between thoracolumbar segments during movement and generally less variability of trunk movement in chronic LBP (Elgueta-Cancino and others 2014; Moseley and Hodges 2006). Furthermore, using large-array surface EMG during a muscle fatigue exercise, chronic LBP patients showed variability in trunk muscle activity that increased less over time compared to healthy subjects, suggesting fewer degrees of freedom regarding trunk muscle recruitment configurations (Abboud and others 2014).…”

Section: Behavioral and Motor System Adaptions In Lbpsupporting

confidence: 71%

Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

2018

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Motor control, which relies on constant communication between motor and sensory systems, is crucial for spine posture, stability and movement. Adaptions of motor control occur in low back pain (LBP) while different motor adaption strategies exist across individuals, probably to reduce LBP and risk of injury. However, in some individuals with LBP, adapted motor control strategies might have long-term consequences, such as increased spinal loading that has been linked with degeneration of intervertebral discs and other tissues, potentially maintaining recurrent or chronic LBP. Factors contributing to motor control adaptations in LBP have been extensively studied on the motor output side, but less attention has been paid to changes in sensory input, specifically proprioception. Furthermore, motor cortex reorganization has been linked with chronic and recurrent LBP, but underlying factors are poorly understood. Here, we review current research on behavioral and neural effects of motor control adaptions in LBP. We conclude that back pain-induced disrupted or reduced proprioceptive signaling likely plays a pivotal role in driving long-term changes in the top-down control of the motor system via motor and sensory cortical reorganization. In the outlook of this review, we explore whether motor control adaptations are also important for other (musculoskeletal) pain conditions.

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Section: Behavioral and Motor System Adaptions In Lbpsupporting

confidence: 71%

Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

2018

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“…Clinical decision-making in primary care is currently mostly based on qualitative questionnaires. On the other hand, recent advances in wearable sensor technology provide new opportunities to develop quantitative assessment methodologies, such as capturing and analyzing patients’ movements during walking or other daily life activities [ 22 , 23 , 24 , 25 , 26 ]. The underlying principle behind these studies centers around utilizing variability in trunk motion (i.e., trunk kinematics) to assess and discriminate people suffering from NSLBP.…”

Section: Introductionmentioning

confidence: 99%

Using a Motion Sensor to Categorize Nonspecific Low Back Pain Patients: A Machine Learning Approach

Abdollahi

Ashouri

Abedi

et al. 2020

Sensors

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Nonspecific low back pain (NSLBP) constitutes a critical health challenge that impacts millions of people worldwide with devastating health and socioeconomic consequences. In today’s clinical settings, practitioners continue to follow conventional guidelines to categorize NSLBP patients based on subjective approaches, such as the STarT Back Screening Tool (SBST). This study aimed to develop a sensor-based machine learning model to classify NSLBP patients into different subgroups according to quantitative kinematic data, i.e., trunk motion and balance-related measures, in conjunction with STarT output. Specifically, inertial measurement units (IMU) were attached to the trunks of ninety-four patients while they performed repetitive trunk flexion/extension movements on a balance board at self-selected pace. Machine learning algorithms (support vector machine (SVM) and multi-layer perceptron (MLP)) were implemented for model development, and SBST results were used as ground truth. The results demonstrated that kinematic data could successfully be used to categorize patients into two main groups: high vs. low-medium risk. Accuracy levels of ~75% and 60% were achieved for SVM and MLP, respectively. Additionally, among a range of variables detailed herein, time-scaled IMU signals yielded the highest accuracy levels (i.e., ~75%). Our findings support the improvement and use of wearable systems in developing diagnostic and prognostic tools for various healthcare applications. This can facilitate development of an improved, cost-effective quantitative NSLBP assessment tool in clinical and home settings towards effective personalized rehabilitation.

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“…Although these changes have been contextualised to be protective in nature30 31 and occur early following the onset of pain,32–34 they appear to be sustained beyond the acute phase13 35 36 and have the potential to contribute to chronicity and repeated painful episodes 12 31 37 38. Although numerous studies have confirmed the presence of altered neuromuscular function in patients with chronic neck18 39 and back pain25 40 41 and systematic reviews have been conducted to critically appraise these studies, and synthesise findings,21 42–44 no systematic review has been conducted to evaluate evidence of neuromuscular changes during a period of remission in people with recurrent spinal pain. The assessment of patients during a period of remission allows to investigate neuromuscular function without pain interference.…”

Section: Introductionmentioning

confidence: 99%

Are neuromuscular adaptations present in people with recurrent spinal pain during a period of remission? A protocol for a systematic review

et al. 2019

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IntroductionThe course of spinal pain (neck or low back pain) is often described as episodic and intermittent, with more than one-third of people continuing to experience episodic symptoms 1 year after first onset. Although ongoing neuromuscular adaptations could contribute to recurrent episodes of pain, no systematic review has synthesised evidence of ongoing neuromuscular changes in people with recurrent spinal pain during a period of symptom remission.Methods and analysisThis protocol is developed and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-P, the Update of the Cochrane Back and Neck Group guidelines and the Methodological Expectations of Cochrane Intervention Reviews. PubMed, Web of Science, MEDLINE, EMBASE, CINAHL, ZETOC, Google Scholar, grey literature sources and key journals will be searched up to September 2019. Observational studies investigating neuromuscular changes in people with recurrent spinal pain during a period of remission will be included. Neuromuscular function will be considered under five outcome domains of muscle activity, spine kinematics, muscle properties, sensorimotor control and neuromuscular performance. Two independent reviewers will search, screen studies, extract data and assess risk of bias (Newcastle-Ottawa Scale). Data will be synthesised per outcome domain. Where clinical and methodological homogeneity across studies exists, a random-effects meta-analysis will be conducted. Otherwise, results will be synthesised narratively. The overall quality of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation guidelines.Ethics and disseminationFindings of this review may aid the identification of factors that could contribute to spinal pain recurrence and aid the development of interventions for secondary prevention aimed at the restoration of optimal neuromuscular function. The results will be submitted for publication in a peer-reviewed journal and presented at conferences. No ethical approval was required.PROSPERO registration numberCRD42019141527.

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Multi-segment analysis of spinal kinematics during sit-to-stand in patients with chronic low back pain

Cited by 66 publications

References 37 publications

Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

Using a Motion Sensor to Categorize Nonspecific Low Back Pain Patients: A Machine Learning Approach

Are neuromuscular adaptations present in people with recurrent spinal pain during a period of remission? A protocol for a systematic review

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