Using inpatient gradual diagnostics to identify the treatment strategy for lumbar back pain—Can treadmill gait analysis objectify the patients' declaration of pain relief?

Sebastian, Shaji; Gesicki, Marco; Winnewisser, Julia; Leichtle, Carmen; Hofmann, Ulf Krister

doi:10.1016/j.gaitpost.2019.07.373

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…A previous study found that lumbar pain might be associated with increased stance phase and reduced swing phase. 8 The results of the current study demonstrate that the gait instability of the corresponding phases in patients with LDH may be affected by pain.…”

Section: Discussionmentioning

confidence: 53%

“…The instability in step (cm), stance phase (%), swing phase (%), single support (%), step time (s), cadence (steps/min) and distance (cm) were analysed ( Table 1 ), which were commonly investigated in previous studies. 6 – 8 …”

Section: Methodsmentioning

confidence: 99%

“… 7 Another study demonstrated that pain reduction reduces gait asymmetry in patients with chronic lumbar pain. 8 LDH-related pain is usually more severe than non-specific lumbar pain and is often associated with radiating pain. Patients with LDH had greater pelvic rotation when walking, and the relative phase of the horizontal rotation of pelvis and thorax decreased compared with healthy subjects.…”

Section: Introductionmentioning

confidence: 99%

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Association between pain and gait instability in patients with lumbar disc herniation

et al. 2021

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Objective To determine whether pain is associated with gait instability in patients with lumbar disc herniation (LDH). Methods This retrospective cross-sectional study used data from electronic medical records. Among patients with lumbar back pain caused by LDH between January 2017 and July 2019, patients that underwent gait analysis were included. LDH was diagnosed using magnetic resonance imaging. An OptoGait photoelectric cell system was used for gait evaluation. Instability was measured using a gait symmetry index. Multivariate linear regression analysis was performed to determine the association between lumbar pain and gait instability. Results A total of 29 patients (12 females [41.4%] and 17 males [58.6%]; mean ± SD age, 40.6 ± 12.0 years) with LDH were enrolled in the study. With each 1-point increase in lumbar pain on the numeric rating scale, the symmetry index of the stance phase (0.33; 95% confidence interval [CI] 0.04, 0.62), swing phase (0.78; 95% CI 0.14, 1.43) and single support (0.79; 95% CI 0.15, 1.43) increased. Conclusions Gait instability in patients with LDH may occur due to an increase in pain.

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Section: Discussionmentioning

confidence: 53%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between pain and gait instability in patients with lumbar disc herniation

et al. 2021

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“…Written informed consent was received from all subjects before participation. Another study on the topic of gait analysis during IGDs was carried out with the same patient group, which had to be published separately due to the complexity of the data set [33]. Inclusion criterion was an indication for IGDs after examination and selection by the abovementioned criteria through the outpatient clinic.…”

Section: Participantsmentioning

confidence: 99%

The Value of Video Rasterstereography in the Detection of Alterations in Posture as a Marker of Pain Relief after Targeted Infiltrations of the Lumbar Spine

et al. 2020

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Background Targeted infiltrations to the lumbar spine are used to identify the correct scope for surgery in patients with chronic lumbar back pain (CLBP) and multi-segmental pathologies, where radiologic imaging and clinical presentation do not match. Conclusions from that method have so far been based on individual statements of pain relief. The main principle for the infiltrations is the assumption that by locally administering an analgesic agent to possible surgical target areas, the effect of surgery can be temporarily simulated. The aim was to investigate the use of rasterstereographic posture measurements to substantiate reported pain reduction after infiltrations. Methods In this case-control study (Level II), rasterstereography was performed on 57 patients and 28 reference subjects to evaluate changes in posture during 1 week of injections under fluoroscopic guidance and correlated with changes in the Numeric Pain Rating Scale (NRS). Statistical analysis was performed with SPSS (α = .05, two-sided) and presented in the form of box, scatter, and Bland-Altman plots. Results and Conclusion The CLBP patientsʼ trunk inclination (median 6°) and absolute lateral tilt were significantly increased (p < .01 each) compared to the reference group. No significant difference was observed for trunk length, kyphotic/lordotic angle, or lateral deviation. During infiltration, no significant difference in posture could be observed. A subgroup analysis of patients reporting the highest pain improvement indicated no significant difference. No correlation was observed with pain improvement reported by the patients during injections. Subsequent rasterstereography does not seem to be able to verify results of injections in the diagnostics of lumbar spine pathologies, as patientsʼ reported pain relief does not correlate with a relevant alteration in posture. The short-term effect of the targeted infiltrations may not suffice to change false posture being developed over years.

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“… 13 This is supported by studies demonstrating that gait instability correlates with pain intensity in individuals with LDH, 20 as well as reduced gait asymmetry after pain reduction among those with chronic lower back pain in general. 26 To date, it is unclear if gait is related to back morphology, pain, and other health outcomes in LDH.…”

Section: Introductionmentioning

confidence: 99%

Back morphology and walking patterns mean 13.8 years after surgery for lumbar disk herniation in adolescents

Ruehr,

Blomé,

Kastrati

et al. 2024

PR9

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Introduction: In many pain conditions, there is lingering pain despite healed tissue damage. Our previous study shows that individuals who underwent surgery for lumbar disk herniation (LDH) during adolescence have worse health, more pain, and increased disk degeneration mean 13 years after surgery compared with controls. It is unclear if walking patterns segregate surgically treated LDH adolescents and controls at mean 13-year follow-up. Objectives: Here, we analyzed the relationship between gait, back morphology and other health outcomes in a cohort of individuals treated surgically because of lumbar disk herniation compared with controls. Methods: We analyzed gait during a walking paradigm, back morphology at the site of surgery, and standardized health outcomes, among individuals who received surgery for LDH as adolescents, “cases” (n = 23), compared with “controls” (n = 23). Results: There were gait differences in head (P = 0.021) and trunk angle (P = 0.021) between cases and controls in a direction where cases exhibited a posture associated with sickness. The gait variance was explained by subjective pain and exercise habits rather than objective disk degeneration. Conclusion: Over a decade after surgery for LDH during adolescence, health among cases is worse compared with controls. The head and trunk angles differ between cases and controls, indicating that the residual pain lingers and may cause changes in movement patterns long after a painful episode in early life. Gait may be a useful target for understanding maintenance of pain and disability among individuals treated surgically for LDH during adolescence.

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Using inpatient gradual diagnostics to identify the treatment strategy for lumbar back pain—Can treadmill gait analysis objectify the patients' declaration of pain relief?

Cited by 4 publications

References 18 publications

Association between pain and gait instability in patients with lumbar disc herniation

Association between pain and gait instability in patients with lumbar disc herniation

The Value of Video Rasterstereography in the Detection of Alterations in Posture as a Marker of Pain Relief after Targeted Infiltrations of the Lumbar Spine

Back morphology and walking patterns mean 13.8 years after surgery for lumbar disk herniation in adolescents

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