![]() ![]() ![]() Although there is evidence of different movement qualities in people with back pain, there is little consensus about which movement attributes are important, how frequently they are seen, or whether movement difference might cause, or be caused by, LBP. ![]() The movement qualities of people with LBP have been observed to differ from those without LBP in a number of ways, including smaller range and lower speed of lumbar motion, differences in muscle size, recruitment and relaxation patterns, different breathing patterns, poorer proprioception, less motor control variability, poorer strength, endurance and muscle force control and different patterns of flexion-related lumbo-pelvic movement. However, these studies have typically quantified changes to pain and activity limitation but not changes to movement qualities, so the relationship between change in movement behaviour and changes in pain and function is not clear. There is some evidence that interventions designed to modify movement behaviour are associated with improvements to pain and activity limitation in chronic LBP. Many clinicians use movement-related interventions to treat low back pain (LBP) based on a view that there is a relationship between back pain and dysfunctional movement. Significant movement differences during flexion were seen in people with LBP, with a higher prevalence of small ROM, slower movement, delayed pelvic movement and greater lumbar extensor muscle activation but without differences for any sitting parameter. High pain intensity was significantly associated with small lumbar ROM and pelvic ROM. No differences between groups were seen for any sitting parameters. Atypical movement was significantly more prevalent in the LBP group for small trunk (× 5.4), lumbar (× 3.0) and pelvic ROM (× 3.9), low FRR (× 4.9), delayed pelvic motion at 20 o flexion (× 2.9), and longer movement duration (× 4.7). Resultsįor standing flexion, significant mean differences, after adjusting for age and gender factors, were seen for the LBP group with (i) reduced ROM (trunk flexion (NoLBP 111 o, LBP 93 o, p < .0001), lumbar flexion (NoLBP 52 o, LBP 46 o, p < .0001), pelvic flexion (NoLBP 59 o, LBP 48 o, p < .0001), (ii) greater extensor muscle activation for the LBP group (NoLBP 0.012, LBP 0.25 p < .0001), (iii) a greater delay in pelvic motion at the onset of flexion (NoLBP − 0.21 s LBP − 0.36 s, p = 0.023), (iv) and longer movement duration for the LBP group (NoLBP 2.28 s LBP 3.18 s, p < .0001). Dichotomised pain scores for ‘high-pain-on-bending’ and ‘high-pain-on-sitting’ were tested for their association with atypical kinematic variables. Mean differences and prevalence rates for atypical movement were calculated. Atypical movement was defined using the 10th/90th centiles of the NoLBP group. Wireless inertial motion and EMG sensors were used to measure lumbo-pelvic kinematics during standing trunk flexion (range of motion (ROM), timing, sequence coordination, and extensor muscle activation) and in sitting (relative sitting position, pelvic tilt range) in a sample of 126 of adults without LBP and 140 chronic LBP subjects. This exploratory study measured, defined and compared atypical kinematic parameters in people with and without LBP. If atypical kinematic parameters and postures have a relationship to LBP, they could be expected to more prevalent in people with LBP compared to people without LBP (NoLBP). ![]() Interventions for low back pain (LBP) commonly target ‘dysfunctional’ or atypical lumbo-pelvic kinematics in the belief that correcting aberrant movement improves patients’ pain and activity outcomes. ![]()
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