Relationship between functional evaluation measures and self-assessment in nonacute low back pain

Area of Science:

• Biomedical Engineering
• Orthopedics
• Rehabilitation Medicine

Background:

• Low back pain often shows poor agreement between pain, physical impairment, and disability.
• Previous attempts to use range of motion and velocity for objective impairment evaluation have been ineffective.
• This study investigated if range of motion and velocity are controllable and linked to self-assessment, while complex spinal coordination is not.

Purpose of the Study:

• To investigate the correlation between self-reported function and objective biomechanical measures in individuals with nonacute low back pain.
• To determine if simple kinematic parameters (range of motion, velocity) or complex spinal coordination patterns (range of lordosis) better reflect functional status.
• To explore the influence of cognitive and affective factors on self-assessment and biomechanical outcomes.

Main Methods:

• Retrospective analysis of 91 subjects with nonacute low back pain.
• Administration of self-assessment questionnaires.
• Measurement of spinal motion and coordination using skin marker kinematics.

Main Results:

• Self-assessments of function strongly correlated with controllable parameters: range of motion, velocity, and load lifted.
• Limited correlation was observed between self-assessment and less controllable measures like range of lordosis and segmental mobility.
• Insurance referrals reported poorer self-assessment scores, irrespective of their actual functional status.

Conclusions:

• Simple functional examination parameters (range of motion, velocity) are influenced by cognitive state, limiting their objectivity.
• Complex spinal coordination is a more reliable indicator of spinal dysfunction.
• Assessing complex spinal coordination aids in distinguishing between pain, disability, and functional impairment.