Non-specific chronic low back pain: differences in spinal kinematics in subgroups during functional tasks.
Rebecca Hemming1, Liba Sheeran2, Robert van Deursen2
1Arthritis Research UK Biomechanics and Bioengineering Centre, School of Healthcare Sciences, Cardiff University, Eastgate House, 35-43 Newport Road, Cardiff, Wales, CF24 0AB, UK. HemmingRL@cardiff.ac.uk.
Summary
Individuals with non-specific chronic low back pain (NSCLBP) exhibit distinct spinal movement patterns. The flexion pattern subgroup shows greater thoracolumbar flexion during functional tasks compared to other groups.
Area of Science:
- Biomedical Engineering
- Orthopedics
- Rehabilitation Science
Background:
- Non-specific chronic low back pain (NSCLBP) is a prevalent condition with poorly understood underlying mechanisms.
- Previous research identified distinct motor control impairment subgroups within NSCLBP, such as the flexion pattern (FP) and active extension pattern (AEP).
- While sitting posture differences are known, functional spinal kinematics in these subgroups remain unexplored.
Purpose of the Study:
- To investigate regional spinal kinematic differences in NSCLBP subgroups (FP and AEP) compared to healthy individuals during functional tasks.
- To determine if functional movement patterns can differentiate between NSCLBP subgroups and healthy controls.
- To explore the clinical implications of observed kinematic differences.
Main Methods:
- Observational, cross-sectional study design.
- 3D motion analysis (Vicon™) was used to capture spinal kinematics in 50 NSCLBP subjects (27 FP, 23 AEP) and 28 healthy controls.
- Kinematics were assessed during various functional tasks including reaching, stepping, lifting, and bending.
Main Results:
- Significant differences in lower thoracic and upper lumbar kinematics were found between NSCLBP subgroups during most functional tasks.
- The FP group exhibited greater thoracolumbar flexion compared to the AEP and healthy groups, particularly during sit-to-stand and bending tasks.
- No significant kinematic differences were observed between the AEP group and healthy individuals.
Conclusions:
- The thoracolumbar spine's movement patterns effectively differentiate between FP and AEP subgroups, and between FP and healthy individuals.
- The increased thoracolumbar flexion observed in the FP group may represent a pain-provoking posture.
- The lack of kinematic differences between AEP and healthy groups suggests distinct underlying mechanisms for this NSCLBP subgroup.
