Do people with low back pain walk differently? A systematic review and meta-analysis
Jo Armour Smith1, Heidi Stabbert1, Jennifer J Bagwell2
1Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA.
Journal of Sport and Health Science
|February 13, 2022
Summary
Individuals with persistent low back pain (LBP) walk slower and with shorter strides than healthy individuals. Running biomechanics show no consistent differences, but walking gait alterations are evident in LBP.
Area of Science:
- Biomechanics
- Gait Analysis
- Low Back Pain Research
Background:
- Low back pain (LBP) is prevalent, often leading to assessments of trunk and lower limb biomechanics during gait.
- Despite extensive research, definitive, generalizable changes in walking or running gait associated with LBP remain unclear.
Purpose of the Study:
- To systematically review and identify biomechanical differences in walking and running gait between individuals with acute/persistent LBP and healthy controls.
Main Methods:
- A comprehensive search of PubMed, CINAHL, SPORTDiscus, and PsycINFO was conducted in June 2019 and December 2020.
- Included studies reported spatiotemporal, kinematic, kinetic, and electromyography data for individuals with and without LBP during walking or running.
- Study quality and bias were assessed, and data were pooled for meta-analysis.
Main Results:
- Ninety-seven studies were reviewed; most focused on persistent LBP, with few on running gait.
- Individuals with persistent LBP walked slower (SMD=-0.59) and with shorter strides (SMD=-0.38) compared to controls.
- Increased in-phase coordination between thorax and lumbar spine/pelvis (SMD=-0.60) and greater paraspinal muscle activation (SMD=0.52) were observed in persistent LBP during walking. No consistent running differences were found.
Conclusions:
- Moderate-to-strong evidence indicates distinct walking gait patterns in individuals with persistent LBP compared to back-healthy individuals.
- Differences in walking biomechanics, including speed, stride length, and muscle activation, are associated with persistent LBP.
