Collision avoidance behaviours in chronic non-specific low back pain participants: A prospective cohort study

Chronic non-specific low back pain (cNSLBP) is a leading cause of disability, influenced by bio-psycho-social factors. However, its impact on everyday activities such as navigating streets and interacting with other pedestrians remains underexplored. This study aimed to assess the effect of cNSLBP on perceptual-motor processes in a pedestrian crossing task, focusing on 1) collision avoidance behaviours, 2) the walker's role in avoiding collisions, and 3) the influence of pain perception.

Seventeen asymptomatic adults (AA, 11 females, 46.4 ± 12.8 years) and seventeen cNSLBP participants (10 females, 47.9 ± 12.7 years) performed a task involving crossing paths at a 90° angle with another walker. Participants interacted in three groups pairings: AA-AA, AA-cNSLBP, and cNSLBP-cNSLBP. Key metrics included crossing order inversion, collision risk threshold informing movement adaptation, crossing distance, and the walker's contribution (speed/orientation).

No significant differences were observed between groups for the collision risk threshold (≈0.93 m) or crossing distance (≈0.8 m). However, cNSLBP participants exhibited distinct avoidance strategies, especially in cNSLBP-cNSLBP interactions, which showed more frequent inversions. When crossing first, cNSLBP participants contributed less, whereas when crossing second, they contributed more, primarily by adjusting their speed. A significant negative correlation emerged between depression scores and the level of contribution when cNSLBP participants crossed second.

These findings suggest that pain perception may influence collision avoidance behaviours. Further research, potentially incorporating virtual reality, is needed to control environmental factors and deepen our understanding of these interactions.