Low back pain status affects pelvis-trunk coordination and variability during walking and running

      Abstract

      Background

      The purpose of this study was to compare pelvis–trunk coordination and coordination variability over a range of walking and running speeds between three groups of runners; runners with low to moderate low back pain; runners who had recovered from a single bout of acute low back pain; and runners who had never experienced any symptoms of low back pain.

      Methods

      Pelvis and trunk kinematic data were collected as speed was systematically increased on a treadmill. Coordination between pelvis and trunk in all three planes of motion was measured using continuous relative phase, and coordination variability was defined as the standard deviation of this measure.

      Findings

      Oswestry Disability Index indicated the low back pain group was high functioning (mean 7.9% out of 100%). During walking, frontal plane coordination was more in-phase for the low back pain group compared to controls (P=0.029), with the resolved group showing an intermediate coordination pattern (P=0.064). During running, both low back pain (P=0.021) and resolved (P=0.025) groups showed more in-phase coordination in the transverse plane than the control group. The low back pain group also showed reduced transverse plane coordination variability compared to controls (P=0.022).

      Interpretation

      Coordination and coordination variability results showed a continuum of responses between our three groups. Taken together, the data lend insight into increased injury risk and performance deficits associated with even one bout of low back pain, and suggest that clinicians need to look beyond the resolution of pain when prescribing rehabilitation for low back pain.

      Keywords

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      References

        • Al-Obaidi S.M.
        • Al-Zoabi B.
        • Al-Shuwaie N.
        • Al-Zaabie N.
        • Nelson R.M.
        The influence of pain and pain-related fear and disability beliefs on walking velocity in chronic low back pain.
        Int. J. Rehabil. Res. 2003; 26: 101-108
        • Cohen J.
        Statistical Power Analysis For The Behavioral Sciences.
        L. Erlbaum Associates, Hillsdale, NJ1988
        • Dingwell J.B.
        • Marin L.C.
        Kinematic variability and local dynamic stability of upper body motions when walking at different speeds.
        J. Biomech. 2006; 39: 444-452
        • Fairbank J.C.
        • Couper J.
        • Davies J.B.
        • O'brien J.P.
        The oswestry low back pain disability questionnaire.
        Physiotherapy. 1980; 66: 271-273
        • Fritz J.M.
        • Irrgang J.J.
        A comparison of a modified oswestry low back pain disability questionnaire and the quebec back pain disability scale.
        Phys. Ther. 2001; 81: 776-788
        • Glass L.
        Synchronization and rhythmic processes in physiology.
        Nature. 2001; 410: 277-284
        • Greene H.S.
        • Cholewicki J.
        • Galloway M.T.
        • Nguyen C.V.
        • Radebold A.
        A history of low back injury is a risk factor for recurrent back injuries in varsity athletes.
        Am. J. Sports Med. 2001; 29: 795-800
        • Hamill J.
        • Haddad J.M.
        • Mcdermott W.J.
        Issues in quantifying variability from a dynamical systems perspective.
        J. Appl. Biomech. 2000; 16: 407-418
        • Hamill J.
        • Van Emmerik R.E.A.
        Variability and stability: a dynamical systems perspective.
        J. Appl. Biomech. 2000; 16: 392-393
        • Hamill J.
        • Van Emmerik R.E.A.
        • Heiderscheit B.C.
        • Li L.
        A dynamical systems approach to lower extremity running injuries.
        Clin. Biomech. 1999; 14: 297-308
        • Heiderscheit B.C.
        • Hamill J.
        • Van Emmerik R.E.A.
        Variability of stride characteristics and joint coordination among individuals with unilateral patellofemoral pain.
        J. Appl. Biomech. 2002; 18: 110-121
        • Holt K.G.
        • Hamill J.
        • Andres R.O.
        Predicting the minimal energy costs of human walking.
        Med. Sci. Sports Exerc. 1991; 23: 491-498
        • Lamoth C.J.
        • Meijer O.G.
        • Wuisman P.I.
        • Van Dieen J.H.
        • Levin M.F.
        • Beek P.J.
        Pelvis-thorax coordination in the transverse plane during walking in persons with nonspecific low back pain.
        Spine. 2002; 27: E92-E99
        • Li L.
        Stability landscapes of walking and running near gait transition speed.
        J. Appl. Biomech. 2000; 16: 428-435
        • Maetzel A.
        • Li L.
        The economic burden of low back pain: a review of studies published between 1996 and 2001.
        Best Pract. Res. Clin. Rheumatol. 2002; 16: 23-30
        • Miller R.H.
        • Meardon S.A.
        • Derrick T.R.
        • Gillette J.C.
        Continuous relative phase variability during an exhaustive run in runners with a history of iliotibial band syndrome.
        J. Appl. Biomech. 2008; 24: 262-270
        • Nadler S.F.
        • Moley P.
        • Malanga G.A.
        • Rubbani M.
        • Prybicien M.
        • Feinberg J.H.
        Functional deficits in athletes with a history of low back pain: a pilot study.
        Arch. Phys. Med. Rehabil. 2002; 83: 1753-1758
        • Pai S.
        • Sundaram L.J.
        Low back pain: an economic assessment in the United States.
        Orthop. Clin. North Am. 2004; 35: 1-5
        • Peters B.T.
        • Haddad J.M.
        • Heiderscheit B.C.
        • Van Emmerik R.E.
        • Hamill J.
        Limitations in the use and interpretation of continuous relative phase.
        J. Biomech. 2003; 36: 271-274
        • Scheer S.J.
        • Watanabe T.K.
        • Radack K.L.
        Randomized controlled trials in industrial low back pain. 3. Subacute/chronic pain interventions.
        Arch. Phys. Med. Rehabil. 1997; 78: 414-423
        • Seay J.
        • Selbie W.S.
        • Hamill J.
        In vivo lumbo-sacral forces and moments during constant speed running at different stride lengths.
        J. Sports Sci. 2008; : 1-11
        • Selles R.W.
        • Wagenaar R.C.
        • Smit T.H.
        • Wuisman P.I.
        Disorders in trunk rotation during walking in patients with low back pain: a dynamical systems approach.
        Clin. Biomech. 2001; 16: 175-181
        • Taylor N.F.
        • Evans O.M.
        • Goldie P.A.
        The effect of walking faster on people with acute low back pain.
        Eur. Spine J. 2003; 12: 166-172
        • Van Emmerik R.E.A
        • McDermott W.J.
        • Haddad J.M.
        • Van Wegen E.E.
        Age-related changes in upper body adaptation to walking speed in human locomotion.
        Gait Posture. 2005; 22: 233-239
        • Van Emmerik R.E.A.
        • Van Wegen E.E.H.
        On variability and stability in human movement.
        J. Appl. Biomech. 2000; 16: 394-406
        • Van Emmerik R.E.A.
        • Wagenaar R.C.
        • Winogrodzka A.
        • Wolters E.C.
        Identification of axial rigidity during locomotion in Parkinson disease.
        Arch. Phys. Med. Rehabil. 1999; 80: 186-191
        • Vianin M.
        Psychometric properties and clinical usefulness of the oswestry disability index.
        J. Chiropr. Med. 2008; 7: 161-163
        • Vogt L.
        • Pfeifer K.
        • Portscher
        • Banzer W.
        Influences of nonspecific low back pain on three-dimensional lumbar spine kinematics in locomotion.
        Spine. 2001; 26: 1910-1919