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Is there evidence to use kinematic/kinetic measures clinically in low back pain patients? A systematic review

Open AccessPublished:April 11, 2018DOI:https://doi.org/10.1016/j.clinbiomech.2018.04.006

      Highlights

      • Current low back pain assessment relies on subjective measures.
      • Use of objective measures (kinematics/kinetics) is encouraged in low back pain assessment.
      • This review highlights the heterogeneity of studies with low back pain and healthy subjects.
      • There is poor evidence for kinematic/kinetic parameters as low back pain objective measures.
      • Functional tasks, whole body and not only range of motion should be considered.

      Abstract

      Background

      Currently, there is a widespread reliance on self-reported questionnaires to assess low back pain patients. However, it has been suggested that objective measures of low back pain patients' functional status should be used to aid clinical assessment. The aim of this study is to systematically review which kinematic /kinetic parameters have been used to assess low back pain patients against healthy controls and to propose clinical kinematic/kinetic measures.

      Methods

      PubMed, Embase and Scopus databases were searched for relevant studies. Reference lists of selected studies and hand searches were performed. Studies had to compare people with and without non-specific low back pain while performing functional tasks and report body segment/joint kinematic and/or kinetic data. Two reviewers independently identified relevant papers.

      Findings

      Sixty-two studies were included. Common biases identified were lack of assessor blinding and sample size calculation, use of samples of convenience, and poor experimental protocol standardization. Studies had small sample sizes. Range of motion maneuvers were the main task performed (33/62). Kinematic/kinetic data of different individual or combination of body segments/joints were reported among the studies, commonest was to assess the hip joint and lumbar segment motion (13/62). Only one study described full body movement. The most commonly reported outcome was range of motion. Statistically significant differences between controls and low back pain groups were reported for different outcomes among the studies. Moreover, when the same outcome was reported disagreements were noted.

      Interpretation

      The literature to date offers limited and inconsistent evidence of kinematic/kinetic measures in low back pain patients that could be used clinically.

      Keywords

      1. Introduction

      Treatment for low back pain (LBP) aims to restore normal movement function and relieve pain. Measurements of movement function and measures of pain reduction, should, therefore, be the focus of LBP evaluation (
      • Newman N.
      • Gracovetsky S.
      • Itoi M.
      • Zucherman J.
      • Richards M.
      • Durand P.
      • Xeller C.
      • Carr D.
      Can the computerized physical examination differentiate normal subjects from abnormal subjects with benign mechanical low back pain?.
      ). This review is focused on measures of movement function. Movement analysis, allowing quantification of human movement, provides a means to objectify impairments from which clinical decisions can be made (
      • Andriacchi T.P.
      • Alexander E.J.
      Studies of human locomotion: past, present and future.
      ). However, clinical assessment of LBP relies predominately on self-reported questionnaires and scores, which depend on the patients' perception of their pain and functional capacity (
      • Smeets R.
      • Köke A.
      • Lin C.W.
      • Ferreira M.
      • Demoulin C.
      Measures of function in low back pain/disorders: low back pain rating scale (LBPRS), Oswestry disability index (ODI), progressive Isoinertial lifting evaluation (PILE), Quebec back pain disability scale (QBPDS), and Roland-Morris disability questionnaire (RDQ).
      ). In many cases of LBP, the origin of pain cannot be identified, with diagnosis occurring in only 5–10% of cases (
      • Krismer M.
      • van Tulder M.
      Low back pain (non-specific).
      ). This relates to the multifactorial and complex nature of LBP. Psychosocial factors, such as fear avoidance, dissatisfaction at work and pain beliefs as well as mechanical factors due to daily movement contribute to LBP development and occurrence (
      • Clays E.
      • De Bacquer D.
      • Leynen F.
      • Kornitzer M.
      • Kittel F.
      • De Backer G.
      The impact of psychosocial factors on low back pain: longitudinal results from the Belstress study.
      ). The interaction among these factors makes non-specific LBP difficult to classify and leaves clinicians facing significant challenges during its evaluation and management with consequences on patients' recovery. Imaging techniques, such as X-rays, computed tomography and magnetic resonance imaging, are employed in clinical practice but do not increase clinicians' ability to assess function and provide few if any indicators on how to manage non-specific LBP (
      • Newman N.
      • Gracovetsky S.
      • Itoi M.
      • Zucherman J.
      • Richards M.
      • Durand P.
      • Xeller C.
      • Carr D.
      Can the computerized physical examination differentiate normal subjects from abnormal subjects with benign mechanical low back pain?.
      ). Conversely, the ability to objectively assess the extent of movement impairments due to LBP has the potential to aid clinical assessment and, combined with psychosocial intervention, may provide important treatment targets.
      The use of objective measures of LBP patients' movement function, alongside self-reported questionnaires, has been recently encouraged (
      • Sanchez-Zuriaga D.
      • Lopez-Pascual J.
      • Garrido-Jaen D.
      • de Moya M.F.
      • Prat-Pastor J.
      Reliability and validity of a new objective tool for low back pain functional assessment.
      ;
      • Smeets R.
      • Köke A.
      • Lin C.W.
      • Ferreira M.
      • Demoulin C.
      Measures of function in low back pain/disorders: low back pain rating scale (LBPRS), Oswestry disability index (ODI), progressive Isoinertial lifting evaluation (PILE), Quebec back pain disability scale (QBPDS), and Roland-Morris disability questionnaire (RDQ).
      ), yet definition of functional motion and what should be measured is lacking. Lumbar range of motion (RoM) is frequently used in the clinical diagnosis of LBP despite its known variability and its questionable ability to discriminate between controls and LBP patients (
      • Laird R.A.
      • Gilbert J.
      • Kent P.
      • Keating J.L.
      Comparing lumbo-pelvic kinematics in people with and without back pain: a systematic review and meta-analysis.
      ;
      • Lehman G.J.
      Biomechanical assessments of lumbar spinal function. How low back pain sufferers differ from normals. Implications for outcome measures research. Part I: kinematic assessments of lumbar function.
      ). Failure in differentiating these two groups on the basis of movement function is further aggravated by not considering the existence of sub-groups of LBP patients based on adopted movement strategies to accomplish a task. Moreover, it has been recently suggested that assessment should not be limited to the spine but should consider the spine in a whole-body context, including the lower limbs (
      • McGregor A.H.
      • Hukins D.W.
      Lower limb involvement in spinal function and low back pain.
      ;
      • Song A.Y.
      • Jo H.J.
      • Sung P.S.
      • Kim Y.H.
      Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain.
      ). The lower limbs interfacing with externally applied forces may play an important role in spinal function during movement and standing as these are part of the body's kinematic chain. However, to date the full role of lower limb mechanics in the development and persistence of LBP is not known (
      • McGregor A.H.
      • Hukins D.W.
      Lower limb involvement in spinal function and low back pain.
      ;
      • Song A.Y.
      • Jo H.J.
      • Sung P.S.
      • Kim Y.H.
      Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain.
      ). Since both the upper and lower body systems are active segments responsible for the achievement of everyday motor tasks none of them should be omitted in functional assessments.
      For this paper, we focus on objective measures of LBP movement function that could empirically, by appropriate techniques, highlight significant differences between control and LBP populations thus providing a greater understanding of LBP biomechanical mechanisms to refine assessments and treatment options. This is to go beyond the subjectivity of self-reported questionnaires and observational clinical assessment. The aim of this systematic review was to evaluate the available literature in relation to kinematic and kinetic parameters that have been used to assess LBP patients' movement function compared to healthy controls and to identify possible objective measures of LBP, based on the parameters reported in published studies, which could be used clinically to aid LBP assessment and management. The research questions we sought to address were: i) Can kinematic/kinetic data differentiate between LBP patients and control subjects? ii) Which measurements and methods have been used to characterise patterns of motion that might be relevant to LBP? iii) Can such methods be translated to the clinical environment?

      2. Methods

      This systematic review was conducted in accordance with the PRISMA Statement (
      • Moher D.
      • Liberati A.
      • Tetzlaff J.
      • Altman D.G.
      Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
      ).

      2.1 Eligibility criteria

      Studies were included in the review if they: 1) included adults over 18 years old, 2) were published in English, 3) considered patients presenting with non-specific LBP only, 4) included data from a healthy control group or healthy database, 5) used joint/body segment kinematic and/or kinetic data as an outcome measure, 6) considered active movements, 7) included appropriate statistical reporting, and 8) were peer-reviewed. Studies were excluded if they: 1) were a case-study design, 2) included subjects with specific LBP caused by pathological entities and attributable to a recognisable pathology (e.g., scoliosis, spinal stenosis, disc herniation, ankylosing spondylitis, cauda equina, tumour, osteoporosis, fracture), 3) reported only imaging or muscle data, and 4) described patients as having back pain with no specific reference made to LBP.

      2.2 Data sources and search strategy

      Electronic databases, PubMed, Embase and Scopus, were searched from the earliest records up until May 2016. The search strategy combined three conceptual groups of terms: LBP, Testing Procedure/Method, and Measurement/Outcome. Controlled vocabulary terms (e.g. Mesh terms) and key words were used. PubMed search strategy, from which other database searches were derived, is reported in Supplementary File 1. Citation tracking of selected studies and hand searches were also performed to identify additional relevant articles missed by the electronic searches. Searched articles were imported into EndNote ×7 software (Thomson, Reuters, Carlsbad, CA) for subsequent study selection.

      2.3 Review process

      Two independent reviewers (EP, AM) screened titles and abstracts to identify eligible studies. Full text articles were assessed for eligibility criteria by EP and AM independently. Disagreements were resolved by consensus discussions.
      Table 1Quality assessment summary.
      Quality assessment domains% of studies scoring yes
      Study population bias
      1Was the study population adequately described?85%
      2Were both groups drawn from the same population?16%
      3Were both groups comparable for age, sex, BMI/weight?72%
      4Were the subjects asked to participate in the study representative of the entire population from which they were recruited?0%
      5Was pain intensity and/or activity limitation described for LBP group?72%
      6Was an attempt made to define back pain characteristics?92%
      7Were the eligibility criteria specified?89%
      Measurement and outcome bias
      8Did the method description enable accurate replication of the measurement procedures?98%
      9Was the measurement equipment adequately described?100%
      10Was a system for standardizing movement instructions reported?42%
      11Were assessors trained in standardized measurement procedure?8%
      12Did the same assessors test those with and without back pain?11%
      13Were assessors blinded as to which group subjects were in?2%
      14Was assessment procedure applied to those with and without back pain the same?100%
      15Were the main outcomes to be measured and the related calculations (if applicable) clearly described?97%
      16Were the main outcome measures used accurate (valid and reliable)?97%
      Data presentation bias
      17Are the main findings of the study clearly described?97%
      18Were the statistical tests appropriate?98%
      19The results of between-group statistical comparisons were reported for at least one key outcome95%
      20Have actual probability values been reported (e.g. 0.035 rather than <0.05) for the main outcomes except where the probability value is <0.001?53%
      21Point estimates and measures of variability were provided for at least one key outcome for those with and without back pain92%
      22Did the study have sufficient power to detect a clinically important effect where the probability value for a difference being due to chance is <5%?10%
      23Was the reliability and/or validity of the outcomes commented upon?56%

      2.4 Data extraction and quality assessment

      The following study details were extracted from each included study, using a customised data extraction form: study aims, design, sample size, participant demographics, task conducted, equipment used, body segments analysed, kinematic and kinetic variables evaluated, statistical analysis technique, statistically significant outcomes. As no standardized or validated quality checklists exist for this type of review, a customised quality assessment tool was constructed based on tools used in similar studies (
      • Downs S.
      • Black N.
      The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions.
      ;
      • Laird R.A.
      • Gilbert J.
      • Kent P.
      • Keating J.L.
      Comparing lumbo-pelvic kinematics in people with and without back pain: a systematic review and meta-analysis.
      ) to determine sources of bias in the selected articles. The quality assessment tool used was divided into three domains: study population bias, measurement and outcome bias, and data presentation bias (Table 1). Population description, experimental methodology and reporting of the results could, thus, be evaluated. Ratcliffe et al.'s rating score was used to rate the quality of the reviewed paper: studies scored as high quality achieve a score >66.8%, medium quality 33.4–66.7%, and low quality <33.3%. (
      • Ratcliffe E.
      • Pickering S.
      • McLean S.
      • Lewis J.
      Is there a relationship between subacromial impingement syndrome and scapular orientation? A systematic review.
      ). Assessment checklist questions and the correspondent decision rules are available in Supplementary File 2.

      3. Results

      3.1 Study selection

      The study selection process is shown in Fig. 1. The initial search yielded 13,211 articles, with duplicates removed, with 6 additional articles identified through citation tracking and hand searches. After screening titles and abstracts, 13,104 articles were excluded as they were deemed irrelevant to this review topic. Inclusion criteria were applied to the full-texts of 110 articles. Of these, 62 met the inclusion criteria; reasons for exclusion of the other 48 articles are shown in Fig. 1. A meta-analysis of the study results was not appropriate as this review did not examine clinical interventions and also because of the diverse methodological approaches adopted. A summary of included studies is available in Supplementary File 3.

      3.2 Quality aspects of reviewed studies

      Six studies had a quality score below 50% (
      • Akinpelu A.O.
      • Adeyemi A.I.
      Range of lumbar flexion in chronic low back pain.
      ;
      • Aluko A.
      • DeSouza L.
      • Peacock J.
      Evaluation of trunk acceleration in healthy individuals and those with low back pain.
      ;
      • Cyteval C.
      • Micallef J.P.
      • Leroux J.L.
      • Blotman F.
      • Lamarque J.L.
      Comparison of spinal range of motion during flexion-extension using a three-dimensional opto-electronic system in healthy volunteers and patients with chronic low back pain.
      ;
      • 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.
      ;
      • McGregor A.H.
      • McCarthy I.D.
      • Dore C.J.
      • Hughes S.P.
      Quantitative assessment of the motion of the lumbar spine in the low back pain population and the effect of different spinal pathologies of this motion.
      ;
      • Newman N.
      • Gracovetsky S.
      • Itoi M.
      • Zucherman J.
      • Richards M.
      • Durand P.
      • Xeller C.
      • Carr D.
      Can the computerized physical examination differentiate normal subjects from abnormal subjects with benign mechanical low back pain?.
      ). The highest score recorded was 78% in 4 studies (
      • Burnett A.F.
      • Cornelius M.W.
      • Dankaerts W.
      • O'Sullivan P.B.
      Spinal kinematics and trunk muscle activity in cyclists: a comparison between healthy controls and non-specific chronic low back pain subjects-a pilot investigation.
      ;
      • Jayaraman G.
      • Nazre A.A.
      • McCann V.
      • Redford J.B.
      A computerized technique for analyzing lateral bending behavior of subjects with normal and impaired lumbar spine. A pilot study.
      ;
      • Song A.Y.
      • Jo H.J.
      • Sung P.S.
      • Kim Y.H.
      Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain.
      ;
      • Sung P.S.
      • Park W.H.
      • Kim Y.H.
      Three-dimensional kinematic lumbar spine motion analyses of trunk motion during axial rotation activities.
      ). Based on Ratcliffe et al.'s (
      • Ratcliffe E.
      • Pickering S.
      • McLean S.
      • Lewis J.
      Is there a relationship between subacromial impingement syndrome and scapular orientation? A systematic review.
      ) rating score, 27 articles [10, 19–43] were of high, and the remaining 35 articles (
      • Akinpelu A.O.
      • Adeyemi A.I.
      Range of lumbar flexion in chronic low back pain.
      ;
      • Al-Eisa E.
      • Egan D.
      • Deluzio K.
      • Wassersug R.
      Effects of pelvic skeletal asymmetry on trunk movement: three-dimensional analysis in healthy individuals versus patients with mechanical low back pain.
      ;
      • Al-Eisa E.
      • Egan D.
      • Deluzio K.
      • Wassersug R.
      Effects of pelvic asymmetry and low back pain on trunk kinematics during sitting: a comparison with standing.
      ;
      • Aluko A.
      • DeSouza L.
      • Peacock J.
      Evaluation of trunk acceleration in healthy individuals and those with low back pain.
      ;
      • Barrett C.J.
      • Singer K.P.
      • Day R.
      Assessment of combined movements of the lumbar spine in asymptomatic and low back pain subjects using a three-dimensional electromagnetic tracking system.
      ;
      • Boline P.D.
      • Keating Jr J.C.
      • Haas M.
      • Anderson A.V.
      Interexaminer reliability and discriminant validity of inclinometric measurement of lumbar rotation in chronic low-back pain patients and subjects without low-back pain.
      ;
      • Crosbie J.
      • de Faria Negrao Filho R.
      • Nascimento D.P.
      • Ferreira P.
      Coordination of spinal motion in the transverse and frontal planes during walking in people with and without recurrent low back pain.
      ;
      • Crosbie J.
      • Nascimento D.P.
      • Filho Rde F.
      • Ferreira P.
      Do people with recurrent back pain constrain spinal motion during seated horizontal and downward reaching?.
      ;
      • Cyteval C.
      • Micallef J.P.
      • Leroux J.L.
      • Blotman F.
      • Lamarque J.L.
      Comparison of spinal range of motion during flexion-extension using a three-dimensional opto-electronic system in healthy volunteers and patients with chronic low back pain.
      ;
      • Fenety A.
      • Kumar S.
      Isokinetic trunk strength and lumbosacral range of motion in elite female field hockey players reporting low-back pain.
      ;
      • Freddolini M.
      • Strike S.
      • Lee R.
      Dynamic stability of the trunk during unstable sitting in people with low back pain.
      ;
      • Freddolini M.
      • Strike S.
      • Lee R.Y.
      Stiffness properties of the trunk in people with low back pain.
      ;
      • Gioftsos G.
      • Grieve D.W.
      The use of artificial neural networks to identify patients with chronic low-back pain conditions from patterns of sit-to-stand manoeuvres.
      ;
      • Henchoz Y.
      • Tetreau C.
      • Abboud J.
      • Piche M.
      • Descarreaux M.
      Effects of noxious stimulation and pain expectations on neuromuscular control of the spine in patients with chronic low back pain.
      ;
      • Jandre Reis F.J.
      • Macedo A.R.
      Influence of hamstring tightness in pelvic, lumbar and trunk range of motion in low back pain and asymptomatic volunteers during forward bending.
      ;
      • Kim M.H.
      • Yi C.H.
      • Kwon O.Y.
      • Cho S.H.
      • Cynn H.S.
      • Kim Y.H.
      • Hwang S.H.
      • Choi B.R.
      • Hong J.A.
      • Jung D.H.
      Comparison of lumbopelvic rhythm and flexion-relaxation response between 2 different low back pain subtypes.
      ;
      • 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.
      ;
      • Lamoth C.J.
      • Daffertshofer A.
      • Meijer O.G.
      • Beek P.J.
      How do persons with chronic low back pain speed up and slow down? Trunk-pelvis coordination and lumbar erector spinae activity during gait.
      ;
      • Lee J.K.
      • Desmoulin G.T.
      • Khan A.H.
      • Park E.J.
      A portable inertial sensing-based spinal motion measurement system for low back pain assessment.
      ;
      • McClure P.W.
      • Esola M.
      • Schreier R.
      • Siegler S.
      Kinematic analysis of lumbar and hip motion while rising from a forward, flexed position in patients with and without a history of low back pain.
      ;
      • McGregor A.H.
      • McCarthy I.D.
      • Dore C.J.
      • Hughes S.P.
      Quantitative assessment of the motion of the lumbar spine in the low back pain population and the effect of different spinal pathologies of this motion.
      ;
      • Morlock M.M.
      • Bonin V.
      • Deuretzbacher G.
      • Müller G.
      • Honl M.
      • Schneider E.
      Determination of the in vivo loading of the lumbar spine with a new approach directly at the workplace - first results for nurses.
      ;
      • Muller R.
      • Ertelt T.
      • Blickhan R.
      Low back pain affects trunk as well as lower limb movements during walking and running.
      ;
      • Newman N.
      • Gracovetsky S.
      • Itoi M.
      • Zucherman J.
      • Richards M.
      • Durand P.
      • Xeller C.
      • Carr D.
      Can the computerized physical examination differentiate normal subjects from abnormal subjects with benign mechanical low back pain?.
      ;
      • Ng J.K.F.
      • Richardson C.A.
      • Kippers V.
      • Parnianpour M.
      Comparison of lumbar range of movement and lumbar lordosis in back pain patients and matched controls.
      ;
      • Porter J.L.
      • Wilkinson A.
      Lumbar-hip flexion motion. A comparative study between asymptomatic and chronic low back pain in 18- to 36-year-old men.
      ;
      • Shum G.L.
      • Crosbie J.
      • Lee R.Y.
      Effect of low back pain on the kinematics and joint coordination of the lumbar spine and hip during sit-to-stand and stand-to-sit.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Symptomatic and asymptomatic movement coordination of the lumbar spine and hip during an everyday activity.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Three-dimensional kinetics of the lumbar spine and hips in low back pain patients during sit-to-stand and stand-to-sit.
      ;
      • Vaisy M.
      • Gizzi L.
      • Petzke F.
      • Consmüller T.
      • Pfingsten M.
      • Falla D.
      Measurement of lumbar spine functional movement in low back pain.
      ;
      • van Wingerden J.P.
      • Vleeming A.
      • Ronchetti I.
      Differences in standing and forward bending in women with chronic low back or pelvic girdle pain: indications for physical compensation strategies.
      ;
      • Vismara L.
      • Menegoni F.
      • Zaina F.
      • Galli M.
      • Negrini S.
      • Capodaglio P.
      Effect of obesity and low back pain on spinal mobility: a cross sectional study in women.
      ;
      • Vogt L.
      • Pfeifer K.
      • Portscher Banzer W.
      Influences of nonspecific low back pain on three-dimensional lumbar spine kinematics in locomotion.
      ;
      • Vogt L.
      • Pfeifer K.
      • Banzer W.
      Neuromuscular control of walking with chronic low-back pain.
      ;
      • Wong T.K.
      • Lee R.Y.
      Effects of low back pain on the relationship between the movements of the lumbar spine and hip.
      ) were of medium quality. Table 1 shows a quality assessment summary of all included studies indicating potential sources of bias. Ten studies (
      • Burnett A.F.
      • Cornelius M.W.
      • Dankaerts W.
      • O'Sullivan P.B.
      Spinal kinematics and trunk muscle activity in cyclists: a comparison between healthy controls and non-specific chronic low back pain subjects-a pilot investigation.
      ;
      • Dunk N.M.
      • Callaghan J.P.
      Lumbar spine movement patterns during prolonged sitting differentiate low back pain developers from matched asymptomatic controls.
      ;
      • Esola M.A.
      • McClure P.W.
      • Fitzgerald G.K.
      • Siegler S.
      Analysis of lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain.
      ;
      • Mellin G.
      Decreased joint and spinal mobility associated with low back pain in young adults.
      ;
      • Mitchell T.
      • O'Sullivan P.B.
      • Burnett A.F.
      • Straker L.
      • Smith A.
      Regional differences in lumbar spinal posture and the influence of low back pain.
      ;
      • Morlock M.M.
      • Bonin V.
      • Deuretzbacher G.
      • Müller G.
      • Honl M.
      • Schneider E.
      Determination of the in vivo loading of the lumbar spine with a new approach directly at the workplace - first results for nurses.
      ;
      • Muller R.
      • Ertelt T.
      • Blickhan R.
      Low back pain affects trunk as well as lower limb movements during walking and running.
      ;
      • Seay J.F.
      • Van Emmerik R.E.
      • Hamill J.
      Influence of low back pain status on pelvis-trunk coordination during walking and running.
      ;
      • Song A.Y.
      • Jo H.J.
      • Sung P.S.
      • Kim Y.H.
      Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain.
      ;
      • Sung P.S.
      • Park W.H.
      • Kim Y.H.
      Three-dimensional kinematic lumbar spine motion analyses of trunk motion during axial rotation activities.
      ;
      • Van Hoof W.
      • Volkaerts K.
      • O'Sullivan K.
      • Verschueren S.
      • Dankaerts W.
      Comparing lower lumbar kinematics in cyclists with low back pain (flexion pattern) versus asymptomatic controls - field study using a wireless posture monitoring system.
      ) used participants from the same population group; none identified the source population for participants, only 1 study (
      • Newman N.
      • Gracovetsky S.
      • Itoi M.
      • Zucherman J.
      • Richards M.
      • Durand P.
      • Xeller C.
      • Carr D.
      Can the computerized physical examination differentiate normal subjects from abnormal subjects with benign mechanical low back pain?.
      ) blinded the assessors to group status and 5 studies (
      • Boline P.D.
      • Keating Jr J.C.
      • Haas M.
      • Anderson A.V.
      Interexaminer reliability and discriminant validity of inclinometric measurement of lumbar rotation in chronic low-back pain patients and subjects without low-back pain.
      ;
      • Gombatto S.P.
      • Brock T.
      • DeLork A.
      • Jones G.
      • Madden E.
      • Rinere C.
      Lumbar spine kinematics during walking in people with and people without low back pain.
      ;
      • Jayaraman G.
      • Nazre A.A.
      • McCann V.
      • Redford J.B.
      A computerized technique for analyzing lateral bending behavior of subjects with normal and impaired lumbar spine. A pilot study.
      ;
      • Park W.H.
      • Kim Y.H.
      • Lee T.R.
      • Sung P.S.
      Factors affecting shoulder-pelvic integration during axial trunk rotation in subjects with recurrent low back pain.
      ;
      • Vismara L.
      • Menegoni F.
      • Zaina F.
      • Galli M.
      • Negrini S.
      • Capodaglio P.
      Effect of obesity and low back pain on spinal mobility: a cross sectional study in women.
      ) gave evidence of assessors' expertise. Seven studies (
      • Barrett C.J.
      • Singer K.P.
      • Day R.
      Assessment of combined movements of the lumbar spine in asymptomatic and low back pain subjects using a three-dimensional electromagnetic tracking system.
      ;
      • Boline P.D.
      • Keating Jr J.C.
      • Haas M.
      • Anderson A.V.
      Interexaminer reliability and discriminant validity of inclinometric measurement of lumbar rotation in chronic low-back pain patients and subjects without low-back pain.
      ;
      • Jayaraman G.
      • Nazre A.A.
      • McCann V.
      • Redford J.B.
      A computerized technique for analyzing lateral bending behavior of subjects with normal and impaired lumbar spine. A pilot study.
      ;
      • Mellin G.
      Decreased joint and spinal mobility associated with low back pain in young adults.
      ;
      • Newcomer K.
      • Laskowski E.R.
      • Yu B.
      • Larson D.R.
      • An K.N.
      Repositioning error in low back pain. Comparing trunk repositioning error in subjects with chronic low back pain and control subjects.
      ;
      • Porter J.L.
      • Wilkinson A.
      Lumbar-hip flexion motion. A comparative study between asymptomatic and chronic low back pain in 18- to 36-year-old men.
      ;
      • Vismara L.
      • Menegoni F.
      • Zaina F.
      • Galli M.
      • Negrini S.
      • Capodaglio P.
      Effect of obesity and low back pain on spinal mobility: a cross sectional study in women.
      ) described if the tests were conducted by the same assessor and 26 reported the use of standardized movement instructions (
      • Al-Eisa E.
      • Egan D.
      • Deluzio K.
      • Wassersug R.
      Effects of pelvic skeletal asymmetry on trunk movement: three-dimensional analysis in healthy individuals versus patients with mechanical low back pain.
      ;
      • Al-Eisa E.
      • Egan D.
      • Deluzio K.
      • Wassersug R.
      Effects of pelvic asymmetry and low back pain on trunk kinematics during sitting: a comparison with standing.
      ;
      • Barrett C.J.
      • Singer K.P.
      • Day R.
      Assessment of combined movements of the lumbar spine in asymptomatic and low back pain subjects using a three-dimensional electromagnetic tracking system.
      ;
      • Boline P.D.
      • Keating Jr J.C.
      • Haas M.
      • Anderson A.V.
      Interexaminer reliability and discriminant validity of inclinometric measurement of lumbar rotation in chronic low-back pain patients and subjects without low-back pain.
      ;
      • Burnett A.F.
      • Cornelius M.W.
      • Dankaerts W.
      • O'Sullivan P.B.
      Spinal kinematics and trunk muscle activity in cyclists: a comparison between healthy controls and non-specific chronic low back pain subjects-a pilot investigation.
      ;
      • Crosbie J.
      • de Faria Negrao Filho R.
      • Nascimento D.P.
      • Ferreira P.
      Coordination of spinal motion in the transverse and frontal planes during walking in people with and without recurrent low back pain.
      ;
      • Crosbie J.
      • Nascimento D.P.
      • Filho Rde F.
      • Ferreira P.
      Do people with recurrent back pain constrain spinal motion during seated horizontal and downward reaching?.
      ;
      • Dankaerts W.
      • O'Sullivan P.
      • Burnett A.
      • Straker L.
      • Davey P.
      • Gupta R.
      Discriminating healthy controls and two clinical subgroups of nonspecific chronic low back pain patients using trunk muscle activation and lumbosacral kinematics of postures and movements: a statistical classification model.
      ;
      • Esola M.A.
      • McClure P.W.
      • Fitzgerald G.K.
      • Siegler S.
      Analysis of lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain.
      ;
      • Gioftsos G.
      • Grieve D.W.
      The use of artificial neural networks to identify patients with chronic low-back pain conditions from patterns of sit-to-stand manoeuvres.
      ;
      • Gombatto S.P.
      • Brock T.
      • DeLork A.
      • Jones G.
      • Madden E.
      • Rinere C.
      Lumbar spine kinematics during walking in people with and people without low back pain.
      ;
      • Jayaraman G.
      • Nazre A.A.
      • McCann V.
      • Redford J.B.
      A computerized technique for analyzing lateral bending behavior of subjects with normal and impaired lumbar spine. A pilot study.
      ;
      • Kim M.H.
      • Yi C.H.
      • Kwon O.Y.
      • Cho S.H.
      • Cynn H.S.
      • Kim Y.H.
      • Hwang S.H.
      • Choi B.R.
      • Hong J.A.
      • Jung D.H.
      Comparison of lumbopelvic rhythm and flexion-relaxation response between 2 different low back pain subtypes.
      ;
      • Kim S.H.
      • Kwon O.Y.
      • Yi C.H.
      • Cynn H.S.
      • Ha S.M.
      • Park K.N.
      Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion.
      ;
      • Kim M.H.
      • Yoo W.G.
      Comparison of the lumbar flexion angle and repositioning error during lumbar flexion-extension in young computer workers in Korea with differing back pain.
      ;
      • 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.
      ;
      • Lamoth C.J.
      • Daffertshofer A.
      • Meijer O.G.
      • Beek P.J.
      How do persons with chronic low back pain speed up and slow down? Trunk-pelvis coordination and lumbar erector spinae activity during gait.
      ;
      • Lariviere C.
      • Gagnon D.
      • Loisel P.
      The effect of load on the coordination of the trunk for subjects with and without chronic low back pain during flexion-extension and lateral bending tasks.
      ;
      • Larivière C.
      • Gagnon D.
      • Loisel P.
      A biomechanical comparison of lifting techniques between subjects with and without chronic low back pain during freestyle lifting and lowering tasks.
      ;
      • Larivière C.
      • Da Silva R.A.
      • Arsenault A.B.
      • Nadeau S.
      • Plamondon A.
      • Vadeboncoeur R.
      Specificity of a back muscle roman chair exercise in healthy and back pain subjects.
      ;
      • Mitchell T.
      • O'Sullivan P.B.
      • Burnett A.F.
      • Straker L.
      • Smith A.
      Regional differences in lumbar spinal posture and the influence of low back pain.
      ;
      • Park W.H.
      • Kim Y.H.
      • Lee T.R.
      • Sung P.S.
      Factors affecting shoulder-pelvic integration during axial trunk rotation in subjects with recurrent low back pain.
      ;
      • Sanchez-Zuriaga D.
      • Lopez-Pascual J.
      • Garrido-Jaen D.
      • de Moya M.F.
      • Prat-Pastor J.
      Reliability and validity of a new objective tool for low back pain functional assessment.
      ;
      • Song A.Y.
      • Jo H.J.
      • Sung P.S.
      • Kim Y.H.
      Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain.
      ;
      • Sung P.S.
      A compensation of angular displacements of the hip joints and lumbosacral spine between subjects with and without idiopathic low back pain during squatting.
      ;
      • Sung P.S.
      • Park W.H.
      • Kim Y.H.
      Three-dimensional kinematic lumbar spine motion analyses of trunk motion during axial rotation activities.
      ). Only 6 justified their sample size (
      • Jayaraman G.
      • Nazre A.A.
      • McCann V.
      • Redford J.B.
      A computerized technique for analyzing lateral bending behavior of subjects with normal and impaired lumbar spine. A pilot study.
      ;
      • Larivière C.
      • Da Silva R.A.
      • Arsenault A.B.
      • Nadeau S.
      • Plamondon A.
      • Vadeboncoeur R.
      Specificity of a back muscle roman chair exercise in healthy and back pain subjects.
      ;
      • Mitchell T.
      • O'Sullivan P.B.
      • Burnett A.F.
      • Straker L.
      • Smith A.
      Regional differences in lumbar spinal posture and the influence of low back pain.
      ;
      • Newcomer K.
      • Laskowski E.R.
      • Yu B.
      • Larson D.R.
      • An K.N.
      Repositioning error in low back pain. Comparing trunk repositioning error in subjects with chronic low back pain and control subjects.
      ;
      • Seay J.F.
      • Van Emmerik R.E.
      • Hamill J.
      Influence of low back pain status on pelvis-trunk coordination during walking and running.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Movement coordination of the lumbar spine and hip during a picking up activity in low back pain subjects.
      ).
      Fig. 1
      Fig. 1PRISMA flow diagram illustrating the review process (
      • Moher D.
      • Liberati A.
      • Tetzlaff J.
      • Altman D.G.
      Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
      ).

      3.3 Study characteristics

      Studies included in the review were published between 1989 and 2015, with the majority published in the last 15 years (49/62) (
      • Al-Eisa E.
      • Egan D.
      • Deluzio K.
      • Wassersug R.
      Effects of pelvic skeletal asymmetry on trunk movement: three-dimensional analysis in healthy individuals versus patients with mechanical low back pain.
      ;
      • Al-Eisa E.
      • Egan D.
      • Deluzio K.
      • Wassersug R.
      Effects of pelvic asymmetry and low back pain on trunk kinematics during sitting: a comparison with standing.
      ;
      • Aluko A.
      • DeSouza L.
      • Peacock J.
      Evaluation of trunk acceleration in healthy individuals and those with low back pain.
      ;
      • Burnett A.F.
      • Cornelius M.W.
      • Dankaerts W.
      • O'Sullivan P.B.
      Spinal kinematics and trunk muscle activity in cyclists: a comparison between healthy controls and non-specific chronic low back pain subjects-a pilot investigation.
      ;
      • Crosbie J.
      • de Faria Negrao Filho R.
      • Nascimento D.P.
      • Ferreira P.
      Coordination of spinal motion in the transverse and frontal planes during walking in people with and without recurrent low back pain.
      ;
      • Crosbie J.
      • Nascimento D.P.
      • Filho Rde F.
      • Ferreira P.
      Do people with recurrent back pain constrain spinal motion during seated horizontal and downward reaching?.
      ;
      • Dankaerts W.
      • O'Sullivan P.
      • Burnett A.
      • Straker L.
      • Davey P.
      • Gupta R.
      Discriminating healthy controls and two clinical subgroups of nonspecific chronic low back pain patients using trunk muscle activation and lumbosacral kinematics of postures and movements: a statistical classification model.
      ;
      • Dunk N.M.
      • Callaghan J.P.
      Lumbar spine movement patterns during prolonged sitting differentiate low back pain developers from matched asymptomatic controls.
      ;
      • Freddolini M.
      • Strike S.
      • Lee R.
      Dynamic stability of the trunk during unstable sitting in people with low back pain.
      ;
      • Freddolini M.
      • Strike S.
      • Lee R.Y.
      Stiffness properties of the trunk in people with low back pain.
      ;
      • Gombatto S.P.
      • Brock T.
      • DeLork A.
      • Jones G.
      • Madden E.
      • Rinere C.
      Lumbar spine kinematics during walking in people with and people without low back pain.
      ;
      • Henchoz Y.
      • Tetreau C.
      • Abboud J.
      • Piche M.
      • Descarreaux M.
      Effects of noxious stimulation and pain expectations on neuromuscular control of the spine in patients with chronic low back pain.
      ;
      • Jandre Reis F.J.
      • Macedo A.R.
      Influence of hamstring tightness in pelvic, lumbar and trunk range of motion in low back pain and asymptomatic volunteers during forward bending.
      ;
      • Kim M.H.
      • Yi C.H.
      • Kwon O.Y.
      • Cho S.H.
      • Cynn H.S.
      • Kim Y.H.
      • Hwang S.H.
      • Choi B.R.
      • Hong J.A.
      • Jung D.H.
      Comparison of lumbopelvic rhythm and flexion-relaxation response between 2 different low back pain subtypes.
      ;
      • Kim S.H.
      • Kwon O.Y.
      • Yi C.H.
      • Cynn H.S.
      • Ha S.M.
      • Park K.N.
      Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion.
      ;
      • Kim M.H.
      • Yoo W.G.
      Comparison of the lumbar flexion angle and repositioning error during lumbar flexion-extension in young computer workers in Korea with differing back pain.
      ;
      • 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.
      ;
      • Lamoth C.J.
      • Meijer O.G.
      • Daffertshofer A.
      • Wuisman P.I.
      • Beek P.J.
      Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control.
      ;
      • Lamoth C.J.
      • Daffertshofer A.
      • Meijer O.G.
      • Beek P.J.
      How do persons with chronic low back pain speed up and slow down? Trunk-pelvis coordination and lumbar erector spinae activity during gait.
      ;
      • Larivière C.
      • Da Silva R.A.
      • Arsenault A.B.
      • Nadeau S.
      • Plamondon A.
      • Vadeboncoeur R.
      Specificity of a back muscle roman chair exercise in healthy and back pain subjects.
      ;
      • Lee J.K.
      • Desmoulin G.T.
      • Khan A.H.
      • Park E.J.
      Comparison of 3D spinal motions during stair-climbing between individuals with and without low back pain.
      ;
      • Lee J.K.
      • Desmoulin G.T.
      • Khan A.H.
      • Park E.J.
      A portable inertial sensing-based spinal motion measurement system for low back pain assessment.
      ;
      • Mitchell T.
      • O'Sullivan P.B.
      • Burnett A.F.
      • Straker L.
      • Smith A.
      Regional differences in lumbar spinal posture and the influence of low back pain.
      ;
      • Morlock M.M.
      • Bonin V.
      • Deuretzbacher G.
      • Müller G.
      • Honl M.
      • Schneider E.
      Determination of the in vivo loading of the lumbar spine with a new approach directly at the workplace - first results for nurses.
      ;
      • Muller R.
      • Ertelt T.
      • Blickhan R.
      Low back pain affects trunk as well as lower limb movements during walking and running.
      ;
      • Ng J.K.F.
      • Richardson C.A.
      • Kippers V.
      • Parnianpour M.
      Comparison of lumbar range of movement and lumbar lordosis in back pain patients and matched controls.
      ;
      • Park W.H.
      • Kim Y.H.
      • Lee T.R.
      • Sung P.S.
      Factors affecting shoulder-pelvic integration during axial trunk rotation in subjects with recurrent low back pain.
      ;
      • Sanchez-Zuriaga D.
      • Lopez-Pascual J.
      • Garrido-Jaen D.
      • de Moya M.F.
      • Prat-Pastor J.
      Reliability and validity of a new objective tool for low back pain functional assessment.
      ;
      • Seay J.F.
      • Van Emmerik R.E.
      • Hamill J.
      Influence of low back pain status on pelvis-trunk coordination during walking and running.
      ;
      • Shum G.L.
      • Crosbie J.
      • Lee R.Y.
      Effect of low back pain on the kinematics and joint coordination of the lumbar spine and hip during sit-to-stand and stand-to-sit.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Symptomatic and asymptomatic movement coordination of the lumbar spine and hip during an everyday activity.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Movement coordination of the lumbar spine and hip during a picking up activity in low back pain subjects.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Three-dimensional kinetics of the lumbar spine and hips in low back pain patients during sit-to-stand and stand-to-sit.
      ;
      • Song A.Y.
      • Jo H.J.
      • Sung P.S.
      • Kim Y.H.
      Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain.
      ;
      • Sung P.S.
      A compensation of angular displacements of the hip joints and lumbosacral spine between subjects with and without idiopathic low back pain during squatting.
      ;
      • Sung P.S.
      • Park W.H.
      • Kim Y.H.
      Three-dimensional kinematic lumbar spine motion analyses of trunk motion during axial rotation activities.
      ;
      • Taylor N.F.
      • Evans O.M.
      • Goldie P.A.
      The effect of walking faster on people with acute low back pain.
      ;
      • Taylor N.
      • Goldie P.
      • Evans O.
      Movements of the pelvis and lumbar spine during walking in people with acute low back pain.
      ;
      • Vaisy M.
      • Gizzi L.
      • Petzke F.
      • Consmüller T.
      • Pfingsten M.
      • Falla D.
      Measurement of lumbar spine functional movement in low back pain.
      ;
      • van den Hoorn W.
      • Bruijn S.M.
      • Meijer O.G.
      • Hodges P.W.
      • van Dieen J.H.
      Mechanical coupling between transverse plane pelvis and thorax rotations during gait is higher in people with low back pain.
      ;
      • Van Hoof W.
      • Volkaerts K.
      • O'Sullivan K.
      • Verschueren S.
      • Dankaerts W.
      Comparing lower lumbar kinematics in cyclists with low back pain (flexion pattern) versus asymptomatic controls - field study using a wireless posture monitoring system.
      ;
      • van Wingerden J.P.
      • Vleeming A.
      • Ronchetti I.
      Differences in standing and forward bending in women with chronic low back or pelvic girdle pain: indications for physical compensation strategies.
      ;
      • Vismara L.
      • Menegoni F.
      • Zaina F.
      • Galli M.
      • Negrini S.
      • Capodaglio P.
      Effect of obesity and low back pain on spinal mobility: a cross sectional study in women.
      ;
      • Vogt L.
      • Pfeifer K.
      • Portscher Banzer W.
      Influences of nonspecific low back pain on three-dimensional lumbar spine kinematics in locomotion.
      ;
      • Vogt L.
      • Pfeifer K.
      • Banzer W.
      Neuromuscular control of walking with chronic low-back pain.
      ;
      • Wong T.K.
      • Lee R.Y.
      Effects of low back pain on the relationship between the movements of the lumbar spine and hip.
      ). Most of the studies (34/62) (
      • Boline P.D.
      • Keating Jr J.C.
      • Haas M.
      • Anderson A.V.
      Interexaminer reliability and discriminant validity of inclinometric measurement of lumbar rotation in chronic low-back pain patients and subjects without low-back pain.
      ;
      • Crosbie J.
      • de Faria Negrao Filho R.
      • Nascimento D.P.
      • Ferreira P.
      Coordination of spinal motion in the transverse and frontal planes during walking in people with and without recurrent low back pain.
      ;
      • Crosbie J.
      • Nascimento D.P.
      • Filho Rde F.
      • Ferreira P.
      Do people with recurrent back pain constrain spinal motion during seated horizontal and downward reaching?.
      ;
      • Cyteval C.
      • Micallef J.P.
      • Leroux J.L.
      • Blotman F.
      • Lamarque J.L.
      Comparison of spinal range of motion during flexion-extension using a three-dimensional opto-electronic system in healthy volunteers and patients with chronic low back pain.
      ;
      • Dunk N.M.
      • Callaghan J.P.
      Lumbar spine movement patterns during prolonged sitting differentiate low back pain developers from matched asymptomatic controls.
      ;
      • Esola M.A.
      • McClure P.W.
      • Fitzgerald G.K.
      • Siegler S.
      Analysis of lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain.
      ;
      • Fenety A.
      • Kumar S.
      Isokinetic trunk strength and lumbosacral range of motion in elite female field hockey players reporting low-back pain.
      ;
      • Gioftsos G.
      • Grieve D.W.
      The use of artificial neural networks to identify patients with chronic low-back pain conditions from patterns of sit-to-stand manoeuvres.
      ;
      • Gombatto S.P.
      • Brock T.
      • DeLork A.
      • Jones G.
      • Madden E.
      • Rinere C.
      Lumbar spine kinematics during walking in people with and people without low back pain.
      ;
      • Henchoz Y.
      • Tetreau C.
      • Abboud J.
      • Piche M.
      • Descarreaux M.
      Effects of noxious stimulation and pain expectations on neuromuscular control of the spine in patients with chronic low back pain.
      ;
      • Jayaraman G.
      • Nazre A.A.
      • McCann V.
      • Redford J.B.
      A computerized technique for analyzing lateral bending behavior of subjects with normal and impaired lumbar spine. A pilot study.
      ;
      • Kim M.H.
      • Yi C.H.
      • Kwon O.Y.
      • Cho S.H.
      • Cynn H.S.
      • Kim Y.H.
      • Hwang S.H.
      • Choi B.R.
      • Hong J.A.
      • Jung D.H.
      Comparison of lumbopelvic rhythm and flexion-relaxation response between 2 different low back pain subtypes.
      ;
      • Kim S.H.
      • Kwon O.Y.
      • Yi C.H.
      • Cynn H.S.
      • Ha S.M.
      • Park K.N.
      Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion.
      ;
      • Kim M.H.
      • Yoo W.G.
      Comparison of the lumbar flexion angle and repositioning error during lumbar flexion-extension in young computer workers in Korea with differing back pain.
      ;
      • Lamoth C.J.
      • Daffertshofer A.
      • Meijer O.G.
      • Beek P.J.
      How do persons with chronic low back pain speed up and slow down? Trunk-pelvis coordination and lumbar erector spinae activity during gait.
      ;
      • Lariviere C.
      • Gagnon D.
      • Loisel P.
      The effect of load on the coordination of the trunk for subjects with and without chronic low back pain during flexion-extension and lateral bending tasks.
      ;
      • Larivière C.
      • Gagnon D.
      • Loisel P.
      A biomechanical comparison of lifting techniques between subjects with and without chronic low back pain during freestyle lifting and lowering tasks.
      ;
      • Larivière C.
      • Da Silva R.A.
      • Arsenault A.B.
      • Nadeau S.
      • Plamondon A.
      • Vadeboncoeur R.
      Specificity of a back muscle roman chair exercise in healthy and back pain subjects.
      ;
      • Lee J.K.
      • Desmoulin G.T.
      • Khan A.H.
      • Park E.J.
      Comparison of 3D spinal motions during stair-climbing between individuals with and without low back pain.
      ;
      • McClure P.W.
      • Esola M.
      • Schreier R.
      • Siegler S.
      Kinematic analysis of lumbar and hip motion while rising from a forward, flexed position in patients with and without a history of low back pain.
      ;
      • Muller R.
      • Ertelt T.
      • Blickhan R.
      Low back pain affects trunk as well as lower limb movements during walking and running.
      ;
      • Newcomer K.
      • Laskowski E.R.
      • Yu B.
      • Larson D.R.
      • An K.N.
      Repositioning error in low back pain. Comparing trunk repositioning error in subjects with chronic low back pain and control subjects.
      ;
      • Ng J.K.F.
      • Richardson C.A.
      • Kippers V.
      • Parnianpour M.
      Comparison of lumbar range of movement and lumbar lordosis in back pain patients and matched controls.
      ;
      • Park W.H.
      • Kim Y.H.
      • Lee T.R.
      • Sung P.S.
      Factors affecting shoulder-pelvic integration during axial trunk rotation in subjects with recurrent low back pain.
      ;
      • Porter J.L.
      • Wilkinson A.
      Lumbar-hip flexion motion. A comparative study between asymptomatic and chronic low back pain in 18- to 36-year-old men.
      ;
      • Seay J.F.
      • Van Emmerik R.E.
      • Hamill J.
      Influence of low back pain status on pelvis-trunk coordination during walking and running.
      ;
      • Song A.Y.
      • Jo H.J.
      • Sung P.S.
      • Kim Y.H.
      Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain.
      ;
      • Sung P.S.
      A compensation of angular displacements of the hip joints and lumbosacral spine between subjects with and without idiopathic low back pain during squatting.
      ;
      • Sung P.S.
      • Park W.H.
      • Kim Y.H.
      Three-dimensional kinematic lumbar spine motion analyses of trunk motion during axial rotation activities.
      ;
      • Taylor N.
      • Goldie P.
      • Evans O.
      Movements of the pelvis and lumbar spine during walking in people with acute low back pain.
      ;
      • Vaisy M.
      • Gizzi L.
      • Petzke F.
      • Consmüller T.
      • Pfingsten M.
      • Falla D.
      Measurement of lumbar spine functional movement in low back pain.
      ;
      • van den Hoorn W.
      • Bruijn S.M.
      • Meijer O.G.
      • Hodges P.W.
      • van Dieen J.H.
      Mechanical coupling between transverse plane pelvis and thorax rotations during gait is higher in people with low back pain.
      ;
      • Vismara L.
      • Menegoni F.
      • Zaina F.
      • Galli M.
      • Negrini S.
      • Capodaglio P.
      Effect of obesity and low back pain on spinal mobility: a cross sectional study in women.
      ;
      • Vogt L.
      • Pfeifer K.
      • Banzer W.
      Neuromuscular control of walking with chronic low-back pain.
      ) had a small sample size with 11 to 25 participants in each group and 7 studies had a maximum of 10 participants per group (Fig. 2a ) (
      • Aluko A.
      • DeSouza L.
      • Peacock J.
      Evaluation of trunk acceleration in healthy individuals and those with low back pain.
      ;
      • Burnett A.F.
      • Cornelius M.W.
      • Dankaerts W.
      • O'Sullivan P.B.
      Spinal kinematics and trunk muscle activity in cyclists: a comparison between healthy controls and non-specific chronic low back pain subjects-a pilot investigation.
      ;
      • Lee J.K.
      • Desmoulin G.T.
      • Khan A.H.
      • Park E.J.
      Comparison of 3D spinal motions during stair-climbing between individuals with and without low back pain.
      ;
      • Lee J.K.
      • Desmoulin G.T.
      • Khan A.H.
      • Park E.J.
      A portable inertial sensing-based spinal motion measurement system for low back pain assessment.
      ;
      • Morlock M.M.
      • Bonin V.
      • Deuretzbacher G.
      • Müller G.
      • Honl M.
      • Schneider E.
      Determination of the in vivo loading of the lumbar spine with a new approach directly at the workplace - first results for nurses.
      ;
      • Taylor N.F.
      • Evans O.M.
      • Goldie P.A.
      The effect of walking faster on people with acute low back pain.
      ;
      • Van Hoof W.
      • Volkaerts K.
      • O'Sullivan K.
      • Verschueren S.
      • Dankaerts W.
      Comparing lower lumbar kinematics in cyclists with low back pain (flexion pattern) versus asymptomatic controls - field study using a wireless posture monitoring system.
      ).
      Fig. 2
      Fig. 2(a) Overall sample size, (b) participants mean age (top) and age variability expressed as standard deviation (SD) per number of selected articles. In brackets corresponding % of articles is shown.
      Chronic LBP patients were recruited in 37 studies (
      • Akinpelu A.O.
      • Adeyemi A.I.
      Range of lumbar flexion in chronic low back pain.
      ;
      • Boline P.D.
      • Keating Jr J.C.
      • Haas M.
      • Anderson A.V.
      Interexaminer reliability and discriminant validity of inclinometric measurement of lumbar rotation in chronic low-back pain patients and subjects without low-back pain.
      ;
      • Burnett A.F.
      • Cornelius M.W.
      • Dankaerts W.
      • O'Sullivan P.B.
      Spinal kinematics and trunk muscle activity in cyclists: a comparison between healthy controls and non-specific chronic low back pain subjects-a pilot investigation.
      ;
      • Crosbie J.
      • de Faria Negrao Filho R.
      • Nascimento D.P.
      • Ferreira P.
      Coordination of spinal motion in the transverse and frontal planes during walking in people with and without recurrent low back pain.
      ;
      • Crosbie J.
      • Nascimento D.P.
      • Filho Rde F.
      • Ferreira P.
      Do people with recurrent back pain constrain spinal motion during seated horizontal and downward reaching?.
      ;
      • Cyteval C.
      • Micallef J.P.
      • Leroux J.L.
      • Blotman F.
      • Lamarque J.L.
      Comparison of spinal range of motion during flexion-extension using a three-dimensional opto-electronic system in healthy volunteers and patients with chronic low back pain.
      ;
      • Dankaerts W.
      • O'Sullivan P.
      • Burnett A.
      • Straker L.
      • Davey P.
      • Gupta R.
      Discriminating healthy controls and two clinical subgroups of nonspecific chronic low back pain patients using trunk muscle activation and lumbosacral kinematics of postures and movements: a statistical classification model.
      ;
      • Gioftsos G.
      • Grieve D.W.
      The use of artificial neural networks to identify patients with chronic low-back pain conditions from patterns of sit-to-stand manoeuvres.
      ;
      • Henchoz Y.
      • Tetreau C.
      • Abboud J.
      • Piche M.
      • Descarreaux M.
      Effects of noxious stimulation and pain expectations on neuromuscular control of the spine in patients with chronic low back pain.
      ;
      • Jandre Reis F.J.
      • Macedo A.R.
      Influence of hamstring tightness in pelvic, lumbar and trunk range of motion in low back pain and asymptomatic volunteers during forward bending.
      ;
      • Jayaraman G.
      • Nazre A.A.
      • McCann V.
      • Redford J.B.
      A computerized technique for analyzing lateral bending behavior of subjects with normal and impaired lumbar spine. A pilot study.
      ;
      • Kim S.H.
      • Kwon O.Y.
      • Yi C.H.
      • Cynn H.S.
      • Ha S.M.
      • Park K.N.
      Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion.
      ;
      • 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.
      ;
      • Lamoth C.J.
      • Meijer O.G.
      • Daffertshofer A.
      • Wuisman P.I.
      • Beek P.J.
      Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control.
      ;
      • Lamoth C.J.
      • Daffertshofer A.
      • Meijer O.G.
      • Beek P.J.
      How do persons with chronic low back pain speed up and slow down? Trunk-pelvis coordination and lumbar erector spinae activity during gait.
      ;
      • Lariviere C.
      • Gagnon D.
      • Loisel P.
      The effect of load on the coordination of the trunk for subjects with and without chronic low back pain during flexion-extension and lateral bending tasks.
      ;
      • Larivière C.
      • Gagnon D.
      • Loisel P.
      A biomechanical comparison of lifting techniques between subjects with and without chronic low back pain during freestyle lifting and lowering tasks.
      ;
      • Larivière C.
      • Da Silva R.A.
      • Arsenault A.B.
      • Nadeau S.
      • Plamondon A.
      • Vadeboncoeur R.
      Specificity of a back muscle roman chair exercise in healthy and back pain subjects.
      ;
      • Lee J.K.
      • Desmoulin G.T.
      • Khan A.H.
      • Park E.J.
      Comparison of 3D spinal motions during stair-climbing between individuals with and without low back pain.
      ;
      • Lee J.K.
      • Desmoulin G.T.
      • Khan A.H.
      • Park E.J.
      A portable inertial sensing-based spinal motion measurement system for low back pain assessment.
      ;
      • McClure P.W.
      • Esola M.
      • Schreier R.
      • Siegler S.
      Kinematic analysis of lumbar and hip motion while rising from a forward, flexed position in patients with and without a history of low back pain.
      ;
      • Muller R.
      • Ertelt T.
      • Blickhan R.
      Low back pain affects trunk as well as lower limb movements during walking and running.
      ;
      • Newcomer K.
      • Laskowski E.R.
      • Yu B.
      • Larson D.R.
      • An K.N.
      Repositioning error in low back pain. Comparing trunk repositioning error in subjects with chronic low back pain and control subjects.
      ;
      • Ng J.K.F.
      • Richardson C.A.
      • Kippers V.
      • Parnianpour M.
      Comparison of lumbar range of movement and lumbar lordosis in back pain patients and matched controls.
      ;
      • Park W.H.
      • Kim Y.H.
      • Lee T.R.
      • Sung P.S.
      Factors affecting shoulder-pelvic integration during axial trunk rotation in subjects with recurrent low back pain.
      ;
      • Porter J.L.
      • Wilkinson A.
      Lumbar-hip flexion motion. A comparative study between asymptomatic and chronic low back pain in 18- to 36-year-old men.
      ;
      • Sanchez-Zuriaga D.
      • Lopez-Pascual J.
      • Garrido-Jaen D.
      • de Moya M.F.
      • Prat-Pastor J.
      Reliability and validity of a new objective tool for low back pain functional assessment.
      ;
      • Seay J.F.
      • Van Emmerik R.E.
      • Hamill J.
      Influence of low back pain status on pelvis-trunk coordination during walking and running.
      ;
      • Sung P.S.
      A compensation of angular displacements of the hip joints and lumbosacral spine between subjects with and without idiopathic low back pain during squatting.
      ;
      • Vaisy M.
      • Gizzi L.
      • Petzke F.
      • Consmüller T.
      • Pfingsten M.
      • Falla D.
      Measurement of lumbar spine functional movement in low back pain.
      ;
      • van den Hoorn W.
      • Bruijn S.M.
      • Meijer O.G.
      • Hodges P.W.
      • van Dieen J.H.
      Mechanical coupling between transverse plane pelvis and thorax rotations during gait is higher in people with low back pain.
      ;
      • Van Hoof W.
      • Volkaerts K.
      • O'Sullivan K.
      • Verschueren S.
      • Dankaerts W.
      Comparing lower lumbar kinematics in cyclists with low back pain (flexion pattern) versus asymptomatic controls - field study using a wireless posture monitoring system.
      ;
      • van Wingerden J.P.
      • Vleeming A.
      • Ronchetti I.
      Differences in standing and forward bending in women with chronic low back or pelvic girdle pain: indications for physical compensation strategies.
      ;
      • Vismara L.
      • Menegoni F.
      • Zaina F.
      • Galli M.
      • Negrini S.
      • Capodaglio P.
      Effect of obesity and low back pain on spinal mobility: a cross sectional study in women.
      ;
      • Vogt L.
      • Pfeifer K.
      • Portscher Banzer W.
      Influences of nonspecific low back pain on three-dimensional lumbar spine kinematics in locomotion.
      ;
      • Vogt L.
      • Pfeifer K.
      • Banzer W.
      Neuromuscular control of walking with chronic low-back pain.
      ;
      • Wong T.K.
      • Lee R.Y.
      Effects of low back pain on the relationship between the movements of the lumbar spine and hip.
      ), 9 studies (
      • Aluko A.
      • DeSouza L.
      • Peacock J.
      Evaluation of trunk acceleration in healthy individuals and those with low back pain.
      ;
      • Freddolini M.
      • Strike S.
      • Lee R.
      Dynamic stability of the trunk during unstable sitting in people with low back pain.
      ;
      • Freddolini M.
      • Strike S.
      • Lee R.Y.
      Stiffness properties of the trunk in people with low back pain.
      ;
      • Shum G.L.
      • Crosbie J.
      • Lee R.Y.
      Effect of low back pain on the kinematics and joint coordination of the lumbar spine and hip during sit-to-stand and stand-to-sit.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Symptomatic and asymptomatic movement coordination of the lumbar spine and hip during an everyday activity.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Movement coordination of the lumbar spine and hip during a picking up activity in low back pain subjects.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Three-dimensional kinetics of the lumbar spine and hips in low back pain patients during sit-to-stand and stand-to-sit.
      ;
      • Taylor N.F.
      • Evans O.M.
      • Goldie P.A.
      The effect of walking faster on people with acute low back pain.
      ;
      • Taylor N.
      • Goldie P.
      • Evans O.
      Movements of the pelvis and lumbar spine during walking in people with acute low back pain.
      ) recruited acute LBP patients and 5 studies had a mix of chronic and acute LBP patients (
      • Dunk N.M.
      • Callaghan J.P.
      Lumbar spine movement patterns during prolonged sitting differentiate low back pain developers from matched asymptomatic controls.
      ;
      • Esola M.A.
      • McClure P.W.
      • Fitzgerald G.K.
      • Siegler S.
      Analysis of lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain.
      ;
      • Gombatto S.P.
      • Brock T.
      • DeLork A.
      • Jones G.
      • Madden E.
      • Rinere C.
      Lumbar spine kinematics during walking in people with and people without low back pain.
      ;
      • Song A.Y.
      • Jo H.J.
      • Sung P.S.
      • Kim Y.H.
      Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain.
      ;
      • Sung P.S.
      • Park W.H.
      • Kim Y.H.
      Three-dimensional kinematic lumbar spine motion analyses of trunk motion during axial rotation activities.
      ). In 11 articles the type of LBP (e.g. Chronic or Acute) was not conveyed (
      • Al-Eisa E.
      • Egan D.
      • Deluzio K.
      • Wassersug R.
      Effects of pelvic skeletal asymmetry on trunk movement: three-dimensional analysis in healthy individuals versus patients with mechanical low back pain.
      ;
      • Al-Eisa E.
      • Egan D.
      • Deluzio K.
      • Wassersug R.
      Effects of pelvic asymmetry and low back pain on trunk kinematics during sitting: a comparison with standing.
      ;
      • Barrett C.J.
      • Singer K.P.
      • Day R.
      Assessment of combined movements of the lumbar spine in asymptomatic and low back pain subjects using a three-dimensional electromagnetic tracking system.
      ;
      • Fenety A.
      • Kumar S.
      Isokinetic trunk strength and lumbosacral range of motion in elite female field hockey players reporting low-back pain.
      ;
      • Kim S.H.
      • Kwon O.Y.
      • Yi C.H.
      • Cynn H.S.
      • Ha S.M.
      • Park K.N.
      Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion.
      ;
      • Kim M.H.
      • Yoo W.G.
      Comparison of the lumbar flexion angle and repositioning error during lumbar flexion-extension in young computer workers in Korea with differing back pain.
      ;
      • McGregor A.H.
      • McCarthy I.D.
      • Dore C.J.
      • Hughes S.P.
      Quantitative assessment of the motion of the lumbar spine in the low back pain population and the effect of different spinal pathologies of this motion.
      ;
      • Mellin G.
      Decreased joint and spinal mobility associated with low back pain in young adults.
      ;
      • Mitchell T.
      • O'Sullivan P.B.
      • Burnett A.F.
      • Straker L.
      • Smith A.
      Regional differences in lumbar spinal posture and the influence of low back pain.
      ;
      • Morlock M.M.
      • Bonin V.
      • Deuretzbacher G.
      • Müller G.
      • Honl M.
      • Schneider E.
      Determination of the in vivo loading of the lumbar spine with a new approach directly at the workplace - first results for nurses.
      ;
      • Newman N.
      • Gracovetsky S.
      • Itoi M.
      • Zucherman J.
      • Richards M.
      • Durand P.
      • Xeller C.
      • Carr D.
      Can the computerized physical examination differentiate normal subjects from abnormal subjects with benign mechanical low back pain?.
      ). Moreover, LBP duration was often lacking and large durations in symptoms were reported (ranging from 3 months to 5 years within one study). The level of pain/disability, if described (43/62), was low to moderate (
      • Aluko A.
      • DeSouza L.
      • Peacock J.
      Evaluation of trunk acceleration in healthy individuals and those with low back pain.
      ;
      • Burnett A.F.
      • Cornelius M.W.
      • Dankaerts W.
      • O'Sullivan P.B.
      Spinal kinematics and trunk muscle activity in cyclists: a comparison between healthy controls and non-specific chronic low back pain subjects-a pilot investigation.
      ;
      • Crosbie J.
      • de Faria Negrao Filho R.
      • Nascimento D.P.
      • Ferreira P.
      Coordination of spinal motion in the transverse and frontal planes during walking in people with and without recurrent low back pain.
      ;
      • Crosbie J.
      • Nascimento D.P.
      • Filho Rde F.
      • Ferreira P.
      Do people with recurrent back pain constrain spinal motion during seated horizontal and downward reaching?.
      ;
      • Dankaerts W.
      • O'Sullivan P.
      • Burnett A.
      • Straker L.
      • Davey P.
      • Gupta R.
      Discriminating healthy controls and two clinical subgroups of nonspecific chronic low back pain patients using trunk muscle activation and lumbosacral kinematics of postures and movements: a statistical classification model.
      ;
      • Dunk N.M.
      • Callaghan J.P.
      Lumbar spine movement patterns during prolonged sitting differentiate low back pain developers from matched asymptomatic controls.
      ;
      • Esola M.A.
      • McClure P.W.
      • Fitzgerald G.K.
      • Siegler S.
      Analysis of lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain.
      ;
      • Freddolini M.
      • Strike S.
      • Lee R.
      Dynamic stability of the trunk during unstable sitting in people with low back pain.
      ;
      • Freddolini M.
      • Strike S.
      • Lee R.Y.
      Stiffness properties of the trunk in people with low back pain.
      ;
      • Gioftsos G.
      • Grieve D.W.
      The use of artificial neural networks to identify patients with chronic low-back pain conditions from patterns of sit-to-stand manoeuvres.
      ;
      • Gombatto S.P.
      • Brock T.
      • DeLork A.
      • Jones G.
      • Madden E.
      • Rinere C.
      Lumbar spine kinematics during walking in people with and people without low back pain.
      ;
      • Henchoz Y.
      • Tetreau C.
      • Abboud J.
      • Piche M.
      • Descarreaux M.
      Effects of noxious stimulation and pain expectations on neuromuscular control of the spine in patients with chronic low back pain.
      ;
      • Kim S.H.
      • Kwon O.Y.
      • Yi C.H.
      • Cynn H.S.
      • Ha S.M.
      • Park K.N.
      Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion.
      ;
      • Kim M.H.
      • Yoo W.G.
      Comparison of the lumbar flexion angle and repositioning error during lumbar flexion-extension in young computer workers in Korea with differing back pain.
      ;
      • Lamoth C.J.
      • Meijer O.G.
      • Daffertshofer A.
      • Wuisman P.I.
      • Beek P.J.
      Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control.
      ;
      • Lee J.K.
      • Desmoulin G.T.
      • Khan A.H.
      • Park E.J.
      A portable inertial sensing-based spinal motion measurement system for low back pain assessment.
      ;
      • McClure P.W.
      • Esola M.
      • Schreier R.
      • Siegler S.
      Kinematic analysis of lumbar and hip motion while rising from a forward, flexed position in patients with and without a history of low back pain.
      ;
      • Mitchell T.
      • O'Sullivan P.B.
      • Burnett A.F.
      • Straker L.
      • Smith A.
      Regional differences in lumbar spinal posture and the influence of low back pain.
      ;
      • Muller R.
      • Ertelt T.
      • Blickhan R.
      Low back pain affects trunk as well as lower limb movements during walking and running.
      ;
      • Newcomer K.
      • Laskowski E.R.
      • Yu B.
      • Larson D.R.
      • An K.N.
      Repositioning error in low back pain. Comparing trunk repositioning error in subjects with chronic low back pain and control subjects.
      ;
      • Ng J.K.F.
      • Richardson C.A.
      • Kippers V.
      • Parnianpour M.
      Comparison of lumbar range of movement and lumbar lordosis in back pain patients and matched controls.
      ;
      • Park W.H.
      • Kim Y.H.
      • Lee T.R.
      • Sung P.S.
      Factors affecting shoulder-pelvic integration during axial trunk rotation in subjects with recurrent low back pain.
      ;
      • Sanchez-Zuriaga D.
      • Lopez-Pascual J.
      • Garrido-Jaen D.
      • de Moya M.F.
      • Prat-Pastor J.
      Reliability and validity of a new objective tool for low back pain functional assessment.
      ;
      • Seay J.F.
      • Van Emmerik R.E.
      • Hamill J.
      Influence of low back pain status on pelvis-trunk coordination during walking and running.
      ;
      • Shum G.L.
      • Crosbie J.
      • Lee R.Y.
      Effect of low back pain on the kinematics and joint coordination of the lumbar spine and hip during sit-to-stand and stand-to-sit.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Symptomatic and asymptomatic movement coordination of the lumbar spine and hip during an everyday activity.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Movement coordination of the lumbar spine and hip during a picking up activity in low back pain subjects.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Three-dimensional kinetics of the lumbar spine and hips in low back pain patients during sit-to-stand and stand-to-sit.
      ;
      • Song A.Y.
      • Jo H.J.
      • Sung P.S.
      • Kim Y.H.
      Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain.
      ;
      • Sung P.S.
      A compensation of angular displacements of the hip joints and lumbosacral spine between subjects with and without idiopathic low back pain during squatting.
      ;
      • Sung P.S.
      • Park W.H.
      • Kim Y.H.
      Three-dimensional kinematic lumbar spine motion analyses of trunk motion during axial rotation activities.
      ;
      • Taylor N.F.
      • Evans O.M.
      • Goldie P.A.
      The effect of walking faster on people with acute low back pain.
      ;
      • Taylor N.
      • Goldie P.
      • Evans O.
      Movements of the pelvis and lumbar spine during walking in people with acute low back pain.
      ;
      • Vaisy M.
      • Gizzi L.
      • Petzke F.
      • Consmüller T.
      • Pfingsten M.
      • Falla D.
      Measurement of lumbar spine functional movement in low back pain.
      ;
      • van den Hoorn W.
      • Bruijn S.M.
      • Meijer O.G.
      • Hodges P.W.
      • van Dieen J.H.
      Mechanical coupling between transverse plane pelvis and thorax rotations during gait is higher in people with low back pain.
      ;
      • Van Hoof W.
      • Volkaerts K.
      • O'Sullivan K.
      • Verschueren S.
      • Dankaerts W.
      Comparing lower lumbar kinematics in cyclists with low back pain (flexion pattern) versus asymptomatic controls - field study using a wireless posture monitoring system.
      ;
      • van Wingerden J.P.
      • Vleeming A.
      • Ronchetti I.
      Differences in standing and forward bending in women with chronic low back or pelvic girdle pain: indications for physical compensation strategies.
      ;
      • Vogt L.
      • Pfeifer K.
      • Portscher Banzer W.
      Influences of nonspecific low back pain on three-dimensional lumbar spine kinematics in locomotion.
      ;
      • Vogt L.
      • Pfeifer K.
      • Banzer W.
      Neuromuscular control of walking with chronic low-back pain.
      ;
      • Wong T.K.
      • Lee R.Y.
      Effects of low back pain on the relationship between the movements of the lumbar spine and hip.
      ).
      Most studies demonstrated an age bias with most participants recruited being in their thirties (Fig. 2b). It is however worth noticing the age variability within groups, in 45 studies age standard deviation values were above 7 years (
      • Akinpelu A.O.
      • Adeyemi A.I.
      Range of lumbar flexion in chronic low back pain.
      ;
      • Al-Eisa E.
      • Egan D.
      • Deluzio K.
      • Wassersug R.
      Effects of pelvic skeletal asymmetry on trunk movement: three-dimensional analysis in healthy individuals versus patients with mechanical low back pain.
      ;
      • Al-Eisa E.
      • Egan D.
      • Deluzio K.
      • Wassersug R.
      Effects of pelvic asymmetry and low back pain on trunk kinematics during sitting: a comparison with standing.
      ;
      • Aluko A.
      • DeSouza L.
      • Peacock J.
      Evaluation of trunk acceleration in healthy individuals and those with low back pain.
      ;
      • Barrett C.J.
      • Singer K.P.
      • Day R.
      Assessment of combined movements of the lumbar spine in asymptomatic and low back pain subjects using a three-dimensional electromagnetic tracking system.
      ;
      • Crosbie J.
      • de Faria Negrao Filho R.
      • Nascimento D.P.
      • Ferreira P.
      Coordination of spinal motion in the transverse and frontal planes during walking in people with and without recurrent low back pain.
      ;
      • Crosbie J.
      • Nascimento D.P.
      • Filho Rde F.
      • Ferreira P.
      Do people with recurrent back pain constrain spinal motion during seated horizontal and downward reaching?.
      ;
      • Cyteval C.
      • Micallef J.P.
      • Leroux J.L.
      • Blotman F.
      • Lamarque J.L.
      Comparison of spinal range of motion during flexion-extension using a three-dimensional opto-electronic system in healthy volunteers and patients with chronic low back pain.
      ;
      • Dankaerts W.
      • O'Sullivan P.
      • Burnett A.
      • Straker L.
      • Davey P.
      • Gupta R.
      Discriminating healthy controls and two clinical subgroups of nonspecific chronic low back pain patients using trunk muscle activation and lumbosacral kinematics of postures and movements: a statistical classification model.
      ;
      • Esola M.A.
      • McClure P.W.
      • Fitzgerald G.K.
      • Siegler S.
      Analysis of lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain.
      ;
      • Freddolini M.
      • Strike S.
      • Lee R.
      Dynamic stability of the trunk during unstable sitting in people with low back pain.
      ;
      • Freddolini M.
      • Strike S.
      • Lee R.Y.
      Stiffness properties of the trunk in people with low back pain.
      ;
      • Gioftsos G.
      • Grieve D.W.
      The use of artificial neural networks to identify patients with chronic low-back pain conditions from patterns of sit-to-stand manoeuvres.
      ;
      • Gombatto S.P.
      • Brock T.
      • DeLork A.
      • Jones G.
      • Madden E.
      • Rinere C.
      Lumbar spine kinematics during walking in people with and people without low back pain.
      ;
      • Henchoz Y.
      • Tetreau C.
      • Abboud J.
      • Piche M.
      • Descarreaux M.
      Effects of noxious stimulation and pain expectations on neuromuscular control of the spine in patients with chronic low back pain.
      ;
      • Lamoth C.J.
      • Meijer O.G.
      • Wuisman P.I.
      • van Dieen J.H.
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      Pelvis-thorax coordination in the transverse plane during walking in persons with nonspecific low back pain.
      ;
      • Lamoth C.J.
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      Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control.
      ;
      • Lamoth C.J.
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      How do persons with chronic low back pain speed up and slow down? Trunk-pelvis coordination and lumbar erector spinae activity during gait.
      ;
      • Larivière C.
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      Specificity of a back muscle roman chair exercise in healthy and back pain subjects.
      ;
      • Lee J.K.
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      • Khan A.H.
      • Park E.J.
      Comparison of 3D spinal motions during stair-climbing between individuals with and without low back pain.
      ;
      • Lee J.K.
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      • Khan A.H.
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      A portable inertial sensing-based spinal motion measurement system for low back pain assessment.
      ;
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      Kinematic analysis of lumbar and hip motion while rising from a forward, flexed position in patients with and without a history of low back pain.
      ;
      • McGregor A.H.
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      Quantitative assessment of the motion of the lumbar spine in the low back pain population and the effect of different spinal pathologies of this motion.
      ;
      • Newcomer K.
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      • Yu B.
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      • An K.N.
      Repositioning error in low back pain. Comparing trunk repositioning error in subjects with chronic low back pain and control subjects.
      ;
      • Newman N.
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      • Richards M.
      • Durand P.
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      Can the computerized physical examination differentiate normal subjects from abnormal subjects with benign mechanical low back pain?.
      ;
      • Sanchez-Zuriaga D.
      • Lopez-Pascual J.
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      • de Moya M.F.
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      Reliability and validity of a new objective tool for low back pain functional assessment.
      ;
      • Seay J.F.
      • Van Emmerik R.E.
      • Hamill J.
      Influence of low back pain status on pelvis-trunk coordination during walking and running.
      ;
      • Shum G.L.
      • Crosbie J.
      • Lee R.Y.
      Effect of low back pain on the kinematics and joint coordination of the lumbar spine and hip during sit-to-stand and stand-to-sit.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Symptomatic and asymptomatic movement coordination of the lumbar spine and hip during an everyday activity.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Movement coordination of the lumbar spine and hip during a picking up activity in low back pain subjects.
      ;
      • Shum G.L.K.
      • Crosbie J.
      • Lee R.Y.W.
      Three-dimensional kinetics of the lumbar spine and hips in low back pain patients during sit-to-stand and stand-to-sit.
      ;
      • Song A.Y.
      • Jo H.J.
      • Sung P.S.
      • Kim Y.H.
      Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain.
      ;
      • Sung P.S.
      A compensation of angular displacements of the hip joints and lumbosacral spine between subjects with and without idiopathic low back pain during squatting.
      ;
      • Sung P.S.
      • Park W.H.
      • Kim Y.H.
      Three-dimensional kinematic lumbar spine motion analyses of trunk motion during axial rotation activities.
      ;
      • Taylor N.F.
      • Evans O.M.
      • Goldie P.A.
      The effect of walking faster on people with acute low back pain.
      ;
      • Taylor N.
      • Goldie P.
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      Movements of the pelvis and lumbar spine during walking in people with acute low back pain.
      ;
      • Vaisy M.
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      • Consmüller T.
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      • Falla D.
      Measurement of lumbar spine functional movement in low back pain.
      ;
      • van den Hoorn W.
      • Bruijn S.M.
      • Meijer O.G.
      • Hodges P.W.
      • van Dieen J.H.
      Mechanical coupling between transverse plane pelvis and thorax rotations during gait is higher in people with low back pain.
      ;
      • Van Hoof W.
      • Volkaerts K.
      • O'Sullivan K.
      • Verschueren S.
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      Comparing lower lumbar kinematics in cyclists with low back pain (flexion pattern) versus asymptomatic controls - field study using a wireless posture monitoring system.
      ;
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      • Vleeming A.
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      Differences in standing and forward bending in women with chronic low back or pelvic girdle pain: indications for physical compensation strategies.
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      Effect of obesity and low back pain on spinal mobility: a cross sectional study in women.
      ;
      • Wong T.K.
      • Lee R.Y.
      Effects of low back pain on the relationship between the movements of the lumbar spine and hip.
      ).
      RoM maneuvers were the main tasks performed during the assessments (33/62) (
      • Akinpelu A.O.
      • Adeyemi A.I.
      Range of lumbar flexion in chronic low back pain.
      ;
      • Al-Eisa E.
      • Egan D.
      • Deluzio K.
      • Wassersug R.
      Effects of pelvic skeletal asymmetry on trunk movement: three-dimensional analysis in healthy individuals versus patients with mechanical low back pain.
      ;
      • Al-Eisa E.
      • Egan D.
      • Deluzio K.
      • Wassersug R.
      Effects of pelvic asymmetry and low back pain on trunk kinematics during sitting: a comparison with standing.
      ;
      • Aluko A.
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      • Peacock J.
      Evaluation of trunk acceleration in healthy individuals and those with low back pain.
      ;
      • Barrett C.J.
      • Singer K.P.
      • Day R.
      Assessment of combined movements of the lumbar spine in asymptomatic and low back pain subjects using a three-dimensional electromagnetic tracking system.
      ;
      • Boline P.D.
      • Keating Jr J.C.
      • Haas M.
      • Anderson A.V.
      Interexaminer reliability and discriminant validity of inclinometric measurement of lumbar rotation in chronic low-back pain patients and subjects without low-back pain.
      ;
      • Crosbie J.
      • de Faria Negrao Filho R.
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      • Ferreira P.
      Coordination of spinal motion in the transverse and frontal planes during walking in people with and without recurrent low back pain.
      ;
      • Cyteval C.
      • Micallef J.P.
      • Leroux J.L.
      • Blotman F.
      • Lamarque J.L.
      Comparison of spinal range of motion during flexion-extension using a three-dimensional opto-electronic system in healthy volunteers and patients with chronic low back pain.
      ;
      • Dankaerts W.
      • O'Sullivan P.
      • Burnett A.
      • Straker L.
      • Davey P.
      • Gupta R.
      Discriminating healthy controls and two clinical subgroups of nonspecific chronic low back pain patients using trunk muscle activation and lumbosacral kinematics of postures and movements: a statistical classification model.
      ;
      • Dunk N.M.
      • Callaghan J.P.
      Lumbar spine movement patterns during prolonged sitting differentiate low back pain developers from matched asymptomatic controls.
      ;
      • Esola M.A.
      • McClure P.W.
      • Fitzgerald G.K.
      • Siegler S.
      Analysis of lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain.
      ;
      • Fenety A.
      • Kumar S.
      Isokinetic trunk strength and lumbosacral range of motion in elite female field hockey players reporting low-back pain.
      ;
      • Henchoz Y.
      • Tetreau C.
      • Abboud J.
      • Piche M.
      • Descarreaux M.
      Effects of noxious stimulation and pain expectations on neuromuscular control of the spine in patients with chronic low back pain.
      ;
      • Jandre Reis F.J.
      • Macedo A.R.
      Influence of hamstring tightness in pelvic, lumbar and trunk range of motion in low back pain and asymptomatic volunteers during forward bending.
      ;
      • Jayaraman G.
      • Nazre A.A.
      • McCann V.
      • Redford J.B.
      A computerized technique for analyzing lateral bending behavior of subjects with normal and impaired lumbar spine. A pilot study.
      ;
      • Kim M.H.
      • Yi C.H.
      • Kwon O.Y.
      • Cho S.H.
      • Cynn H.S.
      • Kim Y.H.
      • Hwang S.H.
      • Choi B.R.
      • Hong J.A.
      • Jung D.H.
      Comparison of lumbopelvic rhythm and flexion-relaxation response between 2 different low back pain subtypes.
      ;
      • Kim M.H.
      • Yoo W.G.
      Comparison of the lumbar flexion angle and repositioning error during lumbar flexion-extension in young computer workers in Korea with differing back pain.