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Non-specific chronic low back pain: differences in spinal kinematics in subgroups during functional tasks

Hemming, Rebecca, Sheeran, Liba, Van Deursen, Robert and Sparkes, Valerie 2018. Non-specific chronic low back pain: differences in spinal kinematics in subgroups during functional tasks. European Spine Journal 27 (1) , pp. 163-170. 10.1007/s00586-017-5217-1

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Abstract

Purpose: A multidimensional classification approach suggests that motor control impairment subgroups exist in non-specific chronic low back pain (NSCLBP). Differences in sitting lumbar posture have been identified between two such subgroups [flexion pattern (FP) and active extension pattern (AEP)] and healthy individuals; however, functional spinal movement has not been explored. This study will evaluate whether NSCLBP subgroups exhibit regional spinal kinematic differences, compared to healthy individuals, during functional tasks. Methods: Observational, cross-sectional study design. Spinal kinematics of 50 NSCLBP subjects (27 FP, 23 AEP) and 28 healthy individuals were investigated using 3D motion analysis (Vicon™) during functional tasks [reaching upwards, step down, step up, lifting, and replacing a box, stand-to-sit, sit-to-stand, bending to retrieve (and returning from retrieving) a pen from the floor]. Mean sagittal angle for the total thoracic, total lumbar, upper thoracic, lower thoracic, upper lumbar, and lower lumbar regions between groups was compared. Results: Significant differences were observed in lower thoracic and upper lumbar regions between NSCLBP subgroups during most tasks. Significant differences were observed between the FP and healthy group in the lower thoracic region during stand-to-sit-to-stand tasks and bending (and returning from) to retrieve a pen from the floor. All significant results demonstrated the FP group to operate in comparatively greater flexion. Conclusions: The thoraco-lumbar spine discriminated between FP and AEP, and FP and healthy groups during functional tasks. FP individuals demonstrated more kyphotic thoraco-lumbar postures, which may be pain provocative. No significant differences were observed between AEP and healthy groups, suggesting that alternative mechanisms may occur in AEP.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Publisher: Springer-Verlag
ISSN: 0940-6719
Funders: Arthritis Research UK
Date of First Compliant Deposit: 4 August 2017
Date of Acceptance: 6 June 2017
Last Modified: 17 Apr 2019 12:56
URI: http://orca.cf.ac.uk/id/eprint/103299

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