Do people with low back pain walk differently? A systematic review and meta-analysis

Objective To identify differences in biomechanics during gait in individuals with acute and persistent low back pain compared with back-healthy controls. Design Systematic review Data Sources A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Eligibility criteria Studies were included if they reported biomechanical characteristics of individuals with and without low back pain during steady-state or perturbed walking and running. Biomechanical data included spatiotemporal, kinematic, kinetic, and electromyography variables. The reporting quality and potential for bias of each study was assessed. Data were pooled where possible to compare the standardized mean differences (SMD) between groups. Results Ninety-seven studies were included. Two studies investigated acute pain and the rest investigated persistent pain. Eight studies investigated running gait. 20% of studies had high reporting quality/low risk of bias. In comparison with back-healthy controls, individuals with persistent low back pain walked more slowly (SMD -0.59 [95% CI -0.77 to -0.42]) and with shorter stride length (−0.38 [-0.60 to -0.16]). There were no differences in the amplitude of motion in the thoracic or lumbar spine, pelvis, or hips in individuals with LBP. During walking, coordination of motion between the thorax and the lumbar spine/pelvis was significantly more in-phase in the LBP groups (−0.60 [-0.90 to -0-.30]), and individuals with LBP exhibited greater amplitude of activation in the paraspinal muscles (0.52 [0.23 to 0.80]). Summary/Conclusion There is moderate to strong evidence that individuals with persistent LBP demonstrate impairments in walking gait compared with back-healthy controls.

/pdf/do-people-with-low-back-pain-walk-differently-a-systematic-3xzjup1j9e.pdf

A randomized controlled study for the treatment of middle-aged and old-aged lumbar disc herniation by Shis spine balance manipulation combined with bone and muscle guidance.

Lower limb kinematics in individuals with chronic low back pain during walking

Lumbar and thoracic kinematics during step-up: Comparison of three-dimensional angles between patients with chronic low back pain and asymptomatic individuals.

Low back pain (LBP) is a common problem that can contribute to motor dysfunction Previous studies reporting the changes in kinematic characteristics caused by LBP present conflicting results This study aimed to apply the multisegmental spinal model to investigate the kinematic changes in patients with lumbar disc herniation (LDH) during five activities of daily living (ADLs) Twenty-six healthy subjects and 7 LDH patients participated in this study and performed level walking, stair climbing, trunk flexion, and ipsilateral and contralateral pickups The angular displacement of the thorax, upper lumbar (ULx), lower lumbar (LLx), pelvis, hip, and knee was calculated using a modified full-gait-model in the AnyBody modeling system In the patient group, the ULx almost showed no sagittal angular displacement while the LLx remained part of the sagittal angular displacement during trunk flexion and the two pickups In the two pickups, pelvic tilt and lower extremities’ flexion increased to compensate for the deficiency in lumbar motion LDH patients exhibited significantly less pelvic rotation during stair climbing and greater pelvic rotation in other ADLs, except in contralateral pickup In addition, LDH patients demonstrated more antiphase movement in the transverse plane between ULx and LLx, during level walking and stair climbing, between thorax and pelvis in the two pickups LDH patients mainly restrict the motion of LLx and ULx in the spinal region during the five ADLs Pelvic rotation is an important method to compensate for the limited lumbar motion Furthermore, pelvic tilt and lower extremities’ flexion increased when ADLs were quite difficult for LDH patients

/pdf/influences-of-lumbar-disc-herniation-on-the-kinematics-in-3pg7pn57tx.pdf

Influences of lumbar disc herniation on the kinematics in multi-segmental spine, pelvis, and lower extremities during five activities of daily living

Continuous lumbar spine rhythms during level walking, stair climbing and trunk flexion in people with and without lumbar disc herniation.

BACKGROUND People with low back pain (LBP) alter their motion patterns during level walking and stair climbing due to pain or fear. However, the alternations of load sharing during the two activities are largely unknown. The objective of this study was to investigate the effect of LBP caused by lumbar disc herniation (LDH) on the muscle activities of 17 main trunk muscle groups and the intradiscal forces acting on the five lumbar discs. MATERIAL AND METHODS Twenty-six healthy adults and seven LDH patients were recruited to perform level walking and stair climbing in the Gait Analysis Laboratory. Eight optical markers were placed on the bony landmarks of the spinous process and pelvis, and the coordinates of these markers were captured during the two activities using motion capture system. The coordinates of the captured markers were applied to developed musculoskeletal model to calculate the kinetic variables. RESULTS LDH patients demonstrated higher muscle activities in most trunk muscle groups during both level walking and stair climbing. There were decreases in anteroposterior shear forces on the discs in the pathological region and increases in the compressive forces on all the lumbar discs during level walking. The symmetry of mediolateral shear forces was worse in LDH patients than healthy adults during stair climbing. CONCLUSIONS LDH patients exhibited different kinetic alternations during level walking and stair climbing. However, both adaptive strategies added extra burdens to the trunk system and further increased the risk for development of LDH.

The Effect of Lumbar Disc Herniation on Musculoskeletal Loadings in the Spinal Region During Level Walking and Stair Climbing

The invention discloses a kinematics parameter capturing method based on visible spatial expansion of an optical motion capturing system, and relates to a human body in vivo and in vitro joint kinematics parameter capturing technology, aiming at solving the problem that the least number of cameras of an optical motion capturing system is increased in the case that mark points are sheltered The method comprises the following steps: arranging a plane reflector in front of cameras, so that the images of sheltered optical mark points are within the view field of the cameras; making a to-be-detected object walk along a gait path, and collecting optical mark point and image point coordinate data on the to-be-detected object; immobilizing the three optical mark points on the front side of a calibration tool, immobilizing a fourth optical mark point on the back side, and then making the calibration tool move along the gait path so as to collect optical mark point and image point coordinate data; and finally, calculating a relation between the image point coordinates and corresponding actual optical mark point coordinates, and reducing the image point coordinates of the to-be-detected object into the actual optical mark point coordinates The kinematics parameter capturing method is applicable to human body in vivo and in vitro specimen motion experiments

Rui Zhang

Papers

Influences of lumbar disc herniation on the kinematics in multi-segmental spine, pelvis, and lower extremities during five activities of daily living

Continuous lumbar spine rhythms during level walking, stair climbing and trunk flexion in people with and without lumbar disc herniation.

The Effect of Lumbar Disc Herniation on Musculoskeletal Loadings in the Spinal Region During Level Walking and Stair Climbing

Kinematics parameter capturing method based on visible spatial expansion of optical motion capturing system