Analysis of Relative Kinematic Index with Normalized Standing Time Between Subjects with and Without Recurrent Low Back Pain

Overview

Journal Eur Spine J

Specialty Orthopedics

Date 2016 Aug 13

PMID 27514675

Citations 7

Authors

Paul S Sung

Pamela Danial

Affiliations

Soon will be listed here.

Abstract

Purpose: Although subjects with recurrent low back pain (LBP) demonstrate altered postural control, their postural steadiness during one leg standing is unknown. The purpose of this study was to investigate postural steadiness based on relative kinematic index of the lower limbs and trunk with normalized standing time in subjects with recurrent LBP during dominant and non-dominant leg standing.

Methods: Sixty individuals participated in the study, including 29 subjects in the control group (18 male, 11 female) and 31 subjects with recurrent LBP (21 male, 10 female). The outcome measures included relative kinematic index of the body regions and normalized standing time during the one leg standing test. The relative kinematic index was the ratio between standstill time and successful standing time. The normalized standing time was defined as a ratio between the successful standing time and the requested standing time.

Results: The control group demonstrated significantly longer normalized standing time on the dominant (t = -2.57, p = 0.013) and non-dominant (t = -2.78, p = 0.007) legs than the LBP group. The relative kinematic index of the core spine model significantly decreased for the dominant (t = -3.01, p = 0.004) and non-dominant (t = -3.06, p = 0.003) legs in the LBP group. In addition, the kinematic index indicated pelvis and non-dominant shank during dominant leg standing (R = 0.97) in the LBP group. In the control group, the pelvis was significantly correlated with the core spine model during standing on the dominant (R = 0.95) and non-dominant (R = 0.97) legs.

Conclusions: The relative kinematic index of the pelvis was found to be most significant for longer standing durations in both groups. In the LBP group, the shank and foot were significantly higher in addition to the pelvis due to possible compensatory motion. The control group took advantage of pelvic control with the core spine to minimize lower limb movements. Clinicians need to consider the core spine for pelvic control to refine postural adaptations in subjects with recurrent LBP.

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References

Sung P, Spratt K, Wilder D . A possible methodological flaw in comparing dominant and nondominant sided lumbar spine muscle responses without simultaneously considering hand dominance. Spine (Phila Pa 1976). 2004; 29(17):1914-22. DOI: 10.1097/01.brs.0000137071.47606.19. View

Jonsson E, Seiger A, Hirschfeld H . Postural steadiness and weight distribution during tandem stance in healthy young and elderly adults. Clin Biomech (Bristol). 2004; 20(2):202-8. DOI: 10.1016/j.clinbiomech.2004.09.008. View

Lee T, Kim Y, Sung P . A comparison of pain level and entropy changes following core stability exercise intervention. Med Sci Monit. 2011; 17(7):CR362-8. PMC: 3539569. DOI: 10.12659/msm.881846. View

Tsao H, Galea M, Hodges P . Reorganization of the motor cortex is associated with postural control deficits in recurrent low back pain. Brain. 2008; 131(Pt 8):2161-71. DOI: 10.1093/brain/awn154. View

Hamaoui A, Do M, Bouisset S . Postural sway increase in low back pain subjects is not related to reduced spine range of motion. Neurosci Lett. 2004; 357(2):135-8. DOI: 10.1016/j.neulet.2003.12.047. View

Jo H, Song A, Lee K, Lee D, Kim Y, Sung P . A kinematic analysis of relative stability of the lower extremities between subjects with and without chronic low back pain. Eur Spine J. 2011; 20(8):1297-303. PMC: 3175847. DOI: 10.1007/s00586-010-1686-1. View

Park W, Kim Y, Lee T, Sung P . Factors affecting shoulder-pelvic integration during axial trunk rotation in subjects with recurrent low back pain. Eur Spine J. 2012; 21(7):1316-23. PMC: 3389122. DOI: 10.1007/s00586-012-2280-5. View

Silfies S, Bhattacharya A, Biely S, Smith S, Giszter S . Trunk control during standing reach: A dynamical system analysis of movement strategies in patients with mechanical low back pain. Gait Posture. 2008; 29(3):370-6. PMC: 2671394. DOI: 10.1016/j.gaitpost.2008.10.053. View

Hodges P, Moseley G . Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electromyogr Kinesiol. 2003; 13(4):361-70. DOI: 10.1016/s1050-6411(03)00042-7. View

10.

Silfies S, Squillante D, Maurer P, Westcott S, Karduna A . Trunk muscle recruitment patterns in specific chronic low back pain populations. Clin Biomech (Bristol). 2005; 20(5):465-73. DOI: 10.1016/j.clinbiomech.2005.01.007. View

11.

Clark N, Roijezon U, Treleaven J . Proprioception in musculoskeletal rehabilitation. Part 2: Clinical assessment and intervention. Man Ther. 2015; 20(3):378-87. DOI: 10.1016/j.math.2015.01.009. View

12.

Tsao H, Danneels L, Hodges P . ISSLS prize winner: Smudging the motor brain in young adults with recurrent low back pain. Spine (Phila Pa 1976). 2011; 36(21):1721-7. DOI: 10.1097/BRS.0b013e31821c4267. View

13.

Tsao H, Hodges P . Persistence of improvements in postural strategies following motor control training in people with recurrent low back pain. J Electromyogr Kinesiol. 2007; 18(4):559-67. DOI: 10.1016/j.jelekin.2006.10.012. View

14.

Andersen T, Floerenes T, Arnason A, Bahr R . Video analysis of the mechanisms for ankle injuries in football. Am J Sports Med. 2004; 32(1 Suppl):69S-79S. DOI: 10.1177/0363546503262023. View

15.

Teyhen D, Miltenberger C, Deiters H, Del Toro Y, Pulliam J, Childs J . The use of ultrasound imaging of the abdominal drawing-in maneuver in subjects with low back pain. J Orthop Sports Phys Ther. 2005; 35(6):346-55. DOI: 10.2519/jospt.2005.35.6.346. View

16.

Brumagne S, Janssens L, Knapen S, Claeys K, Suuden-Johanson E . Persons with recurrent low back pain exhibit a rigid postural control strategy. Eur Spine J. 2008; 17(9):1177-84. PMC: 2527415. DOI: 10.1007/s00586-008-0709-7. View

17.

Brophy R, Silvers H, Gonzales T, Mandelbaum B . Gender influences: the role of leg dominance in ACL injury among soccer players. Br J Sports Med. 2010; 44(10):694-7. DOI: 10.1136/bjsm.2008.051243. View

18.

Johanson E, Brumagne S, Janssens L, Pijnenburg M, Claeys K, Paasuke M . The effect of acute back muscle fatigue on postural control strategy in people with and without recurrent low back pain. Eur Spine J. 2011; 20(12):2152-9. PMC: 3229729. DOI: 10.1007/s00586-011-1825-3. View

19.

Izzo R, Guarnieri G, Guglielmi G, Muto M . Biomechanics of the spine. Part I: spinal stability. Eur J Radiol. 2012; 82(1):118-26. DOI: 10.1016/j.ejrad.2012.07.024. View

20.

Ben Kibler W, Press J, Sciascia A . The role of core stability in athletic function. Sports Med. 2006; 36(3):189-98. DOI: 10.2165/00007256-200636030-00001. View