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NSCLBP patients should be physically examined for functional thoracolumbar spine
movement as thoraco-lumbar spine was found to differ in subgroups during
functional tasks.
Non-specific low back pain lasting for 12 weeks or more is termed
as non-specific chronic low back pain (NSCLBP). Motor control impairment
subgroups exist in non-specific chronic low back pain (NSCLBP) as per a
multidimensional classification approach. The changes in sitting lumbar posture
were revealed between two such subgroups- flexion pattern (FP) and active
extension pattern (AEP) and healthy individuals, although, the functional
spinal movement was not investigated. This study was performed to explore
whether NSCLBP subgroups displayed regional spinal kinematic differences, as
distinguished from healthy individuals, during functional tasks.
A total of 78 subjects comprising 50 NSCLBP (27 FP, 23 AEP) and 28 healthy
individuals were considered for this observational, cross-sectional study
design. Their spinal kinematics was examined using 3D motion analysis 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]. The mean sagittal angle for the total
thoracic, total lumbar, upper thoracic, lower thoracic, upper lumbar, and lower
lumbar regions between groups were distinguished.
During most tasks, the notable changes were observed in the lower thoracic and
upper lumbar regions between NSCLBP subgroups. The tasks like
stand-to-sit-to-stand and bending (and returning from) to retrieve a pen from
the floor portrayed significant changes between the FP and healthy group in the
lower thoracic region. All important outcomes revealed that the FP group should
operate in comparatively greater flexion.
It was concluded that the thoracolumbar spine discriminated between FP and AEP,
and FP and healthy groups during functional tasks. In the FP individuals, more
kyphotic thoracolumbar postures were observed which may provoke pain.
Alternative mechanisms may occur in AEP as no notable differences were observed
between AEP and healthy groups.
Eur Spine J. 2017 Jul 21
Non-specific chronic low back pain: differences in spinal kinematics in subgroups during functional tasks
Hemming R et al.
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