A pilot study to compare passive lumbar spine re-positioning error in those with chronic low back pain with healthy volunteers

This source preferred by Ahmed Khattab and Carol Clark

Authors: Clark, C., Docherty, S., Osborne, N. and Khattab, A.

Start date: 6 October 2014

AIM OF INVESTIGATION: To investigate passive frontal plane repositioning accuracy, as a measure of lumbar kinaesthesis in a group of females with chronic non-specific low back pain (CNSLBP). It is suggested for those with CNSLBP that perception and body image may be impaired therefore impacting on kinaesthesis and global body image perception. For those with back pain there are alterations in trunk movement patterns which over time may contribute to changes in ligamentous muscular perception and kinaesthesis. METHODS: Fourteen female participants, representing two groups, took part in the study. Participants in group one (n=7) were those with CNSLBP (mean age 47.1 ±15.41) and participants in group two (n=7) were healthy volunteers (mean age 45.6 ± 10.63). There were no significant differences between the groups with regards to age, education, height, weight, hip and waist circumference and all were right handed. Passive lumbar re-positioning accuracy was measured in the frontal plane using a motorised plinth with the Zebris ® ultrasound-based motion analyser at L4/5 with target positions 10° left and right lumbar side flexion and lumbar neutral. Body image laterality perception was measured using the Recognise ® on-line package. Participants were required to identify whether a picture was oriented left or right for 10 back and 10 hand images. The percentage accuracy and mean time taken to make the decision were recorded. RESULTS: Participants with CNSLBP were significantly more accurate in lumbar spine re-positioning in left side flexion than healthy volunteers (< 1.5º and < 2.0º) on both occasions (p<0.01; p<0.05). There was no significant difference between the two groups for right side flexion or neutral positions. There were no significant differences between the two groups with regards to percentage accuracy and mean time taken in either of the body image laterality tests.

CONCLUSION: There was a significant difference in passive re-positioning accuracy to one side between participants with chronic low back pain and healthy volunteers. Participants with CNSLBP were significantly more accurate with repositioning to left side flexion than healthy volunteers. This might indicate that those with CNSLBP have enhanced kinaesthetic perception. It is suggested this may represent an important finding in relation to ligamentous patho-physiology and ongoing pain in those with chronic low back pain. However, a larger sample that includes male participants is needed to verify findings.

This data was imported from Scopus:

Authors: Clark, C.J., Docherty, S., Osborne, N. and Khattab, A.

Journal: International Musculoskeletal Medicine

Volume: 36

Issue: 3

Pages: 104-110

eISSN: 1753-6154

ISSN: 1753-6146

DOI: 10.1179/1753614614Z.00000000075

© W. S. Maney & Son Ltd and the British Institute of Musculoskeletal Medicine 2014. Study design: Cross-sectional laboratory study.Objective: To compare the difference in passive re-positioning accuracy in the frontal plane, as a measure of lumbar kinaesthesis, between participants with chronic non-specific low back pain (CNSLBP) and healthy volunteers.Background: Evidence suggests that spinal kinaesthesis impacting on spinal stability might be compromised in those with CNSLBP. It is suggested that in those with CNSLBP, there may be changes in ligamentous patho-physiology which lead to altered kinaesthetic perception.Methods: Fourteen female participants, representing two groups, took part in the study. Participants in group one (n=7) were those with CNSLBP (mean age 47.1±15.41) and participants in group two (n=7) were healthy volunteers (mean age 45.6±10.63). There were no significant differences between the groups with regards to age, education, height, weight, hip, and waist circumference and all were right handed. Passive lumbar repositioning accuracy was measured in the frontal plane using a motorized plinth with the Zebris® ultrasoundbased motion analyser and the target positions were 10° left and right lumbar side flexion and neutral.Results: The mean reporting error for the neutral position for participants with CNSLBP vs. healthy volunteers was <2.4° and <2.2° on both occasions (P > 0.05), respectively. The mean reporting error in left-side flexion for participants with CNSLBP vs. healthy volunteers was <1.5° and <2.0° on both occasions (P < 0.01; P < 0.05). The mean reporting error in right-side flexion for participants with CNSLBP vs. healthy volunteers was <2.1° and <1.1° on both occasions (P > 0.05).Conclusion: There was a statistically significant difference in passive re-positioning accuracy to the left side only between participants with CNSLBP and healthy volunteers. This may represent an important finding in relation to structures that provide sensory information and the integration of that information in those with CNSLBP.

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