Evaluation of trunk acceleration in healthy individuals and those with low back pain (original) (raw)
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Human Factors, 2020
This study aimed to employ nonlinear dynamic approaches to assess trunk dynamic stability with speed, symmetry, and load during repetitive flexion-extension (FE) movements for individuals with and without nonspecific low back pain (NSLBP). Background: Repetitive trunk FE movement is a typical workrelated LBP risk factor contingent on speed, symmetry, and load. Improper settings/adjustments of these control parameters could undermine the dynamic stability of the trunk, hence leading to low back injuries. The underlying stability mechanisms and associated control impairments during such dynamic movements remain elusive. Method: Thirty-eight male volunteers (19 healthy, 19 NSLBP) enrolled in the current study. All participants performed repetitive trunk FE movements at high/low speeds, in symmetric/asymmetric directions, with/without a wearable loaded vest. Trunk instantaneous rotation angle was computed for each trial to be assessed in terms of local and orbital stability, using maximum finite-time Lyapunov exponents (LyEs) and Floquet multipliers (FMs), respectively. Results: Both groups demonstrated equivalent competency in terms of trunk control and stability, suggesting functional adaptation strategies may be used by the NSLBP group. Wearing the loaded vest magnified the effects of trunk control impairment for the NSLBP group. The combined presence of high-speed and symmetrical FE movements was associated with least trunk local stability. Conclusion: Nonlinear dynamic techniques, particularly LyE, are potentially effective for assessing trunk dynamic stability dysfunction for individuals with NSLBP during various activities. Application: This work can be applied toward the development of quantitative personalized spinal evaluation tools with a wide range of potential occupational and clinical applications.
Introduction: Approximately 60–80% of people in Western societies experience low back pain (LBP) at some stage of life (1). Only an estimated 10-20% of LBP diagnoses are accurate and able to identify the origin of the disorder (2). In clinical practice, non-specific LBP is classified by examining active trunk movements in various directions (e.g. movements impairment classification system) (3). Objectives: To develop a standardized, reliable and valid spine model of active trunk movements that accurately discriminates kinematic patterns of patients with non-specific chronic LBP from those of healthy subjects. Method: Fifty subjects performed 7 trunk movements from a seated position (Flexion, lateral side-bending L and R, Rotation L and R, Flexion with rotation L and R) at non-imposed speed during 2 sessions. Results: Both groups showed excellent reliability in all movements for range of motion and speed of all spinal segments (intraclass correlation (ICC), 0.70-0.96; standard error ...
Fisioterapia e Pesquisa, 2014
Mismo con una gran variabilidad de metodos e instrumentos disponibles para evaluar la amplitud de movimiento de la columna, son raros los metodos cuantitativos precisos de mensuracion. El objetivo de eso estudio fue verificar la reproductibilidad intra- e inter-examinadores y validad del constructo entre medidas de amplitud de movimiento de la columna en pacientes con dolor en la region lumbar, las cuales fueron obtenidas con los instrumentos goniometro, inclinometro y electrogoniometro. La reproductibilidad y validad del constructo de instrumentos fueron testadas en 58 pacientes con dolor en la region lumbar en un diseno de test y re-test, en la linea de base y despues de 24 a 72 horas. Todos los instrumentos presentaron buena correlacion entre si (r>0,60), lo que reflete buena validad del constructo, y tuvieron buenos niveles de confiabilidades inter- e intra-examinadores. Entre todos los movimientos evaluados, el inclinometro presento un error absoluto inter- e intra-examinado...
Journal of rehabilitation medicine
Objective: To develop a standardized, reliable, valid spine model of active trunk movements that accurately discriminates kinematic patterns of patients with chronic non-speci-Design: Subjects: n = 25) and patients with chronic n Methods: markers on bony landmarks measured range of motion and speed of 5 spinal segments, recorded by 8 optoelectronic Results: Both groups showed good-excellent reliability in all movements for range of motion and speed of all spinal seg--The minimal detectable change in the patient group was p d Conclusion: Kinematic variables are valid, reliable measures low back pain, manage treatment, and as quantitative out-Fig. 4. Boxplots of logit scores for range of motion (ROM) and speed (chronic NS-LBP). CS: cut-off score. J Rehabil Med 44
Trunk Motion Perturbations in Low Back Pain Patients
Motion analysis is one of several complementary tests used in the diagnosis and follow-up of patients with low back pain (LBP). The objectives of this study were to a) estimate the minimum number of motion trials required for clinical assessment using a three-dimensional video-based system, b) test if trunk primary and coupling motions are perturbed in LBP patients and c) determine whether trunk range of motion increased and pain level decreased after eight weeks of physiotherapy. Reflective markers were placed over T1, L1 and S1 of fourteen LBP patients and thirteen able-bodied adults. Data were collected using a four-camera high-resolution motion analysis video-based system while subjects performed five primary movements, namely, right and left lateral bendings and rotations as well as forward trunk flexion to determine the level of pain in LBP subjects and the improvement after eight weeks of physiotherapy by mean of the Quebec low back pain questionnaire. The inter-class correlation coefficients for the five primary motions were 0.77 between the first two repetitions; then they decreased for the others. A significant reduction in pain after physiotherapy was noted by a reduction of 24.5% in the score of the questionnaire. The only significant differences were observed in coupling motions. These were noted only between the patients before treatment and the other groups. There was a reduction of 27% in the coupling in rotation for the lumbar segment during lateral bending of the trunk and of 7° and 14° in the lateral bending of the trunk and that of the thoracic segment during trunk rotation respectively. The principal movements do not seem to be an indicator of trunk mobility in LBP patients. Coupling motions reduced in the subjects with LBP before treatment and returned to near normal values after treatment.
2008
The current study examined the validity and reliability of a new system that was developed to measure lumbar region passive stiffness and end range of motion during a trunk lateral bending movement in vivo. Variables measured included force, end range lumbar region motion, torque, lumbar region stiffness, and passive elastic energy. Validity of the force measurements was examined using standard weights. Validity of lumbar region angle measurements was examined using an instrumented trunk with an electrogoniometer. Reliability of the measurements between trials within a session was examined in a sample of 50 people (25 men, 25 women; mean +/standard deviation age = 30.7 +/-8.9 yr); 31 people reported a history of chronic or recurrent low back pain (LBP) and 19 reported no prior history of LBP. The end range lumbar region motion and force measurements demonstrated an excellent linear relationship with the criterion standard measures. Average error between the criterion standard and observed measurements was minimal for all measurements. For reliability testing, the majority of intraclass correlation coefficient values were >0.75. The validity and reliability of the current system are sufficient to examine lumbar region stiffness and end range of motion in people with and people without LBP.
Trunk flexion measurement for the assessment of low back pain
Vojnotehnicki glasnik, 2015
Low Back Pain (LBP) is one of the most common incidences all over the world. For the assessment of LBP, descriptive medical scores are widely used. Nevertheless, there is a need for the quantitative assessment of LBP by appropriate physiological and kinematic measurements. Quantitative assessment methods are of interest since they might provide reliable and repeatable measures related to low back pain in both everyday clinical practice and at home or work. In this paper, we proposed simple measurements of the trunk angle and the activity of back muscles during simple flexion/relaxation task for an improved assessment of LBP (Low Back Pain). The application of the proposed instrumentation and signal processing is evaluated in three healthy subjects and in two individuals with LBP.The presented data analysis indicates that angle velocity might be a promising parameter in a combination with electromyography profiles for differentiation between healthy subjects and in individuals with LBP for improved medical diagnostics and assessment.
Evidence-Based Normative Data in Lumbar Flexion Control Tests; a Pilot Study
Study Design: Descriptive pilot study. Objectives: To develop evidence-based ‘normative’ data for range of movement (ROM) at the hip, knee and lumbar spine during four clinical tests for lumbar flexion control. Summary of background data: Recently several studies have highlighted movement control dysfunction of the lumbar region as a potential diagnostic area. However, evidence-based ‘normative’ ROM data for a ‘normal’ population has yet to be uncovered, making lumbar control assessments difficult. This is the first study to utilize a biomechanical device to evaluate the ROM during lumbar flexion control tests. Methods: 20 people without LBP performed 4 clinical tests involving the control of lumbar flexion. ROM during the tests was evaluated using electrogoniometry at the hip, knee and lumbar spine. The lumbar spine electrode monitored flexion control and 5 degrees of lumbar flexion was classed as a loss of control. Each participant was recorded performing the tests 3 times after being taught the tests by the researcher. Results: Average ROM values were shown to be 10-15° less than the previously reported values. The intra-measure and inter-rater agreement results demonstrated that the majority of the ROM variables had moderate or above (>0.4) correlation. However, several of the results showed poor (<0.2) to fair (>0.2 – 0.4) intra-measure agreement and inter-rater agreement. Bland-Altman Plots showed that the majority of the ROM differences were within 1°-10°, however there were outliers of up to 30° difference. Therefore, there were large variations in the ROM measurements between test attempts due to the limitations of the data collection procedures. Conclusions: This study was not able to provide accurate ‘normative’ ROM values due to the limitations of the methodology. However, the conclusion of this pilot study was that the lumbar flexion control testing methodology is feasible but requires modifications. Further study is required on the validity of the utilised motor control tests.
International Journal of Sports Physical Therapy, 2021
Background Low back pain (LBP) is one of the most common complaints in individuals who seek medical care and is a leading cause of movement impairments. The Functional Movement Screen (FMS™) was developed to evaluate neuromuscular impairments during movement. However, the reliability and validity of the FMS™ have not yet been established for the LBP population because of a limitation of its original scoring system. Purpose The purposes of this study were to determine the reliability and validity of the FMS™ with a modified scoring system in young adults with and without LBP. The FMS™ scores were modified by assigning a zero score only when there was an increase in LBP during the FMS™, not simply for the presence of pain, as in the original FMS™ scoring system. Study Design: Reliability and validity study. Methods Twenty-two participants with LBP (8 males and 14 females, 26.7 ± 4.68 years old) and 22 age- and gender-matched participants without LBP (26.64 ± 4.20 years old) completed the study. Each participant performed the FMS™ once while being scored simultaneously and independently by two investigators. In addition, each participant’s FMS™ performance was video-recorded and then was scored by another two investigators separately. The video-recorded performance also was scored twice six weeks apart by the same investigator to determine intra-rater reliability. Results The results showed excellent inter-rater and intra-rater reliability of the FMS™ composite score with intraclass correlation coefficients ranging from 0.93 to 0.99 for both groups. In addition, the LBP group scored significantly lower than the group without LBP (p = 0.008). Conclusions The results indicate that the FMS™ is able to distinguish between individuals with and without LBP, and that it could be a useful test for clinicians to quantify movement quality and to assess movement restrictions in individuals with LBP. Levels of Evidence: 2b.
Chiropractic & Manual Therapies, 2016
Background: In order for measurements to be clinically useful, data on psychometric conditions such as reliability should be available in the population for which the measurements are intended to be used. This study comprises a test-retest design separated by 7 to 14 days, and evaluates the intra and interrater reliability of regional frontal and horizontal spinal motion in 219 chronic LBP patients using the CA6000 Spine Motion Analyzer. In addition, it compares these results on the frontal and horizontal plane with previously published results on the sagittal plane. 219 individuals with chronic mechanical LBP, classified as either Quebec Task Force group 1, 2, 3 or 4 were included, and kinematics of the lumbar spine were sampled during standardized spinal lateral flexion and rotation motion using a 6-df instrumented spatial linkage system. Test-retest reliability and measurement error were evaluated using intraclass correlation coefficients ICC (1,1) and Bland-Altman limits of agreement (LOAs). Results: The reliability analysis based on the whole study sample showed ICC (1,1) coefficients varying between 0.68 and 0.73 for the frontal plane and 0.33 and 0.49 for the horizontal plane. Relatively wide LOAs were observed for all parameters. Reliability measures in patient subgroups ICC (1,1) ranged between 0.55 and 0.81 for the frontal plane and 0.28 and 0.69 for the horizontal plane. Greater ICC (1,1) coefficients and smaller LOA were observed when patients were examined by the same examiner, had a stable pain level between tests, and were male. ROM measurements were more reliable in patients with a BMI higher than 30, and measurements on patients with LBP and leg pain showed higher reliability and smaller measurement error in all parameters except for the jerk index. Conclusion: Frontal plane measurements obtained using the CA6000 Spine Motion Analyzer are sufficiently reliable to be used for group comparisons but not individual comparisons. Measurements in the horizontal plane can be used for neither group nor individual comparisons.