Gait Kinetic and Kinematic Changes in Chronic Low Back Pain Patients and the Effect of Manual Therapy: A Randomized Controlled Trial (original) (raw)
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Effects of Mechanical Low Back Pain in Spatiotemporal Parameters of Gait
Effects of Mechanical Low Back Pain in Spatiotemporal Parameters of Gait, 2019
Background: Mechanical low back pain is one of the most common complaints of people, which may interfere with some aspects of daily living activity such as walking. Objectives: The aim of the present study was to objectively assess the effects of mechanical low back pain on the gait pattern. Methods: Thirty mechanical low back pain patients and 30 healthy subjects were recruited randomly (age 18-60). The spatiotemporal parameters of gait were assessed and recorded as subjects walked on a two-meter platform three times at their normal walking speed. Descriptive statistical methods were used to evaluate demographic characteristics. The independent samples t-test was used to compare the groups for the gait parameters. Results: No significant differences were found between controls and patients in demographic variables. Significant differences were obtained between patients and healthy subjects in step length (P < 0.04), step time (0.009), single support time (0.04), stride length (0...
International Journal of Physiotherapy and Research
We report a 38 yrs old patient with a previously diagnosed Chronic Low Back Pain who became severely functionally impaired as evidenced by the Oswestry Disability Questionnaire (56%). The aim of this study was to introduce changes in functional gait parameters as an assessment tool before and after a single session of Kinesiotape application in a patient with chronic LBP. We introduced, for the first time, gait parameters including the 10-meter walk test and the 6-minute walk test as the functional gait parameters of interest. There was (1) a 25% & 36% increase in normal walking speed and fast walking speed, respectively as evidenced by the 10MWT with 72% decrease in pain and (2) a 86% increase in walking tolerance as evidenced by the 6MWT with 88% decrease in pain. Our data demonstrated for the first time the possible effective use of gait assessment as objective motor performance measures to assess the therapy-induced improvement following therapeutic intervention in patient with chronic low back pain. We hope that these data will act as a starting point for further research to test the potential gait assessment measures to provide a more in-depth objective assessment in response to rehabilitation therapies in chronic low back pain patients.
European Spine Journal, 2015
Purpose To assess the changes in gait pattern and clinical symptoms of patients with chronic non-specific low back pain (CNSLBP) following a home-based biomechanical treatment (HBBT). Methods This was a retrospective analysis of 60 CNSLBP patients. All patients underwent a gait evaluation and completed self-assessment questionnaires at pre-treatment and after 3 and 6 months of a HBBT (AposTherapy). Twenty-four healthy, aged-matched individuals served as a reference group. Results Significant differences were found in all gait parameters and clinical symptoms between patients with CNSLBP and healthy people before treatment. Significant improvements were found in all gait parameters and clinical measures following 6 months of therapy including an increase in gait velocity (10.6 %), step length (5.6 %), cadence (5 %), and quality of life and a decrease in pain (13.3 %). There were no significant differences between groups in the gait parameters following 6 months of treatment. Conclusions Significant differences exist between patients with CNSLBP and healthy controls in terms of gait pattern and self-assessed health status. The examined HBBT led to significant improvements in gait pattern, reduction in pain, improved function and increased quality of life. However, future studies should validate these results while comparing this treatment to other treatment modalities.
2021
Background: In chronic low back pain (CLBP) due to the phenomenon of central sensitization there might be persistent pain and flare-ups. Further due to its lasting periodicity in nature, it also results in significant economic burden. However, the mechanisms for chronicity in low back pain have not been established. Objectives: The purpose of this study is to investigate whether there are differences in spatio-temporal parameters in subjects with chronic low back pain compared with the healthy controls subjects during the gait cycle. Methods: The methodology used for the systematic review follows the PRISMA guidelines. A literature search was performed in PubMed, EMBASE, Scopus and Medline. Twelve articles comparing spatio-temporal parameters (speed, stride length and step length) in people with CLBP and healthy controls during walking or running were selected. Two persons independently performed the data extraction and quality assessment. Results: The results showed that among ten ...
A Novel Biomechanical Device Improves Gait Pattern in Patient With Chronic Nonspecific Low Back Pain
Spine, 2009
A retrospective study on patients with chronic nonspecific low back pain (NSLBP). To describe the gait stride characteristics of patients with chronic NSLBP, and to examine the effect of a novel biomechanical device on the gait stride characteristics of these patients. Patient with NSLBP alters their gait patterns. This is considered a protective mechanism as patients try to avoid extensive hip and spine ranges of motion and minimize forces and moments acting on the body. In addition, there are changes in the neuromuscular control system in patients with LBP that could possibly be attributed to the effects of pain on motor control. Nineteen patients underwent a gait test, using an electronic walkway, at baseline and after 12 weeks of treatment. Spatiotemporal parameters were used to identify changes in gait pattern. A novel biomechanical device comprised of 4 modular elements attached to foot-worn platforms was used in the study. The modules are 2 convex shaped biomechanical elements attached to each foot, one is located under the hindfoot region and the other is located under the forefoot region. The device was individually calibrated to each patient. The patients were instructed to walk with the calibrated biomechanical device on a daily basis for a period of 12 weeks. Significant differences were found at baseline and after 12 weeks in normalized velocity (P = 0.03), cadence (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), left normalized step length (P = 0.02), right normalized step length (P = 0.02), right swing (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), right stance (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), left single limb support (P = 0.01), left double limb support (P = 0.02), and right double limb support (P = 0.02). Patients with NSLBP treated with the novel biomechanical device for 3 months increased walking speed through longer step length and eliminated asymmetrical differences.
Research Paper: Effectiveness of Kinesiotaping and Conventional Physiotherapy on Patients With Non-Specific Chronic Low Back Pain Purpose: Low Back Pain (LBP) is among the most common reasons of medical visits worldwide. It can cause limited movements, long lasting disability, and low quality of life and work. Thus, studying the efficacy of conservative treatment strategies to help patients with LBP is very important. The present study aimed to evaluate the effect of kinesiotaping in addition to conventional physiotherapy on pain and disability in patients with non-specific chronic LBP. Methods: Of the non-specific chronic LBP patients who referred to a private physiotherapy clinic in Karaj City, Iran, patients with the age range of 20-55 years were included in this study, using simple random sampling method. Before the onset of intervention, patients on the waiting list for treatment for 2 weeks were considered as the controls. The intervention program performed in 10 sessions (2 weeks), comprising physiotherapy (ultrasound, hot pack, electrical stimulation and stability exercise) in addition to kinesiotaping which was applied on every session. Pain severity (using Visual Analog Scale) and disability (using Oswestry) were evaluated before, during and after the intervention. The repeated measures ANOVA was used for statistical analysis. Results: Overall, 15 patients with the Mean±SD age of 39±8.9 years and the body mass index of 26.92±5.46 kg/m 2 , participated in the study. During the time that we considered as the period of control, assessments were performed and the results regarding pain and disability showed no significant changes (P>0.05). Changes in the mean score of pain severity were significant (P>0.001); it altered from 7.33 before the intervention to 1.80 after the intervention. Disability based on the Oswestry scale changes were also significant (P>0.03); it changed from 50% before the intervention to 11% after that. Conclusion: Combined kinesiotaping and conventional physiotherapy can decline pain and disability in patients with LBP.
European Spine Journal, 2011
Patients with chronic non-specific low back pain (LBP) walk with more synchronous (in-phase) horizontal pelvis and thorax rotations than controls. Low thorax-pelvis relative phase in these patients appears to result from in-phase motion of the thorax with the legs, which was hypothesized to affect arm swing. In the present study, gait kinematics were compared between LBP patients with lumbar disc herniation and healthy controls during treadmill walking at different speeds and with different step lengths. Movements of legs, arms, and trunk were recorded. The patients walked with larger pelvis rotations than healthy controls, and with lower relative phase between pelvis and thorax horizontal rotations, specifically when taking large steps. They did so by rotating the thorax more in-phase with the pendular movements of the legs, thereby limiting the amplitudes of spine rotation. In the patients, arm swing was out-of phase with the leg, as in controls. Consequently, the phase relationship between thorax rotations and arm swing was altered in the patients.