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Elucidating the Relationship Between Self-Reported Disability and Functional Movement in Individuals with Chronic Low Back Pain

INTRODUCTION: Low back pain (LBP) is often exacerbated by movement and, during functional movements, people with LBP tend to inherently modify their posture and movement patterns to avoid aggravating their pain further. Therefore, analysis of spinal movement in people with LBP is necessary and may lead to the identification of movement-based clusters for optimal treatment. PURPOSE: The overall purpose of this study was to investigate how movement patterns in people with chronic LBP relate to their subjective level of pain-related disability. First, we determined which spinal movements best discriminate between people with chronic LBP and asymptomatic controls; second, we ascertained whether the level of movement dysfunction in people with chronic LBP correlates with the Oswestry Disability Index (ODI). METHODS: 44 volunteers (26 with current chronic LBP, 15 asymptomatic controls) participated in this study. An OPAL (APDM Wearable Technology) inertial measurement unit (IMU) sensor was attached to the skin over the spinal region of L3-L4, which allowed for transmission of motion data from the lumbar spine. Participants were instructed to perform a series of eleven uniplanar and functional multiplanar spinal movements at a comfortable pace. The median peak angular velocity values from the lumbar spine (measured by the gyroscope component of the IMU) were extracted from MATLAB and Python, and all statistical analyses were subsequently performed in RStudio. RESULTS: From a mixed-direction stepwise regression based on the minimization of the Aikake Information Criterion (AIC), a binomial logistic regression model containing kinematic data from Flexion, Extension-Twist, Axial Rotation, and Sit-to-Stand tasks was selected as the best model to predict chronic LBP status (McFadden’s pseudo-R-squared: 0.310). Moreover, compared to sagittal uniplanar tasks, functional multiplanar movements were better at predicting LBP status (AICmulti-uni = −3.2). Lastly, we found no association between the kinematic data from the movements that best predicted LBP status and ODI scores (p-value = 0.405). CONCLUSION: In this study, we found no correlation between self-reported disability and kinematic median peak angular velocity data from Flexion, Extension-Twist, Axial Rotation, and Sit-to-Stand tasks. Therefore, other factors that may modulate physical function, such as psychosocial factors, should be investigated.

Identiferoai:union.ndltd.org:BGMYU2/oai:scholarsarchive.byu.edu:etd-11143
Date03 August 2022
CreatorsClark, Kelsey Ampudia
PublisherBYU ScholarsArchive
Source SetsBrigham Young University
Detected LanguageEnglish
Typetext
Formatapplication/pdf
SourceTheses and Dissertations
Rightshttps://lib.byu.edu/about/copyright/

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