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Rodríguez-Romero B, Gallo-Marcos C, Mancebo-Blanco D, Tuñas-Maceiras I, Silva AG. Tactile acuity and active joint repositioning sense in individuals with and without chronic low back pain: a cross-sectional study. Physiother Theory Pract 2024:1-12. [PMID: 38953518 DOI: 10.1080/09593985.2024.2374468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Sensorimotor dysfunction, as measured by tactile acuity and active joint repositioning, has been identified as a contributing factor of chronic low back pain (CLBP). Existing research suggests that further research is necessary to improve the characterization of sensorimotor perception in patients with CLBP. OBJECTIVES The main aim is to investigate whether tactile acuity and repositioning errors differ between individuals with CLBP and controls without CLBP. A secondary aim was to investigate the association between age, body mass index (BMI) and physical activity, and tactile acuity and repositioning sense. METHODS Cross-sectional study. Sixty-eight participants (36 with, 32 without CLBP) were examined. Two-Point Discrimination (TPD) test (four measures: horizontal and vertical run, left and right side) and Active Joint Reposition Sense (AJRS) test (2 directions: to flexion and to extension) were used. RESULTS No differences were found for TPD (right horizontal run: p = .069; left horizontal run: p = .066; right vertical run: p = .933; left vertical run: p = .285) or AJRS (flexion: p = .792; extension: p = .956) between participants with and without CLBP. Older subjects had significantly worse tactile acuity (3 sites, p = .018, p = .004, p = .041) and worse repositioning sense (2 directions, p = .026, p = .040,) than younger subjects. Individuals with BMI ≥ 25 had significantly worse TPD compared to individuals with normal weight (2 sites, p = .028, p = .020). CONCLUSIONS Individuals with CLBP did not have impaired tactile and repositioning accuracy when compared to controls without CLBP. Future studies comparing sensorimotor performance should consider age and BMI as potential confounding factors.
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Affiliation(s)
- Beatriz Rodríguez-Romero
- Department of Physiotherapy, Medicine and BiomedicalSciences, Universidade da Coruña, A Coruña, Spain
| | - Carla Gallo-Marcos
- Department of Physiotherapy, Medicine and BiomedicalSciences, Universidade da Coruña, A Coruña, Spain
| | - Daniel Mancebo-Blanco
- Department of Physiotherapy, Medicine and BiomedicalSciences, Universidade da Coruña, A Coruña, Spain
| | - Isabel Tuñas-Maceiras
- Department of Physiotherapy, Medicine and BiomedicalSciences, Universidade da Coruña, A Coruña, Spain
| | - Anabela G Silva
- Escola Superior de Saúde, Universidade de Aveiro, Aveiro, Portugal
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Oda H, Fukuda S, Tsujinaka R, Gao H, Hiraoka K. Short-Term Reproduction of Active Movement with Visual Feedback and Passive Movement with a Therapist's Hands. Brain Sci 2024; 14:531. [PMID: 38928531 PMCID: PMC11201912 DOI: 10.3390/brainsci14060531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
Reproducing instructed movements is crucial for practice in motor learning. In this study, we compared the short-term reproduction of active pelvis movements with visual feedback and passive movement with the therapist's hands in an upright stance. Sixteen healthy males (M age = 34.1; SD = 10.2 years) participated in this study. In one condition, healthy males maintained an upright stance while a physical therapist moved the participant's pelvis (passive movement instruction), and in a second condition, the participant actively moved their pelvis with visual feedback of the target and the online trajectory of the center of pressure (active movement instruction). Reproduction errors (displacement of the center of pressure in the medial-lateral axis) 10 s after the passive movement instruction were significantly greater than after the active movement instruction (p < 0.001), but this difference disappeared 30 s after the instruction (p = 0.118). Error of movement reproduction in the anterior-posterior axis after the passive movement instruction was significantly greater than after the active movement instruction, no matter how long the retention interval was between the instruction and reproduction phases (p = 0.025). Taken together, active pelvis movements with visual feedback, rather than passive movement with the therapist's hand, is better to be used for instructing pelvis movements.
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Affiliation(s)
- Hitoshi Oda
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan; (H.O.); (S.F.); (H.G.)
| | - Shiho Fukuda
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan; (H.O.); (S.F.); (H.G.)
| | - Ryo Tsujinaka
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan;
| | - Han Gao
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan; (H.O.); (S.F.); (H.G.)
| | - Koichi Hiraoka
- School of Medicine, Osaka Metropolitan University, 3-7-30 Habikino, Habikino 583-8555, Osaka, Japan
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Klerx SP, Mokkink LB, Coppieters MW, Pool-Goudzwaard AL, Kiers H. Reliability of two lumbar motor control tests for people with low back pain that are feasible in clinical practice. Musculoskelet Sci Pract 2023; 66:102775. [PMID: 37269589 DOI: 10.1016/j.msksp.2023.102775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Clinically feasible and reliable methods to measure motor control in people with low back pain (LBP) are lacking. This reliability and measurement error study design (i.e. repeated measurements in stable patients) aimed to determine the intra- and interrater reliability, and measurement errors of several parameters for two clinical lumbar motor control tests. METHOD Participants 18-65 years of age, with current or a history of LBP performed a spiral tracking task (n = 33; i.e., tracing a spiral on a computer monitor by making spinal movements) or a repositioning task (n = 34; i.e., returning the trunk to a predefined position). Accelerometers were used to measure trunk positions. To explore the potential of these tests, we evaluated a broad range of parameters. To assess intra- and interrater reliability, we calculated the intraclass correlation coefficient (ICC(2,1) for absolute agreement), standard error of measurement and smallest detectable change for each parameter. FINDINGS Overall, the interrater reliability of the spiral tracking test was good (ICC>0.75). The reliability of the second and third trial revealed higher ICC values compared to the reliability of the first two trials. The intra- and interrater reliability of the repositioning test was overall poor (ICC <0.5, with the exception of trunk inclination: ICC: 0.5 to 0.75). CONCLUSION The reliability and set-up of the spiral tracking test supports its feasibility for clinical use. Considering the poor reliability of the repositioning test, it is doubtful whether further development of this measurement protocol is indicated. Only for the direction trunk inclination further standardisation might be warranted.
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Affiliation(s)
- Sabrine P Klerx
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Research Group Lifestyle and Health, Section Movement Adaptation and Prognosis, HU University of Applied Sciences, Utrecht, the Netherlands.
| | - Lidwine B Mokkink
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
| | - Michel W Coppieters
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Australia; School of Health Sciences and Social Work, Griffith University, Brisbane and Gold Coast, Australia.
| | - Annelies L Pool-Goudzwaard
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; SOMT University of Physiotherapy, Amersfoort, the Netherlands.
| | - Henri Kiers
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Research Group Lifestyle and Health, Section Movement Adaptation and Prognosis, HU University of Applied Sciences, Utrecht, the Netherlands.
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Morito T, Kaneoka K. Sacroiliac joint pain increases repositioning error during active straight leg-raising. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:2042-2047. [PMID: 37043054 DOI: 10.1007/s00586-023-07556-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/21/2022] [Accepted: 01/22/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE This study aimed to compare the repositioning error (RE) of patients with unilateral sacroiliac joint pain (SIJP) to that of patients with low back pain (LBP) and a healthy control (HC) group. Differences between the symptomatic and asymptomatic sides were also investigated. METHODS Sixty-six patients with SIJP, LBP, and HC were included in this study. An active straight leg-raising repositioning test (ASLR-Rt) was performed. ASLR was performed three times each on the left and right sides, targeting a set base angle. RE was calculated as the difference between the base angle and the participant's attempt to adjust the target angle. RE was expressed as constant error (CE) and absolute error (AE). RESULTS The CE of the SIJP group (median [interquartile range]) (6.9 [4.6‒10.4]) was significantly higher than that in the LBP group (3.2 [1.3‒7.1]) and the HC group (2.7 [0.3‒4.6]) (P = 0.009, d = 0.91, P < 0.001, d = 1.30). The AE of the SIJP group (7.3[5.0‒10.4]) was also significantly higher than that in the LBP (3.7[2.8‒7.1]) and HC groups (3.0[1.9‒4.2]) (P = 0.003, d = 1.04; P = 0.001, d = 1.57). Comparing the symptomatic and asymptomatic sides in the SIJP group, the symptomatic side (8.0[6.0‒10.6]) was significantly higher than the asymptomatic side (5.7[3.6‒8.1]) in terms of CE (P = 0.05, d = 0.51). CONCLUSION Patients with SIJP increased RE during ASLR, which may be related to impaired proprioception and decreased motor control.
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Affiliation(s)
- Tsuyoshi Morito
- Graduate School of Sports Sciences, Waseda University, Nishitokyo, Tokyo, Japan
| | - Koji Kaneoka
- Faculty of Sport Sciences, Waseda University, 3-4-1, Higashifushimi, Nishitokyo, Tokyo, 202-0021, Japan.
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Simsek S, Altindal F, Kiliçarslan B. Comparison of affected lumbar proprioception due to different injuries with healthy controls: An observational study. INT J OSTEOPATH MED 2023. [DOI: 10.1016/j.ijosm.2023.100662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Decay of Short-Term Motor Memory Regarding Force Reproduction. Motor Control 2022; 27:338-353. [PMID: 36448489 DOI: 10.1123/mc.2022-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/25/2022] [Accepted: 09/28/2022] [Indexed: 12/02/2022]
Abstract
This study investigated the process that contributes to the decay of short-term motor memory regarding force reproduction. Participants performed tonic flexion of the right index finger with the target force feedback (criterion phase) and reproduced this force level without feedback 3, 10, 30, or 60 s after the end of the criterion phase (recall phase). The constant error for force reproduction was significantly greater than zero, indicating that information about the somatosensation and/or motor command in the criterion phase is positively biased. Constant and absolute errors were not influenced by the retention interval, indicating that neither bias nor error represents the decay of short-term motor memory over time. Variable error, defined as SD of bias (force in the recall phase minus that in the criterion phase), increased as the retention interval increased. This indicates that the decay of short-term motor memory is represented by the increase in inconsistency of memory bias among the trials. The correlation coefficient of the force between the criterion and recall phases with 3-s retention interval was greater than that with longer intervals. This is explained by the view that the contribution of the information of the practiced force to the force reproduction process is great within 3 s after the end of the practice, but the additional contribution of the noise information becomes greater after this time, causing lesser relative contribution of the information of the practiced force to the force reproduction process.
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Gait Kinetic and Kinematic Changes in Chronic Low Back Pain Patients and the Effect of Manual Therapy: A Randomized Controlled Trial. J Clin Med 2021; 10:jcm10163593. [PMID: 34441888 PMCID: PMC8396934 DOI: 10.3390/jcm10163593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/05/2021] [Accepted: 08/13/2021] [Indexed: 11/17/2022] Open
Abstract
Patients with chronic back pain as a result of degenerated disc disease, besides pain, also present with impaired gait. The purpose of the article was to evaluate kinetic and kinematic characteristics during gait analysis in patients with chronic low back pain as a result of degenerated disc disease, before and after the application of physiotherapy, including manual therapy techniques. Seventy-five patients suffering from chronic low back pain were randomly divided into 3 groups of 25 each. Each group received five sessions (one per week) of interventions with the first group receiving manual therapy treatment, the second a sham treatment and the third, classic physiotherapy (stretching exercises, TENS and massage). The effectiveness of each treatment was evaluated using an optoelectronic system for recording and analysis of gait (kinetic and kinematic data). Patients overall showed an impaired gait pattern with a difference in kinetic and kinematic data between the left and the right side. Following the application of the above-named interventions, only the group that received manual therapy showed a tendency towards symmetry between the right and left side. In patients suffering from chronic low back pain as a result of degenerated disc disease, the application of five manual therapy sessions seems to produce a tendency towards symmetry in gait.
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Reddy RS, Alahmari KA, Samuel PS, Tedla JS, Kakaraparthi VN, Rengaramanujam K. Intra-rater and inter-rater reliability of neutral and target lumbar positioning tests in subjects with and without non-specific lower back pain. J Back Musculoskelet Rehabil 2021; 34:289-299. [PMID: 33285625 DOI: 10.3233/bmr-200010] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Proprioception, one's sense of movement and position, is a common term used in back rehabilitation. Kinesthetic rehabilitation may be useful in managing lower back pain; however, reliable measures are required to quantify lumbar proprioception sense. OBJECTIVE To investigate intrarater and interrater reliability of neutral lumbar positioning (NLP) and target lumbar positioning (TLP) tests and compare the position sense errors in subjects with non-specific low back pain and healthy controls. METHODS Intrarater (between-day) and interrater (within-day) reliability of NLP and TLP tests were assessed in 30 subjects with low back pain and 30 healthy subjects using a digital inclinometer. NLP is evaluated when the subject is repositioned to neutral from flexion, while TLP is evaluated in lumbar flexion, by bending laterally left and right. RESULTS Intrarater reliability for NLP tests had ICC values of 0.85 and 0.89 and TLP tests had 0.78 and 0.92. Likewise, interrater reliability for NLP had ICC values of 0.75 and 0.85, and for the TLP test, the interrater reliability had 0.78 and 0.93. Subjects with back pain had significantly larger neutral and target lumbar proprioceptive errors compared to healthy controls (p< 0.001). CONCLUSIONS Intrarater and interrater reliability showed good agreement for both NLP and TLP tests of lumbar proprioception. Subjects with nonspecific low back pain have impaired lumbar proprioceptive sense.
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Korakakis V, O’Sullivan K, Kotsifaki A, Sotiralis Y, Giakas G. Lumbo-pelvic proprioception in sitting is impaired in subgroups of low back pain-But the clinical utility of the differences is unclear. A systematic review and meta-analysis. PLoS One 2021; 16:e0250673. [PMID: 33901255 PMCID: PMC8075231 DOI: 10.1371/journal.pone.0250673] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 04/08/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Altered spinal postures and altered motor control observed among people with non-specific low back pain have been associated with abnormal processing of sensory inputs. Evidence indicates that patients with non-specific low back pain have impaired lumbo-pelvic proprioceptive acuity compared to asymptomatic individuals. OBJECTIVE To systematically review seated lumbo-pelvic proprioception among people with non-specific low back pain. METHODS Five electronic databases were searched to identify studies comparing lumbo-pelvic proprioception using active repositioning accuracy in sitting posture in individuals with and without non-specific low back pain. Study quality was assessed by using a modified Downs and Black's checklist. Risk of bias was assessed using an adapted tool for cross-sectional design and case-control studies. We performed meta-analysis using a random effects model. Meta-analyses included subgroup analyses according to disability level, directional subgrouping pattern, and availability of vision during testing. We rated the quality of evidence using the GRADE approach. RESULTS 16 studies met the eligibility criteria. Pooled meta-analyses were possible for absolute error, variable error, and constant error, measured in sagittal and transverse planes. There is very low and low certainty evidence of greater absolute and variable repositioning error in seated tasks among non-specific low back pain patients overall compared to asymptomatic individuals (sagittal plane). Subgroup analyses indicate moderate certainty evidence of greater absolute and variable error in seated tasks among directional subgroups of adults with non-specific low back pain, along with weaker evidence (low-very low certainty) of greater constant error. DISCUSSION Lumbo-pelvic proprioception is impaired among people with non-specific low back pain. However, the low certainty of evidence, the small magnitude of error observed and the calculated "noise" of proprioception measures, suggest that any observed differences in lumbo-pelvic proprioception may be of limited clinical utility. PROSPERO-ID CRD42018107671.
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Affiliation(s)
- Vasileios Korakakis
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Faculty of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
- Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece
- * E-mail:
| | - Kieran O’Sullivan
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, University of Limerick, Limerick, Ireland
| | | | - Yiannis Sotiralis
- Faculty of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Giannis Giakas
- Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece
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Abdelnaeem AO, Rehan Youssef A, Mahmoud NF, Fayaz NA, Vining R. Psychometric properties of chronic low back pain diagnostic classification systems: a systematic review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:957-989. [PMID: 33471180 DOI: 10.1007/s00586-020-06712-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 11/23/2020] [Accepted: 12/27/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To identify and critically appraise studies evaluating psychometric properties of functionally oriented diagnostic classification systems for Non-Specific Chronic Low Back Pain (NS-CLBP). METHODS This review employed methodology consistent with PRISMA guidelines. Electronic databases and journals: (PubMed, EMBASE, Cochrane, PEDro, CINAHL, Index to chiropractic literature, ProQuest, Physical Therapy, Journal of Physiotherapy, Canadian Physiotherapy and Physiotherapy Theory and Practice) were searched from inception until January 2020. Included studies evaluated the validity and reliability of NS-CLBP diagnostic classification systems in adults. Risk of bias was assessed using a Critical Appraisal Tool. RESULTS Twenty-two studies were eligible: Five investigated inter-rater reliability, and 17 studies analyzed validity of O'Sullivan's classification system (OCS, n = 15), motor control impairment (MCI) test battery (n = 1), and Pain Behavior Assessment (PBA, n = 1). Evidence from multiple low risk of bias studies demonstrates that OCS has moderate to excellent inter-rater reliability (kappa > 0.4). Also, two low risk of bias studies support of OCS-MCI subcategory. Three tests within the MCI test battery show acceptable inter- and intra-rater reliability for clinical use (the "sitting knee extension," the "one leg stance," and the "pelvic tilt" tests). Evidence for the reliability and validity of the PBA is limited to one high bias risk study. CONCLUSIONS Multiple low risk of bias studies demonstrate strong inter-rater reliability for OCS classification specifically OCS-MCI subcategory. Future studies with low risk of bias are needed to evaluate reliability and validity of the MCI test battery and the PBA.
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Affiliation(s)
| | - Aliaa Rehan Youssef
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt.,Faculty of Physical Therapy, Ahram Canadian University, Giza, Egypt
| | | | | | - Robert Vining
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA
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Viggiani D, Mannen EM, Nelson-Wong E, Wong A, Ghiselli G, Shelburne KB, Davidson BS, Callaghan JP. Lumbar Intervertebral Kinematics During an Unstable Sitting Task and Its Association With Standing-Induced Low Back Pain. J Appl Biomech 2020; 36:423-435. [PMID: 32971516 DOI: 10.1123/jab.2019-0382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 05/05/2020] [Accepted: 06/30/2020] [Indexed: 11/18/2022]
Abstract
People developing transient low back pain during standing have altered control of their spine and hips during standing tasks, but the transfer of these responses to other tasks has not been assessed. This study used video fluoroscopy to assess lumbar spine intervertebral kinematics of people who do and do not develop standing-induced low back pain during a seated chair-tilting task. A total of 9 females and 8 males were categorized as pain developers (5 females and 3 males) or nonpain developers (4 females and 5 males) using a 2-hour standing exposure; pain developers reported transient low back pain and nonpain developers did not. Participants were imaged with sagittal plane fluoroscopy at 25 Hz while cyclically tilting their pelvises anteriorly and posteriorly on an unstable chair. Intervertebral angles, relative contributions, and anterior-posterior translations were measured for the L3/L4, L4/L5, and L5/S1 joints and compared between sexes, pain groups, joints, and tilting directions. Female pain developers experienced more extension in their L5/S1 joints in both tilting directions compared with female nonpain developers, a finding not present in males. The specificity in intervertebral kinematics to sex-pain group combinations suggests that these subgroups of pain developers and nonpain developers may implement different control strategies.
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Affiliation(s)
| | - Erin M Mannen
- University of Denver
- University of Arkansas for Medical Sciences
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Abbasi S, Hadian Rasanani MR, Ghotbi N, Olyaei GR, Bozorgmehr A, Rasouli O. Short-term effect of kinesiology taping on pain, functional disability and lumbar proprioception in individuals with nonspecific chronic low back pain: a double-blinded, randomized trial. Chiropr Man Therap 2020; 28:63. [PMID: 33213492 PMCID: PMC7678105 DOI: 10.1186/s12998-020-00349-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 10/22/2020] [Indexed: 11/27/2022] Open
Abstract
Background This study aimed to evaluate the effect of kinesiology taping (KT) on lumbar proprioception, pain, and functional disability in individuals with nonspecific chronic low back pain (CLBP). Methods Thirty individuals with nonspecific CLBP participated in this double-blinded, randomized clinical trial from July 2017 to September 2018. The participants were randomized into two groups: KT (n = 15) and placebo group (n = 15). KT was applied with 15–25% tension for 72 h, and placebo taping was used without tension. Lumbar repositioning error was measured by a bubble inclinometer at three different angles (45° and 60° flexion, and 15° extension) in upright standing. Pain and disability were assessed by the Short-Form McGill Pain Questionnaire and Oswestry Disability Index, respectively. All measurements were recorded at baseline and 3 days after taping. Results Pain and disability scores reduced 3 days after taping in the KT group with large effect sizes (p < 0.05). Only the total score of pain was significantly different between the groups 3 days after taping and improved more in the KT group with a large effect size (p < 0.05). However, lumbar repositioning errors were similar between the groups after 3 days (p > 0.05). Also, only constant error of 15° extension showed a moderate correlation with disability (r = 0.39, p = 0.02). Conclusion KT can decrease pain and disability scores after 3 days of application. Although placebo taping can reduce pain, the effect of KT is higher than placebo taping. The findings do not support the therapeutic effect of KT and placebo taping as a tool to enhance lumbar proprioception in patients with nonspecific CLBP. Trial registration The study prospectively registered on 21.05.2018 at the Iranian Registry of Clinical Trials: IRCT20090301001722N20.
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Affiliation(s)
- Soheila Abbasi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, (TUMS), Tehran, Iran
| | - Mohammad-Reza Hadian Rasanani
- Postgraduate Department, School of Rehabilitation, Tehran University of Medical Sciences, International, Brain and Spinal Injury Research Center (BASIR), Institute of Neuroscirnce, P.O. Box: 111551683, Tehran, Iran.
| | - Nastaran Ghotbi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, (TUMS), Tehran, Iran
| | - Gholam Reza Olyaei
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, (TUMS), Tehran, Iran
| | - Ali Bozorgmehr
- Rehabilitation Research Center, Department of Physical Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Omid Rasouli
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Korakakis V, O’Sullivan K, Sideris V, Giakas G. No differences in spinal repositioning error in patients with low back pain presenting with a directional preference into extension. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2019.1585474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Vasileios Korakakis
- Faculty of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
- Aspetar, Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Kieran O’Sullivan
- Aspetar, Orthopedic and Sports Medicine Hospital, Doha, Qatar
- Faculty of Education and Health Sciences, University of Limerick, School of Allied Health, Limerick, Ireland
| | - Vasileios Sideris
- Faculty of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
- Aspetar, Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Giannis Giakas
- Faculty of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
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Identifying non-specific low back pain clinical subgroups from sitting and standing repositioning posture tasks using a novel Cardiff Dempster-Shafer Theory Classifier. Clin Biomech (Bristol, Avon) 2019; 70:237-244. [PMID: 31669957 PMCID: PMC7374406 DOI: 10.1016/j.clinbiomech.2019.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 09/25/2019] [Accepted: 10/01/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Low back pain (LBP) classification systems are used to deliver targeted treatments matched to an individual profile, however, distinguishing between different subsets of LBP remains a clinical challenge. METHODS A novel application of the Cardiff Dempster-Shafer Theory Classifier was employed to identify clinical subgroups of LBP on the basis of repositioning accuracy for subjects performing a sitting and standing posture task. 87 LBP subjects, clinically subclassified into flexion (n = 50), passive extension (n = 14), and active extension (n = 23) motor control impairment subgroups and 31 subjects with no LBP were recruited. Thoracic, lumbar and pelvic repositioning errors were quantified. The Classifier then transformed the error variables from each subject into a set of three belief values: (i) consistent with no LBP, (ii) consistent with LBP, (iii) indicating either LBP or no LBP. FINDINGS In discriminating LBP from no LBP the Classifier accuracy was 96.61%. From no-LBP, subsets of flexion LBP, active extension and passive extension achieved 93.83, 98.15% and 97.62% accuracy, respectively. Classification accuracies of 96.8%, 87.7% and 70.27% were found when discriminating flexion from passive extension, flexion from active extension and active from passive extension subsets, respectively. Sitting lumbar error magnitude best discriminated LBP from no LBP (92.4% accuracy) and the flexion subset from no-LBP (90.1% accuracy). Standing lumbar error best discriminated active and passive extension from no LBP (94.4% and 95.2% accuracy, respectively). INTERPRETATION Using repositioning accuracy, the Cardiff Dempster-Shafer Theory Classifier distinguishes between subsets of LBP and could assist decision making for targeted exercise in LBP management.
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Effect of sustained experimental muscle pain on joint position sense. Pain Rep 2019; 4:e737. [PMID: 31583352 PMCID: PMC6749891 DOI: 10.1097/pr9.0000000000000737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 11/30/2022] Open
Abstract
Introduction: Joint position sense (JPS) is impaired in clinical musculoskeletal pain conditions, but when this impairment develops in the transition from initial to prolonged pain is not known. Objectives: This study assessed whether progressively developing sustained experimentally induced muscle pain impacts JPS in healthy individuals. Methods: Twenty-eight healthy individuals received injection of nerve growth factor (NGF) into the right extensor carpi radialis brevis muscle on days 0 and 2 to induce sustained pain and hyperalgesia. Wrist JPS was assessed 2 days before day 0 (day −2), before the injection on days 0 and 2, and on days 4 and 14. Joint position sense was quantified as the ability to return the wrist to a neutral position following movements in the direction of radial and ulnar deviation. A 3-dimensional motion analysis system was used to calculate absolute, relative, and joint-angle repositioning errors. Numerical rating scale scores of pain intensity, body chart pain drawings, and pressure pain thresholds (PPTs) were recorded on each day. Results: Compared with baseline, pressure pain thresholds decreased while pain intensity and area increased at day 2 (P < 0.001) and day 4 (P < 0.001) before returning to baseline on day 14 (P > 0.13). Relative to day 0, there was no change in wrist JPS at day 2, 4, and 14 following movements in either target direction (P > 0.05). Conclusion: Despite the presence of sustained muscle pain and hyperalgesia for 4 days at the elbow, no statistical change in wrist joint position error was observed. These findings suggest that pain and hyperalgesia lasting as long as 4 days does not impair JPS.
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Single leg landing kinematics in volleyball athletes: A comparison between athletes with and without active extension low back pain. J Bodyw Mov Ther 2019; 23:924-929. [DOI: 10.1016/j.jbmt.2019.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 01/26/2019] [Accepted: 01/27/2019] [Indexed: 01/23/2023]
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Relationship Between Proprioception and Pain and Disability in People With Non-Specific Low Back Pain: A Systematic Review With Meta-Analysis. Spine (Phila Pa 1976) 2019; 44:E606-E617. [PMID: 30726200 DOI: 10.1097/brs.0000000000002917] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Systematic review with meta-analysis. OBJECTIVE To examine the association between proprioception and pain and disability in people with non-specific low back pain (NSLBP) and the impact of potential moderators on the strength of the association. SUMMARY OF BACKGROUND DATA NSLBP is a common musculoskeletal disorder and a leading cause of disability. Proprioception deficit has been associated with low back pain and correlated with pain and disability; however, the correlation coefficients presented are conflicting. METHODS Systematic literature search was performed in eight databases and Google scholar. Two independent reviewers assessed the literature and extracted data. Data of interest included participant characteristics of NSLBP group, pain and disability, proprioception test protocol, and the correlation coefficient between proprioception and pain/disability. Meta-analysis of data from homogeneous studies was performed according to proprioception test methods. Subgroup of movement directions was analyzed. The methodological quality of studies was assessed. RESULTS The literature search identified 3067 records of which 14 studies were included for meta-analysis. Proprioception was measured by active joint repositioning sense (AJRS), passive joint repositioning sense (PJRS), and threshold to detect passive motion (TTDPM). Meta-analysis revealed no significant correlation coefficient between any proprioception measures and pain or disability (P > 0.05). The subgroup analysis showed little correlation between absolute error (AE) of passive lumbar flexion and pain (r = 0.225, 95% CI 0.040-0.395), and between AE of passive lumbar extension and disability (r = 0.196, 95%CI 0.010-0.369). CONCLUSION AJRS and TTDPM are not correlated with pain and disability in people with NSLBP. The AE of passive lumbar movement is correlated to a small degree with pain and disability. However, the degree of correlation is small and should be interpreted with caution. Therefore, the differences in proprioception observed between people with pain and people without pain seem to be independent of the symptoms. LEVEL OF EVIDENCE 1.
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Pain and Pain-Related Disability Associated With Proprioceptive Impairment in Chronic Low Back Pain Patients: A Systematic Review. J Manipulative Physiol Ther 2019; 42:210-217. [DOI: 10.1016/j.jmpt.2018.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 08/05/2018] [Accepted: 10/21/2018] [Indexed: 12/27/2022]
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Korakakis V, O’Sullivan K, Sotiralis Y, Karanasios S, Sideris V, Sideris A, Sakellariou K, Giakas G. Evaluation of the within- and between-day intra-tester and inter-tester reliability of positioning subjects into neutral and lordotic sitting postures. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2018. [DOI: 10.1080/21679169.2018.1503719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Vasileios Korakakis
- Faculty of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece
| | - Kieran O’Sullivan
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Faculty of Education and Health Sciences, University of Limerick, School of Allied Health, Limerick, Ireland
| | - Yiannis Sotiralis
- Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece
| | | | - Vasilis Sideris
- Faculty of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
- Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Alexandros Sideris
- Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece
| | | | - Giannis Giakas
- Faculty of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
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Gumina S, Camerota F, Celletti C, Venditto T, Candela V. The effects of rotator cuff tear on shoulder proprioception. INTERNATIONAL ORTHOPAEDICS 2018; 43:229-235. [DOI: 10.1007/s00264-018-4150-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/06/2018] [Indexed: 12/19/2022]
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Repeated end range spinal movement while seated abolishes the proprioceptive deficit induced by prolonged flexed sitting posture. A study assessing the statistical and clinical significance of spinal position sense. Musculoskelet Sci Pract 2017. [PMID: 28624723 DOI: 10.1016/j.msksp.2017.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Sustained spinal flexion has been proposed to affect the properties of spinal tissues, increase postural muscle's activation latency and act detrimentally on proprioception. OBJECTIVES This study evaluated the effect of flexed posture (FP) on spinal proprioception and assessed the immediate effect of spinal movement on the presumable flexion-induced proprioceptive deficit. DESIGN Clinical measurement study. METHODS Marker-based kinematic analyses of the head, spine, and pelvis were conducted on 50 individuals. Subjects were educated in a lordotic sitting posture (IOSP) that they reproduced immediately; after 10 and 30 min in FP; and after sagittal spinal movement. Nine sagittal angles were calculated. Absolute error (AE) and constant error (CE) were used to evaluate repositioning accuracy. Repeated measures ANOVA was used to test for significant differences in angles obtained among postures, as well as for the AE and CE calculated from the trials. RESULTS No significant differences were found in reposition error (RE) after immediate reproduction of IOSP (all p > 0.0083). Following FP AEs presented significant differences for head (4.1°), head protraction (1.9°), head tilt (2.1°), lumbar (3.2°) and pelvis angle (2.1°). CEs revealed significant differences for head protraction (-1.8°) and lumbar angle (-3.5°). No significant differences were found for AE and CE after spinal sagittal movement (all p > 0.0083). CONCLUSIONS Prolonged FP can affect spinal position sense, but sagittal spinal movement can abolish the proprioceptive deficit. The significant differences documented, may be of limited clinical utility given their magnitude, and the reliability data presented may be of use in reinterpreting previously documented proprioceptive analyses.
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February 2017 Letter to the Editor-in-Chief. J Orthop Sports Phys Ther 2017; 47:126-129. [PMID: 28142370 DOI: 10.2519/jospt.2017.0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Letter to the Editor-in-Chief of JOSPT as follows: "Regarding the Complexity of Low Back Pain" with Authors' Response J Orthop Sports Phys Ther 2017;47(2):126-129. doi:10.2519/jospt.2017.0201.
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Is There a Relationship Between Lumbar Proprioception and Low Back Pain? A Systematic Review With Meta-Analysis. Arch Phys Med Rehabil 2016; 98:120-136.e2. [PMID: 27317866 DOI: 10.1016/j.apmr.2016.05.016] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 04/08/2016] [Accepted: 05/16/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To systematically review the relationship between lumbar proprioception and low back pain (LBP). DATA SOURCES Four electronic databases (PubMed, EMBASE, CINAHL, SPORTDiscus) and reference lists of relevant articles were searched from inception to March-April 2014. STUDY SELECTION Studies compared lumbar proprioception in patients with LBP with controls or prospectively evaluated the relationship between proprioception and LBP. Two reviewers independently screened articles and determined inclusion through consensus. DATA EXTRACTION Data extraction and methodologic quality assessment were independently performed using standardized checklists. DATA SYNTHESIS Twenty-two studies (1203 participants) were included. Studies measured lumbar proprioception via active or passive joint repositioning sense (JRS) or threshold to detection of passive motion (TTDPM). Data from 17 studies were pooled for meta-analyses to compare patients with controls. Otherwise, descriptive syntheses were performed. Data were analyzed according to measurement method and LBP subgroup. Active JRS was worse in patients compared with controls when measured in sitting (standard mean difference, .97; 95% confidence interval [CI], .31-1.64). There were no differences between groups measured via active JRS in standing (standard mean difference, .41; 95% CI, -.07 to .89) or passive JRS in sitting (standard mean difference, .38; 95% CI, -.83 to 1.58). Patients in the O'Sullivan flexion impairment subgroup had worse proprioception than the total LBP cohort. The TTDPM was significantly worse in patients than controls. One prospective study found no link between lumbar proprioception and LBP. CONCLUSIONS Patients with LBP have impaired lumbar proprioception compared with controls when measured actively in sitting positions (particularly those in the O'Sullivan flexion impairment subgroup) or via TTDPM. Clinicians should consider the relationship between sitting and proprioception in LBP and subgroup patients to guide management. Further studies focusing on subgroups, longitudinal assessment, and improving proprioception measurement are needed.
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Neck Pain and Proprioception Revisited Using the Proprioception Incongruence Detection Test. Phys Ther 2016; 96:671-8. [PMID: 26405091 DOI: 10.2522/ptj.20150210] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 09/13/2015] [Indexed: 02/09/2023]
Abstract
BACKGROUND Proprioceptive imprecision is believed to contribute to persistent pain. Detecting imprecision in order to study or treat it remains challenging given the limitations of current tests. OBJECTIVES The aim of this study was to determine whether proprioceptive imprecision could be detected in people with neck pain by testing their ability to identify incongruence between true head motion and a false visual reference using the Proprioception Incongruence Detection (PID) Test. DESIGN A cross-sectional study was conducted. METHODS Twenty-four people with neck pain and 24 matched controls repeatedly rotated to specific markers within a virtual world and indicated if their true head rotation was more or less than the rotation suggested by the visual feedback. Visual feedback was manipulated at 6 corrections, ranging from 60% of true movement to 140% of true movement. A standard repositioning error (RPE) test as undertaken for comparison. RESULTS Healthy controls were better able to detect incongruence between vision and true head rotation (X̅=75.6%, SD=8.5%) than people with neck pain were (X̅=69.6%, SD=12.7%). The RPE test scores were not different between groups. The PID Test score related to self-reported pain intensity but did not relate to RPE test score. LIMITATIONS Causality cannot be established from this cross-sectional study, and further work refining the PID Test is needed for it to offer clinical utility. CONCLUSIONS Proprioceptive precision for neck movement appears worse in people with neck pain than in those without neck pain, and the extent of the deficit appears to be related to usual pain severity. The PID Test appears to be a more sensitive test than the RPE test and is likely to be useful for assessment of proprioceptive function in research and clinical settings.
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Kienbacher T, Fehrmann E, Habenicht R, Koller D, Oeffel C, Kollmitzer J, Mair P, Ebenbichler G. Age and gender related neuromuscular pattern during trunk flexion-extension in chronic low back pain patients. J Neuroeng Rehabil 2016; 13:16. [PMID: 26896325 PMCID: PMC4759955 DOI: 10.1186/s12984-016-0121-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 02/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The root mean square surface electromyographic activity of lumbar extensor muscles during dynamic trunk flexion and extension from standing has repeatedly been recommended to objectively assess muscle function in chronic low back pain patients. However, literature addressing older patients is sparse. This cross sectional study sought to examine differences in neuromuscular activation between age groups (>60 versus 40-60 versus <40 years) and sexes during a standardized trunk flexion-extension task. METHODS A total of 216 patients (62 older, 84 middle-aged, 70 younger) performed maximum trunk extensions followed by trunk flexion extension testing thereby holding static positions at standing, half, and full trunk flexion. The lumbar extensor muscle activity and 3d-accelerometric signals intended to monitor hip and trunk position angles were recorded from the L5 (multifidus) and T4 (semispinalis thoracis) levels. Permutation ANOVA with bootstrapped confidence intervals were performed to examine for age and gender related differences. Ridge-regressions investigated the impact of physical-functional and psychological variables to the half flexion relaxation ratio (i.e. muscle activity at the half divided by that in maximum flexion position). RESULTS Maximum back extension torque was slightly but significantly higher in youngest compared to oldest patients if male and females were pooled. Normalized RMS-SEMG revealed highest lumbar extensor muscle activity at standing in the oldest and the female groups. Patients over 60 years showed lowest activity changes from standing to half (increments) and from half to the maximum flexion position (decrements) leading to a significantly lower half flexion relaxation ratio compared to the youngest patients. These oldest patients demonstrated the highest hip and lowest lumbothoracic changes of position angles. Females had higher regional hip and gross trunk ranges of movement compared to males. Lumbothoracic flexion and the muscle activity at standing had a significant impact on the half flexion relaxation ratio. CONCLUSIONS The neuromuscular activation pattern and the kinematics in this trunk flexion-extension task involving static half flexion position changed according to age and sex. The test has a good potential to discriminate between impaired and unimpaired neuromuscular regulation of back extensors in cLBP patients, thereby allowing the design of more individualized exercise programs.
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Affiliation(s)
- Thomas Kienbacher
- Karl-Landsteiner-Institute for outpatient rehabilitation research, Vienna, Austria.
| | - Elisabeth Fehrmann
- Karl-Landsteiner-Institute for outpatient rehabilitation research, Vienna, Austria.
| | - Richard Habenicht
- Karl-Landsteiner-Institute for outpatient rehabilitation research, Vienna, Austria.
| | - Daniela Koller
- Karl-Landsteiner-Institute for outpatient rehabilitation research, Vienna, Austria. .,University of biomedical engineering, Vienna, Austria.
| | - Christian Oeffel
- Karl-Landsteiner-Institute for outpatient rehabilitation research, Vienna, Austria. .,University of biomedical engineering, Vienna, Austria.
| | - Josef Kollmitzer
- Karl-Landsteiner-Institute for outpatient rehabilitation research, Vienna, Austria. .,Technical school of engineering, Vienna, Austria. .,University of biomedical engineering, Vienna, Austria.
| | - Patrick Mair
- Karl-Landsteiner-Institute for outpatient rehabilitation research, Vienna, Austria. .,Department of psychology, Harvard University, Cambridge, MA, USA.
| | - Gerold Ebenbichler
- Karl-Landsteiner-Institute for outpatient rehabilitation research, Vienna, Austria. .,Department of physical medicine and rehabilitation, Medical University of Vienna, Vienna, Austria.
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Rethinking design parameters in the search for optimal dynamic seating. J Bodyw Mov Ther 2015; 19:291-303. [DOI: 10.1016/j.jbmt.2014.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 07/07/2014] [Accepted: 07/10/2014] [Indexed: 11/22/2022]
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Roosink M, McFadyen BJ, Hébert LJ, Jackson PL, Bouyer LJ, Mercier C. Assessing the perception of trunk movements in military personnel with chronic non-specific low back pain using a virtual mirror. PLoS One 2015; 10:e0120251. [PMID: 25799009 PMCID: PMC4370585 DOI: 10.1371/journal.pone.0120251] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 01/31/2015] [Indexed: 12/19/2022] Open
Abstract
Chronic pain, including chronic non-specific low back pain (CNSLBP), is often associated with body perception disturbances, but these have generally been assessed under static conditions. The objective of this study was to use a "virtual mirror" that scaled visual movement feedback to assess body perception during active movement in military personnel with CNSLBP (n = 15) as compared to military healthy control subjects (n = 15). Subjects performed a trunk flexion task while sitting and standing in front of a large screen displaying a full-body virtual mirror-image (avatar) in real-time. Avatar movements were scaled to appear greater, identical, or smaller than the subjects' actual movements. A total of 126 trials with 11 different scaling factors were pseudo-randomized across 6 blocks. After each trial, subjects had to decide whether the avatar's movements were "greater" or "smaller" than their own movements. Based on this two-alternative forced choice paradigm, a psychophysical curve was fitted to the data for each subject, and several metrics were derived from this curve. In addition, task adherence (kinematics) and virtual reality immersion were assessed. Groups displayed a similar ability to discriminate between different levels of movement scaling. Still, subjects with CNSLBP showed an abnormal performance and tended to overestimate their own movements (a right-shifted psychophysical curve). Subjects showed adequate task adherence, and on average virtual reality immersion was reported to be very good. In conclusion, these results extend previous work in patients with CNSLBP, and denote an important relationship between body perception, movement and pain. As such, the assessment of body perception during active movement can offer new avenues for understanding and managing body perception disturbances and abnormal movement patterns in patients with pain.
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Affiliation(s)
- Meyke Roosink
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, Québec, Canada
| | - Bradford J. McFadyen
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, Québec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Luc J. Hébert
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, Québec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec, Québec, Canada
- Canadian Forces Health Services Group Headquarters, Directorate of Medical Policy (Physiotherapy), Valcartier Garrison, Québec, Québec, Canada
- Department of Radiology, Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Philip L. Jackson
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, Québec, Canada
- School of Psychology, Laval University, Québec, Québec, Canada
| | - Laurent J. Bouyer
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, Québec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Catherine Mercier
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, Québec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec, Québec, Canada
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Measuring lumbar reposition accuracy in patients with unspecific low back pain: systematic review and meta-analysis. Spine (Phila Pa 1976) 2015; 40:E97-E111. [PMID: 25575094 DOI: 10.1097/brs.0000000000000677] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Systematic review and meta-analysis. OBJECTIVE To evaluate if patients with nonspecific chronic low back pain (NSCLBP) show a greater lumbar reposition error (RE) than healthy controls. SUMMARY OF BACKGROUND DATA Studies on lumbar RE in patients with NSCLBP present conflicting results. METHODS A systematic review and meta-analysis of the available literature were performed to evaluate differences in RE between patients with NSCLBP and healthy controls. Data on absolute error, constant error (CE), and variable error were extracted and effect sizes (ESs) were calculated. For the CE flexion pattern and active extension pattern, subgroups of patients with NSCLBP were analyzed. Results of homogeneous studies were pooled. Measurement protocols and study outcomes were compared. The quality of reporting and the authors' appraisal of risk of bias were investigated. RESULTS The original search revealed 178 records of which 13 fulfilled the inclusion criteria. The majority of studies showed that patients with NSCLBP produced a significantly larger absolute error (ES, 0.81; 95% confidence interval [95% CI], 0.13-1.49) and variable error (ES, 0.57; 95% CI, 0.05-1.09) compared with controls. CE is direction specific in flexion and active extension pattern subgroups of patients with NSCLBP (ES, 0.39; 95% CI, -1.09 to 0.3) and ES, 0.18; 95% CI, -0.3 to 0.65, respectively). The quality of reporting and the authors' appraisal of risk of bias varied considerably. The applied test procedures and instrumentation varied between the studies, which hampered the comparability of studies. CONCLUSION Although patients with NSCLBP seemed to produce a larger lumbar RE compared with healthy controls, study limitations render firm conclusions unsafe. Future studies should pay closer attention to power, precision, and reliability of the measurement approach, definition of outcome measures, and patient selection. We recommend a large, well-powered, prospective randomized control study that uses a standardized measurement approach and definitions for absolute error, CE, and variable error to address the hypothesis that proprioception may be impaired with CLBP.
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Noh KH, Oh JS, Yoo WG. Comparison of lumbar repositioning error according to different lumbar angles in a flexion pattern (FP) subgroup of patients with non-specific chronic low back pain. J Phys Ther Sci 2015; 27:293-4. [PMID: 25642094 PMCID: PMC4305585 DOI: 10.1589/jpts.27.293] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 08/24/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study determined the change in lumbar position sense according to lumbar
angles in a flexion pattern (FP) subgroup of patients with non-specific chronic low back
pain (NCSLBP). [Subjects] Thirteen subjects with FP low back pain participated. [Methods]
The lumbar repositioning error (RE) of subjects was measured between a neutral starting
position and re-position phases at three angles, in sitting and standing upright
positions. [Results] Lumbar RE was significantly greater during lumbar flexion at a 30°
angle in the sitting position than in the other tasks. [Conclusion] In the flexion-related
subgroup, the lumbar RE measurement may be a more sensitive evaluation method using a
lumbar flexion angle of 30° while in the sitting position, compared with other angles in
sitting or standing positions.
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Affiliation(s)
- Kyung-Hee Noh
- Department of Rehabilitation Science, Graduate School, Inje University, Republic of Korea
| | - Jae-Seop Oh
- Department of Physical Therapy, College of Biomedical Science and engineering, Inje University, Republic of Korea
| | - Won-Gyu Yoo
- Department of Physical Therapy, College of Biomedical Science and engineering, Inje University, Republic of Korea
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Sole G, Osborne H, Wassinger C. The effect of experimentally-induced subacromial pain on proprioception. ACTA ACUST UNITED AC 2014; 20:166-70. [PMID: 25261091 DOI: 10.1016/j.math.2014.08.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 08/02/2014] [Accepted: 08/26/2014] [Indexed: 02/06/2023]
Abstract
Shoulder injuries may be associated with proprioceptive deficits, however, it is unknown whether these changes are due to the experience of pain, tissue damage, or a combination of these. The aim of this study was to investigate the effect of experimentally-induced sub-acromial pain on proprioceptive variables. Sub-acromial pain was induced via hypertonic saline injection in 20 healthy participants. Passive joint replication (PJR) and threshold to detection of movement direction (TTDMD) were assessed with a Biodex System 3 Pro isokinetic dynamometer for baseline control, experimental pain and recovery control conditions with a starting position of 60° shoulder abduction. The target angle for PJR was 60° external rotation, starting from 40°. TTDMD was tested from a position of 20° external rotation. Repeated measures ANOVAs were used to determine differences between PJR absolute and variable errors and TTDMD for the control and experimental conditions. Pain was elicited with a median 7 on the Numeric Pain Rating Scale. TTDMD was significantly decreased for the experimental pain condition compared to baseline and recovery conditions (≈30%, P = 0.003). No significant differences were found for absolute (P = 0.152) and variable (P = 0.514) error for PJR. Movement sense was enhanced for the experimental sub-acromial pain condition, which may reflect protective effects of the central nervous system in response to the pain. Where decreased passive proprioception is observed in shoulders with injuries, these may be due to a combination of peripheral tissue injury and neural adaptations that differ from those due to acute pain.
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Affiliation(s)
- Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, University of Otago, New Zealand.
| | | | - Craig Wassinger
- Department of Physical Therapy, East Tennessee State University, USA
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Fyhr C, Gustavsson L, Wassinger C, Sole G. The effects of shoulder injury on kinaesthesia: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2014; 20:28-37. [PMID: 25241661 DOI: 10.1016/j.math.2014.08.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 08/08/2014] [Accepted: 08/26/2014] [Indexed: 11/16/2022]
Abstract
The aim of this systematic review was to synthesize the evidence for changes for proprioceptive variables consisting of movement and position sense in participants with glenohumeral musculoskeletal disorders. Five databases were searched until 13th August 2013. Methodological quality was assessed and meta-analyses were performed for active and passive joint reposition sense (AJPS and PJPS) and movement sense, determined with threshold to detection of passive motion (TTDPM). The search yielded 17 studies, four of which were classified as having high methodological quality, seven as moderate and six as low quality. For participants with post-traumatic glenohumeral instability, pooled findings indicate moderate evidence for higher TTDPM for involved shoulders compared to control groups and the contralateral uninvolved side, indicating decreased movement sense. For AJPS and PJPS there was moderate to limited evidence for significant increased errors for involved compared to uninvovled shoulders, but not when compared to the control groups. Limited evidence was found for decreased AJPS acuity for patients with chronic rotator cuff pain and for patients with unspecified shoulder pain compared to healthy controls. Movement sense is most likely to be impaired after shoulder injury involving post-traumatic instability when compared to the contralateral shoulder and to controls, while deficits for AJPS and PJPS are more likely to be evident compared to the contralateral shoulder in participants with glenohumeral musculoskeletal disorders.
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Affiliation(s)
- Charlotte Fyhr
- Institution of Community Medicine and Rehabilitation, Physiotherapy, University of Umeå, Sweden
| | - Linnéa Gustavsson
- Institution of Community Medicine and Rehabilitation, Physiotherapy, University of Umeå, Sweden
| | - Craig Wassinger
- Department of Physical Therapy, East Tennessee State University, USA
| | - Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand.
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Laird RA, Gilbert J, Kent P, Keating JL. Comparing lumbo-pelvic kinematics in people with and without back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord 2014; 15:229. [PMID: 25012528 PMCID: PMC4096432 DOI: 10.1186/1471-2474-15-229] [Citation(s) in RCA: 245] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 07/01/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Clinicians commonly examine posture and movement in people with the belief that correcting dysfunctional movement may reduce pain. If dysfunctional movement is to be accurately identified, clinicians should know what constitutes normal movement and how this differs in people with low back pain (LBP). This systematic review examined studies that compared biomechanical aspects of lumbo-pelvic movement in people with and without LBP. METHODS MEDLINE, Cochrane Central, EMBASE, AMI, CINAHL, Scopus, AMED, ISI Web of Science were searched from inception until January 2014 for relevant studies. Studies had to compare adults with and without LBP using skin surface measurement techniques to measure lumbo-pelvic posture or movement. Two reviewers independently applied inclusion and exclusion criteria, and identified and extracted data. Standardised mean differences and 95% confidence intervals were estimated for group differences between people with and without LBP, and where possible, meta-analyses were performed. Within-group variability in all measurements was also compared. RESULTS The search identified 43 eligible studies. Compared to people without LBP, on average, people with LBP display: (i) no difference in lordosis angle (8 studies), (ii) reduced lumbar ROM (19 studies), (iii) no difference in lumbar relative to hip contribution to end-range flexion (4 studies), (iv) no difference in standing pelvic tilt angle (3 studies), (v) slower movement (8 studies), and (vi) reduced proprioception (17 studies). Movement variability appeared greater for people with LBP for flexion, lateral flexion and rotation ROM, and movement speed, but not for other movement characteristics. Considerable heterogeneity exists between studies, including a lack of detail or standardization between studies on the criteria used to define participants as people with LBP (cases) or without LBP (controls). CONCLUSIONS On average, people with LBP have reduced lumbar ROM and proprioception, and move more slowly compared to people without LBP. Whether these deficits exist prior to LBP onset is unknown.
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Affiliation(s)
- Robert A Laird
- Department of Physiotherapy, Monash University, PO Box 527, Frankston, VIC 3199, Australia
- 7 Kerry Rd, Warranwood, Melbourne, VIC 3134, Australia
| | - Jayce Gilbert
- Peak MSK Physiotherapy, Suite 4/544 Hampton St, Hampton, VIC 3188, Australia
| | - Peter Kent
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense 5230, Denmark
- Research Department, Spine Centre of Southern Denmark, Lillebaelt Hospital, Institute of Regional Health Services Research, University of Southern Denmark, Middelfart 5500, Denmark
| | - Jennifer L Keating
- Department of Physiotherapy, Monash University, PO Box 527, Frankston, VIC 3199, Australia
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Curran M, Dankaerts W, O'Sullivan P, O'Sullivan L, O'Sullivan K. The effect of a backrest and seatpan inclination on sitting discomfort and trunk muscle activation in subjects with extension-related low back pain. ERGONOMICS 2014; 57:733-43. [PMID: 24670078 DOI: 10.1080/00140139.2014.897378] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Few studies have demonstrated that seating modifications reduce low back pain (LBP). One recent study found that a forward-inclined seatpan reduced low back discomfort (LBD), however this was only examined in people with flexion-related LBP. No study has yet investigated its effectiveness among people with extension-related LBP. This crossover study examined 12 subjects with extension-related LBP. Sitting discomfort and surface electromyography of three trunk muscles were recorded during a 10-minute typing task while sitting with two different seatpan inclinations, both with and without a backrest. LBD (p < 0.001) and overall body discomfort (OBD) (p = 0.016) were significantly greater on the forward-inclined seatpan. The backrest did not alter trunk muscle activation or sitting discomfort. The results demonstrate that in a specific subgroup of people with extension-related LBP, increasing forward seatpan inclination significantly increased LBD and OBD. Future research should consider matching ergonomics prescriptions according to the individual presentation of people with LBP.
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Affiliation(s)
- Máire Curran
- a Department of Clinical Therapies, University of Limerick , Limerick , Ireland
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