Fear of movement is not associated with trunk movement variability during gait in patients with low back pain

Purpose To identify impaired trunk movement during work-related activity in individuals with low back pain (LBP) and investigate whether abnormalities were caused by generalized fear of movement-related pain. Methods This cross-sectional study was conducted at a hospital in Japan. We recruited 35 participants with LBP (LBP group; 26 males, 9 females) and 20 healthy controls (HC group) via posters at our hospital. The task required lifting an object. We used a 3D motion capture system to calculate the peak angular velocity of trunk flexion and extension during a lifting task. Pain-related factors for the LBP group were assessed using the visual analogue scale (VAS) for pain intensity over the past 4 weeks and during the task, the Tampa Scale for Kinesiophobia (TSK), the Pain Catastrophizing Scale (PCS), and the Pain Anxiety Symptoms Scale-20 (PASS-20). We compared kinematic variables between groups with a generalized linear mixed model and investigated the relationship between kinematic variables, VAS scores, and psychological factors by performing a mediation analysis. Results The peak angular velocity of trunk extension showed significant main effects on the group factors (LBP group vs. HC group) and their interactions; the value of the kinematic variable was lower at Trial 1 in the LBP group. No LBP participant reported pain during the experiment. The mediation analysis revealed that the relationship between the VAS score for pain intensity over the past 4 weeks and the peak angular velocity of trunk extension in the first trial was completely mediated by the TSK (complete mediation model, 95% bootstrapped CI: 0.07–0.56). Conclusion Individuals with LBP had reduced trunk extension during a lifting task. Generalized fear of movement-related pain may contribute to such impaired trunk movement. Our findings suggest that intervention to ameliorate fear of movement may be needed to improve LBP-associated disability.

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Gait kinematics in Low Back Pain: A non-linear approach

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200260 ◽

2021 ◽

pp. 1-8

Author(s):

Christos Tsigkanos ◽

Theano Demestiha ◽

Chara Spiliopoulou ◽

Georgios Tsigkanos

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Healthy Subjects ◽

Infrared Camera ◽

Low Back ◽

Movement Variability ◽

Optoelectronic System ◽

Mean Values ◽

Non Linear ◽

Healthy Participants

BACKGROUND: Kinematic analysis has been a dominant tool for addressing the neuromuscular and proprioceptive alterations that occur in Low Back Pain (LBP) patients. Movement variability is a crucial component of this analysis. During the past years a promising approach appears to be the application of non-linear indices. OBJECTIVE: The aim of the study was to compare movement variability, as expressed mainly by non-linear indices, at the pelvis and lumbar between LBP patients and healthy participants during gait. METHODS: Sixteen (16) LBP patients and thirteen (13) healthy control subjects (non-athletes) participated in the study. Participants walked on a treadmill at different walking conditions while recorded by a 6-infrared camera optoelectronic system. Kinematic variability of pelvic and lumbar movement was analyzed using linear (standard deviation) and non-linear indices (Maximal Lyapunov Exponent – LyE and Approximate Entropy – ApEn). RESULTS: Healthy subjects were found to have significantly greater mean values than LBP patients at seven pelvic and lumbar components in LyE, ApEn and SD. Specifically, the calculated LyE at the pelvis during normal gait was proven to have a sensitivity of 92.3% and a specificity of 90% in the discrimination of healthy subjects from LBP patients. Female subjects presented with higher variability in gait measures than males. CONCLUSION: Healthy participants presented with higher movement variability in their kinematic behavior in comparison to LBP patients. Lower variability values may be partly explained by the attempt of LBP patients to avoid painful end of range of motion positions. In this perspective non-linear indices seem to relate to qualitive characteristics of movement that need to be taken into consideration during rehabilitation.

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Fear of Movement/(Re)Injury Predicting Chronic Disabling Low Back Pain: A Prospective Inception Cohort Study

Spine ◽

10.1097/01.brs.0000203709.65384.9d ◽

2006 ◽

Vol 31 (6) ◽

pp. 658-664 ◽

Cited By ~ 113

Author(s):

Ilse E. J. Swinkels-Meewisse ◽

Jeffrey Roelofs ◽

Erik G. W. Schouten ◽

André L. M. Verbeek ◽

Rob A. B. Oostendorp ◽

...

Keyword(s):

Cohort Study ◽

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Inception Cohort ◽

Fear Of Movement

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The Role of Fear of Movement and Injury in Selective Attentional Processing in Patients with Chronic Low Back Pain: A Dot-Probe Evaluation

Journal of Pain ◽

10.1016/j.jpain.2004.12.011 ◽

2005 ◽

Vol 6 (5) ◽

pp. 294-300 ◽

Cited By ~ 60

Author(s):

Jeffrey Roelofs ◽

Madelon L. Peters ◽

Thijs Fassaert ◽

Johan W.S. Vlaeyen

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Low Back ◽

Dot Probe ◽

Attentional Processing ◽

Fear Of Movement

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Movement variability in adults with low back pain during sit-to-stand-to-sit

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2018.07.011 ◽

2018 ◽

Vol 58 ◽

pp. 90-95 ◽

Cited By ~ 8

Author(s):

Patrick Ippersiel ◽

Shawn Robbins ◽

Richard Preuss

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Low Back ◽

Movement Variability ◽

Sit To Stand

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Associations between the severity of disability level and fear of movement and pain beliefs in patients with chronic low back pain

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-171039 ◽

2020 ◽

Vol 33 (5) ◽

pp. 785-791 ◽

Cited By ~ 1

Author(s):

Nuray Alaca ◽

Hande Kaba ◽

Ayce Atalay

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Behavioral Therapy ◽

Short Form ◽

Low Back ◽

Pain Beliefs ◽

Fear Of Movement ◽

Severity Of Disability ◽

The Impact

BACKGROUND AND OBJECTIVES: Low back pain (LBP) is one of the leading forms of chronic pain and is among the leading causes of pain and disability. In this study, we investigated the associations between the severity of disability and fear of movement and pain beliefs as well as the impact of the fear of movement and pain beliefs on the quality of life in patients with chronic LBP. METHODS: A total of 89 patients (42.29 ± 16.05 years) with chronic low back pain were included in the study. The instruments used in the assessments include the Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), the Tampa Kinesiophobia Scale (TKS), the Pain Belief Questionnaire (PBQ), and the SF 36-Short Form. Patients were assigned into three groups by disability severity based on ODI scores. Statistical analysis was performed using SPSS 15. RESULTS: No statistically significant intergroup differences were found in TKS and PBQ scores (p> 0.05). A positive correlation was found between TKS scores, age (r: 0.227/p< 0.05), PBQ organic (r: -0.250/p< 0.05) scores. CONCLUSIONS: Our study revealed high levels of kinesiophobia and similar pain beliefs, independent of the severity level of disability. We believe that cognitive-behavioral therapy that may reduce fear-avoidance behaviors and convert negative pain beliefs into positive ones should be added to rehabilitation procedures for LBP.

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