Sensorimotor and Body Perception Assessments of Chronic Nonspecific Low Back Pain: A Case-Control Study
Abstract Background: Low back pain is one of the most common musculoskeletal disorders. It leads to major costs in health care systems and causes significant personal and social burdens. Current research focuses on the processes of the central nervous system such as cortical changes in pain perception to discover new and more efficient ways to treat chronic low back pain (CLBP). Several clinical tests have been suggested that might correlate with altered cortical representation. These include back-photo assessment (BPA), movement control tests (MCI) and two-point discrimination thresholds (TPD).Objective: The aim of this study was to determine whether BPA, MCI and TPD tests can discriminate between CLBP patients with altered body perception and healthy controls.Design: A case-control study matched by gender and age.Methods: Using MCI, BPA and TPD tests on the lower back, thirty patients with CLBP and thirty healthy controls were investigated at one point in time. Participants were also required to complete three questionnaires: the ‘Fear Avoidance Belief Questionnaire’, the ‘Hospital Anxiety and Depression Scale’ and the ‘Fremantle Back Awareness Questionnaire’. Correlations among the main covariates and odds ratios for group differences were calculated.Results: The MCI showed a statistically significant odds ratio for the presence of CLBP of 0.65 (p< 0.05), whereas TPD and BPA did not determine differences between the groups.Conclusion: The movement control test was found to be the only suitable test to discriminate CLBP patients from healthy controls.Trial registration: The study was approved by the Swiss Ethical Commission Northwest and Central Switzerland (EKNZ) and registered at 21.8.2015, reference number 2015-243.