Changes in Trunk Variability and Stability of Gait in Patients with Chronic Low Back Pain: Impact of Laboratory Versus Daily-living Environments
Abstract This study investigated the impact of environment and pathology in trunk variability and stability of gait among individuals with CLBP. CLBP patients (n = 20) and healthy controls (HC) with no LBP history (n = 20) attached an accelerometer to the low back and performed gait in laboratory and daily-living settings. We calculated stride-to-stride standard deviation (SD) and multiscale sample entropy (MSE) as “gait variability” and maximum Lyapunov exponents (LyE) as “gait stability” in both the anterior-posterior (AP) and medial-lateral (ML) directions. In repeated-measures ANOVA, SD was affected by environment in the AP direction and by group and environment in the ML direction. MSE showed no effect in the AP direction and both effects in the ML direction. LyE showed both effects in the AP direction, but none in the ML direction. These change of trunk motor control by LBP have a relation to pain intensity, fear of movement and/or RMDQ in the daily-living but not laboratory settings. Evaluation of adaptation to environment in CLBP will enhance our understanding of changes in sensory-motor control and contribute to optimal management of such patients.