scholarly journals Can We Identify Subgroups of Patients with Chronic Low Back Pain Based on Motor Variability? A Systematic Scoping Review

Biomechanics ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 358-370
Author(s):  
Lars Dijk ◽  
Marika T. Leving ◽  
Michiel F. Reneman ◽  
Claudine J. C. Lamoth
Keyword(s):  
Low Back Pain ◽  
Motor Control ◽  
Back Pain ◽  
Longitudinal Studies ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Theoretical Frameworks ◽  
Cross Sectional ◽  
Motor Variability ◽  
The Relationship

The identification of homogeneous subgroups of patients with chronic low back pain (CLBP), based on distinct patterns of motor control, could support the tailoring of therapy and improve the effectiveness of rehabilitation. The purpose of this review was (1) to assess if there are differences in motor variability between patients with CLBP and pain-free controls, as well as inter-individually among patients with CLBP, during the performance of functional tasks; and (2) to examine the relationship between motor variability and CLBP across time. A literature search was conducted on the electronic databases Pubmed, EMBASE, and Web of Science, including papers published any time up to September 2021. Two reviewers independently screened the search results, assessed the risk of bias, and extracted the data. Twenty-two cross-sectional and three longitudinal studies investigating motor variability during functional tasks were examined. There are differences in motor variability between patients with CLBP and pain-free controls during the performance of functional tasks, albeit with discrepant results between tasks and among studies. The longitudinal studies revealed the persistence of motor control changes following interventions, but the relationship between changes in motor variability and reduction in pain intensity was inconclusive. Based on the reviewed literature, no stratification of homogeneous subgroups into distinct patterns of motor variability in the CLBP population could be made. Studies diverged in methodologies and theoretical frameworks and in metrics used to assess and interpret motor variability. In the future, more large-sample studies, including longitudinal designs, are needed, with standardized metrics that quantify motor variability to fill the identified evidence gaps.

scholarly journals The Relationship between Cross Sectional Area and Strength of Back Muscles in Patients with Chronic Low Back Pain

2012 ◽  
Vol 36 (2) ◽  
pp. 173 ◽  
Author(s):  
Ho Jun Lee ◽  
Woo Hyun Lim ◽  
Jin-Woo Park ◽  
Bum Sun Kwon ◽  
Ki Hyung Ryu ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Cross Sectional Area ◽  
Low Back ◽  
Sectional Area ◽  
Back Muscles ◽  
Cross Sectional ◽  
The Relationship

scholarly journals A Comparison of Lumbosacral Kinematics during Prolonged Sitting in Non-specific Chronic Low Back Pain Subgroups; a cross-sectional study

2019 ◽  
Author(s):  
Mansoor Alameri ◽  
Everett Lohman III ◽  
Noha Daher ◽  
Robert Dudley ◽  
Amjad Shallan ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Motor Control ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Rating Scale ◽  
Lumbar Vertebrae ◽  
Low Back ◽  
Significant Deterioration ◽  
Cross Sectional ◽  
Prolonged Sitting

Abstract Abstract Background: Although, non-specific chronic low back pain (NSCLBP) has been associated with abnormal lumbosacral kinematics, little is known about the possible driving mechanisms of pain development overtime during prolonged sitting period. Therefore, the purpose of this study was to examine the differences in lumbosacral postures in adults with and without NSCLBP, and their role on pain development during a 1-hour of prolonged sitting task. Methods: Twenty NSCLBP subjects with motor control impairment (MCI) [10 classified as having flexion pattern (FP) disorder, and 10 with active extension pattern (AEP) disorder], and 10 healthy controls participated in the study. Subjects underwent a 1-hour sitting protocol on a standard office chair. Lumbosacral postures including: sacral tilt (ST), third lumbar vertebrae (L3) position, and relative lower lumbar angle (RLLA) were recorded using a two-dimensional inclinometer over the 1-hour period. Perceived back pain intensity was recorded using a numeric pain rating scale every 10 minutes throughout the sitting period. Results: All study groups presented with significantly distinctive lumbosacral kinematics at the lowest level of pain (the beginning of the sitting period) (p<0.05), as well as at the highest level of pain (the end of the sitting period) (p£0.05). The MCI subgroups showed a significant deterioration in lumbosacral kinematics and pain levels overtime (p<0.01). The directions of deterioration in lumbosacral kinematics over the 1-hour sitting period occurred in the direction of the motor control impairment (kyphosis for FP subgroup or lordosis for the AEP subgroup). Both MCI subgroups reported a similarly significant increase in pain through mid-sitting (p<0.001). However, after mid-sitting, the AEP subgroup displayed a significantly reversed decrease in the lordotic postures (p=0.001) which was accompanied by much less increase in pain level compared to the FP subgroup. Conclusion : The present study’s findings suggest that MCI subgroups presented with distinctive underlying maladaptive postural patterns. However, the significant increase in pain over the 1-hour sitting might not be only attributed to the inherent maladaptive postures, also it may be related to the directional deterioration in lumbosacral postures overtime.

The Relationship Between Structural and Functional Brain Changes and Altered Emotion and Cognition in Chronic Low Back Pain Brain Changes

2018 ◽  
Vol 34 (3) ◽  
pp. 237-261 ◽  
Author(s):  
Sin Ki Ng ◽  
Donna M. Urquhart ◽  
Paul B. Fitzgerald ◽  
Flavia M. Cicuttini ◽  
Sultana M. Hussain ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Functional Brain ◽  
Brain Changes ◽  
The Relationship

The relationship between cigarette smoking and chronic low back pain

1991 ◽  
Vol 16 (3-4) ◽  
pp. 103-110 ◽  
Author(s):  
Robert N. Jamison ◽  
Barbara A. Stetson ◽  
Winston C.V. Parris
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cigarette Smoking ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
The Relationship

scholarly journals Motor Control Exercise for Chronic Low Back Pain: A Randomized Placebo-Controlled Trial

2009 ◽  
Vol 89 (12) ◽  
pp. 1275-1286 ◽  
Author(s):  
Leonardo O.P. Costa ◽  
Christopher G. Maher ◽  
Jane Latimer ◽  
Paul W. Hodges ◽  
Robert D. Herbert ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Motor Control ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Exercise Intervention ◽  
Patient Specific ◽  
Low Back ◽  
Functional Scale ◽  
The Mean ◽  
Control Exercise

BackgroundThe evidence that exercise intervention is effective for treatment of chronic low back pain comes from trials that are not placebo-controlled.ObjectiveThe purpose of this study was to investigate the efficacy of motor control exercise for people with chronic low back pain.DesignThis was a randomized, placebo-controlled trial.SettingThe study was conducted in an outpatient physical therapy department in Australia.PatientsThe participants were 154 patients with chronic low back pain of more than 12 weeks’ duration.InterventionTwelve sessions of motor control exercise (ie, exercises designed to improve function of specific muscles of the low back region and the control of posture and movement) or placebo (ie, detuned ultrasound therapy and detuned short-wave therapy) were conducted over 8 weeks.MeasurementsPrimary outcomes were pain intensity, activity (measured by the Patient-Specific Functional Scale), and patient's global impression of recovery measured at 2 months. Secondary outcomes were pain; activity (measured by the Patient-Specific Functional Scale); patient's global impression of recovery measured at 6 and 12 months; activity limitation (measured by the Roland-Morris Disability Questionnaire) at 2, 6, and 12 months; and risk of persistent or recurrent pain at 12 months.ResultsThe exercise intervention improved activity and patient's global impression of recovery but did not clearly reduce pain at 2 months. The mean effect of exercise on activity (measured by the Patient-Specific Functional Scale) was 1.1 points (95% confidence interval [CI]=0.3 to 1.8), the mean effect on global impression of recovery was 1.5 points (95% CI=0.4 to 2.5), and the mean effect on pain was 0.9 points (95% CI=−0.01 to 1.8), all measured on 11-point scales. Secondary outcomes also favored motor control exercise.LimitationClinicians could not be blinded to the intervention they provided.ConclusionsMotor control exercise produced short-term improvements in global impression of recovery and activity, but not pain, for people with chronic low back pain. Most of the effects observed in the short term were maintained at the 6- and 12-month follow-ups.

scholarly journals Prevalence and Associated Factors of Depressive Symptoms Among Patients With Chronic Low Back Pain: A Cross-Sectional Study

2022 ◽  
Vol 12 ◽  
Author(s):  
Yueming Hu ◽  
Zechuan Yang ◽  
Yong Li ◽  
Yong Xu ◽  
Mengge Tian ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Depressive Symptoms ◽  
Chronic Low Back Pain ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Low Back ◽  
Sectional Study ◽  
Cross Sectional ◽  
Family Function

Background: Few studies have focused on depressive symptoms among patients with chronic low back pain in China. The aim of this cross-sectional study was to assess the prevalence and associated factors of depressive symptoms in patients with chronic low back pain.Methods: From May to August 2021, 1,172 patients with chronic low back pain were recruited in China. Depressive symptoms were assessed through the Patient Health Questionnaire. Associations of demographic characteristics, clinical characters and social-psychological factors with depressive symptoms were investigated among patients with chronic low back pain.Results: The prevalence of depressive symptoms was 25.00%. Logistic regression analysis found that duration of pain in 1-5 years (1-3 years: OR = 2.91, 95%CI: 1.65-5.14, 3-5 years: OR = 3.09, 95%CI: 1.55-6.15) and more severe pain (OR = 1.13, 95%CI: 1.10-1.17) were associated with higher risks of depressive symptoms. Better family function (good family function: OR = 0.25, 95%CI: 0.15-0.41, moderate family dysfunction: OR = 0.47, 95%CI: 0.29-0.77) and higher pain self-efficacy (OR = 0.94, 95%CI: 0.93-0.95) were associated with lower risks of depressive symptoms.Conclusion: Patients with chronic low back pain have a high prevalence of depressive symptoms in China. Duration of pain, pain severity, family function and pain self-efficacy were predictors of depressive symptoms among chronic low back pain patients in China. Early identification of the associated factors may be helpful for the timely management of depressive symptoms.

scholarly journals Pharmacological and toxicological profile of opioid-treated, chronic low back pain patients entering a mindfulness intervention randomized controlled trial

2014 ◽  
Vol 10 (5) ◽  
pp. 323 ◽  
Author(s):  
Aleksandra Zgierska, MD, PhD ◽  
Margaret L. Wallace, PharmD, BCACP ◽  
Cindy A. Burzinski, MS ◽  
Jennifer Cox, BS ◽  
Miroslav Backonja, MD
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Drug Testing ◽  
Illicit Drugs ◽  
Rating Scale ◽  
Controlled Trial ◽  
Low Back ◽  
Cross Sectional ◽  
Toxicological Profile

Objective: Refractory chronic low back pain (CLBP) often leads to treatment with long-term opioids. Our goal was to describe the pharmaco-toxicological profile of opioid-treated CLBP patients and identify potential areas for care optimization.Design: Cross-sectional analysis.Setting: Outpatient primary care.Participants: CLBP patients prescribed ≥ 30 mg/d of morphine-equivalent dose (MED) for ≥3 months.Outcome Measures: Self-reported clinical, medication (verified) and substance use, and urine drug testing (UDT) data were collected.Results: Participants (N = 35) were 51.8 ± 9.7 years old, 80 percent female with CLBP for 14.2 ± 10.1 years, treated with opioids for 7.9 ± 5.7 years, with severe disability (Oswestry Disability Index score: 66.7 ± 11.4), and average pain score of 5.6 ± 1.5 (0-10 rating scale). Participants reported using tobacco (N = 14), alcohol (N = 9) and illicit drugs or unprescribed medications (N = 10). On average, participants took 13.4 ± 6.8 daily medications, including 4.7 ± 1.8 pain-modulating and 4.7 ± 2.0 sedating medications. Among prescribed opioids, 57.1 percent were long-acting and 91.4 percent were short-acting, with a total of 144.5 ± 127.8 mg/d of MED. Sixteen participants were prescribed benzodiazepines and/or zolpidem/zaleplon. Fifteen participants had UDT positive for illicit drugs or unprescribed medications; in addition, eight tested positive for alcohol and 19 for cotinine. Compared to those with negative UDTs, those with positive UDTs (N = 15) received lower daily “total” and “extended release” opioid doses, and were more likely to test positive for cotinine (p < 0.05).Conclusions: Study findings corroborate existing evidence for high medication burden and high likelihood of substance misuse among opioid-treated CLBP patients. Further research is needed to help understand causality and ways to optimize care and clinical outcomes.

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