Lumbo-Pelvic and Lower Limb Joint Kinematics in Subjects with and Without Low Back Pain: A Protocol for Systematic Review

Background Low back pain (LBP) is one of the leading causes of disability worldwide. While its main cause is mostly unknown, more than 80% of people experience this disorder during their lifetime .Some clinical evidence suggests that people with chronic LBP have various lower extremity movement disorders. This study aims to systematically review the literature on comparing the kinematics of the lumbopelvic region and lower limb joints in people with non-specific low back pain (NS-LBP) compared to healthy individuals. Methods/design: We will search main electronic databases (Medline/PubMed, Scopus, Embase, Web of Science, Pedro, ProQuest and Google Scholar) and two key journals (Journal of Electromyography and Kinesiology, Clinical Biomechanics). Also, the reference list of the previous systematic reviews would be hand-searched. Studies that have examined the kinematic differences in lumbopelvic or lower limbs between NS-LBP and healthy individuals will be included. We will examine the methodological quality and statistical reporting of each eligible trial using the Newcastle – Ottawa Scale (NOS). Discussion To our knowledge, this study will be the first systematic review to examine the kinematic differences of the lower limb joints and pelvic complex between healthy people and NS-LBP. Since the kinematic assessment of the lower extremities and pelvic joints during daily activities may help understand underlying factors causing LBP, it is important to evaluate the kinematic changes in these regions, during repetitive daily functions in these patients. Systematic review registration: PROSPERO (CRD42021230826)

Clinical and Kinematic Features of Valproate-Induced Tremor and Differences with Essential Tremor

Tremor is a common movement disorder that can be induced by medications, including valproate, which is used for the treatment of epilepsy. However, the clinical and neurophysiological features of valproate-induced tremor are still under-investigated. We performed a clinical and kinematic assessment of valproate-induced tremor by considering tremor body distribution and activation conditions. We investigated possible correlations between demographic and clinical data and kinematic features. Valproate-induced tremor results were also compared with those collected in a large sample of patients with essential tremor. Sixteen valproate-induced tremor patients and 93 essential tremor patients were enrolled. All participants underwent a standardised neurological examination and video recording. Patients also underwent an objective assessment of postural, kinetic and rest tremor of the upper limbs and head tremor through kinematic analysis. Nonparametric tests were used for statistical comparisons between the two groups. Clinical evaluation showed a higher occurrence of rest tremor as well as head or voice, and lower limb involvement in patients with valproate-induced tremor. Kinematic analysis showed a substantial variability in the tremor features of patients with valproate-induced tremor. Compared to essential tremor, we found a higher occurrence of rest tremor of the upper limbs and the involvement of more body segments in valproate-induced tremor patients. Valproate-induced tremor has distinctive clinical and kinematic features, which may suggest that valproate interferes with the cerebellar functions.

Functional objective parameters which may discriminate patients with mild cognitive impairment from cognitively healthy individuals: a systematic review and meta-analysis using an instrumented kinematic assessment

Background a systematic review in 2015 showed kinematic gait and balance parameters which can discriminate patients with mild cognitive impairment (MCI) from cognitively healthy individuals. Objective this systematic review and meta-analysis aims to summarise and synthesise the evidence published after the previous review about the functional objective parameters obtained by an instrumented kinematic assessment which could discriminate patients with MCI from cognitively healthy individuals, as well as to assess the level of evidence per outcome. Methods major electronic databases were searched from inception to August 2019 for cross-sectional studies published after 2015 examining kinematic gait and balance parameters, which may discriminate patients with MCI from cognitively healthy individuals. Meta-analysis was carried out for each parameter reported in two or more studies. Results Ten cross-sectional studies with a total of 1,405 patients with MCI and 2,277 cognitively healthy individuals were included. Eight of the included studies reported a low risk of bias. Patients with MCI showed a slower gait speed than cognitively healthy individuals. Thus, single-task gait speed (d = −0.44, 95%CI [−0.60 to −0.28]; P < 0.001), gait speed at fast pace (d = −0.48, 95%CI [−0.72 to −0.24]; P < 0.001) and arithmetic dual-task gait speed (d = −1.20, 95%CI [−2.12 to −0.28]; P = 0.01) were the functional objective parameters which best discriminated both groups. Conclusion the present review shows kinematic gait parameters which may discriminate patients with MCI from cognitively healthy individuals. Most of the included studies reported a low risk of bias, but the grading of recommendations assessment, development and evaluation criteria showed a low level of evidence per outcome.