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A Novel Biomechanical Device Improves Gait Pattern in Patient With Chronic Nonspecific Low Back Pain

Elbaz, Avi MD*; Mirovsky, Yigal MD†; Mor, Amit MD*; Enosh, Shavit BPT*; Debbi, Eytan BA*; Segal, Ganit BEd*; Barzilay, Yair MD‡; Debi, Ronen MD†

doi: 10.1097/BRS.0b013e3181a98d3f
Biomechanics

Study Design. A retrospective study on patients with chronic nonspecific low back pain (NSLBP).

Objective. To describe the gait stride characteristics of patients with chronic NSLBP, and to examine the effect of a novel biomechanical device on the gait stride characteristics of these patients.

Summary of Background Data. Patient with NSLBP alters their gait patterns. This is considered a protective mechanism as patients try to avoid extensive hip and spine ranges of motion and minimize forces and moments acting on the body. In addition, there are changes in the neuromuscular control system in patients with LBP that could possibly be attributed to the effects of pain on motor control.

Methods. Nineteen patients underwent a gait test, using an electronic walkway, at baseline and after 12 weeks of treatment. Spatiotemporal parameters were used to identify changes in gait pattern. A novel biomechanical device comprised of 4 modular elements attached to foot-worn platforms was used in the study. The modules are 2 convex shaped biomechanical elements attached to each foot, one is located under the hindfoot region and the other is located under the forefoot region. The device was individually calibrated to each patient. The patients were instructed to walk with the calibrated biomechanical device on a daily basis for a period of 12 weeks.

Results. Significant differences were found at baseline and after 12 weeks in normalized velocity (P = 0.03), cadence (P < 0.01), left normalized step length (P = 0.02), right normalized step length (P = 0.02), right swing (P < 0.01), right stance (P < 0.01), left single limb support (P = 0.01), left double limb support (P = 0.02), and right double limb support (P = 0.02).

Conclusion. Patients with NSLBP treated with the novel biomechanical device for 3 months increased walking speed through longer step length and eliminated asymmetrical differences.

The aims of the current study were to describe the gait stride characteristics of patients with chronic nonspecific low back pain, and to examine the effect of a novel biomechanical device on the gait stride characteristics of these patients.

From the *APOS Research group, Herzliya, Israel; †Department of Orthopedic Surgery, Assaf Harofeh Medical Center, Zerifin, Israel; and ‡Department of Orthopedic Surgery, Hadassah Medical Center, Jerusalem, Israel.

Acknowledgment date: December 16, 2008. First revision date: February 1, 2009. Acceptance date: February 3, 2009.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

The study was registered in the NIH clinical trial registration, protocol No. NCT00767780.

Address correspondence and reprint requests to Ronen Debi, MD, Department of Orthopedic Surgery, Assaf Harofeh Medical Center, Zerifin 70600, Israel; E-mail: debbi.ronen@gmail.com

© 2009 Lippincott Williams & Wilkins, Inc.