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Coordination of Spinal Motion in the Transverse and Frontal Planes During Walking in People With and Without Recurrent Low Back Pain

Crosbie, Jack, PhD*; de Faria Negrão Filho, Ruben, PhD; Nascimento, Dafne Port, BSc*,‡; Ferreira, Paulo, PhD*

doi: 10.1097/BRS.0b013e318281de28

Study Design. Observational cohort study.

Objective. To investigate spinal coordination during preferred and fast speed walking in pain-free subjects with and without a history of recurrent low back pain (LBP).

Summary of Background Data. Dynamic motion of the spine during walking is compromised in the presence of back pain (LBP), but its analysis often presents some challenges. The coexistence of significant symptoms may change gait because of pain or adaptation of the musculoskeletal structures or both. A history of LBP without the overlay of a current symptomatic episode allows a better model in which to explore the impact on spinal coordination during walking.

Methods. Spinal and lower limb segmental motions were tracked using electromagnetic sensors. Analyses were conducted to explore the synchrony and spatial coordination of the segments and to compare the control and subjects with LBP.

Results. We found no apparent differences between the groups for either overall amplitude of motion or most indicators of coordination in the lumbar region; however, there were significant postural differences in the mid-stance phase and other indicators of less phase locking in controls compared with subjects with LBP. The lower thoracic spinal segment was more affected by the history of back pain than the lumbar segment.

Conclusion. Although small, there were indicators that alterations in spinal movement and coordination in subjects with recurrent LBP were due to adaptive changes rather than the presence of pain.

We examined several manifestations of coordination within the lower thoracic and lumbar spinal regions during walking in people with and without a history of recurrent low back pain. Back pain was associated with altered coordination and changes to spinal posture, especially in the lower thoracic region.

*Clinical & Rehabilitation Sciences Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia

Faculdade de Ciências e Tecnologia–Unesp, Campus de Presidente Prudente, Laboratório de Fisioterapia Aplicada ao Movimento Humano, Departamento de Fisioterapia, Sao Paulo, Brazil; and

Faculdade de Medicina da Universidade de São Paulo, FMUSP, Sao Paulo, Brazil.

Address correspondence and reprint requests to Jack Crosbie, PhD, Clinical & Rehabilitation Sciences Research Group, Faculty of Health Sciences, The University of Sydney, 75 E St., Lidcombe 2141, New South Wales, Australia; E-mail:

Acknowledgment date: September 25, 2012. Revision date: December 4, 2012. Acceptance date: December 6, 2012.

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

No funds were received in support of this work.

No relevant financial activities outside the submitted work.

© 2013 Lippincott Williams & Wilkins, Inc.