Background

Chronic low back pain (CLBP) is associated with an increased trunk stiffness and muscle coactivation during walking. However, it is still unclear whether CLBP individuals are unable to control neuromechanically their upper body motion during a sudden termination of gait (GT), which involves a challenging balance transition from walking to standing.

Research question

Does CLBP elicit neuromuscular and kinematic changes which are specific to walking and GT?.

Methods

Eleven individuals with non-specific CLBP and 11 healthy controls performed walking and sudden GT in response to an external visual cue. 3D kinematic characteristics of thorax, lumbar and pelvis were obtained, with measures of range of motion (ROM) and intra-subject variability of segmental movement being calculated. Electromyographic activity of lumbar and abdominal muscles was recorded to calculate bilateral as well as dorsoventral muscle coactivation.

Results

CLBP group reported greater transverse ROM of the lumbar segment during walking and GT compared to healthy controls. Thorax sagittal ROM was higher in CLBP than healthy participants during GT. Greater overall movement variability in the transverse plane was observed in the CLBP group while walking, whereas GT produced greater variability of lumbar frontal motion. CLBP participants showed higher bilateral lumbar coactivation compared to healthy participants after the stopping stimulus delivery during GT.

Significance

These results suggest that CLBP can elicit a wider and more variable movement of the upper body during walking and GT, especially in the transverse plane and at lumbar level. Alterations in upper body motor control appeared to depend on task, plane of motion and segmental level. Therefore, these findings should be considered by practitioners when screening before planning specific training interventions for recovery of motor control patterns in CLBP population.

中文翻译：

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非特异性慢性下腰痛引起行走和步态终止的运动学和神经肌肉变化

背景

慢性腰背痛（CLBP）与步行过程中躯干刚度增加和肌肉共激活有关。然而，尚不清楚CLBP个体是否在步态突然终止（GT）期间无法控制其上身的神经机械运动，这涉及从步行到站立的挑战性平衡过渡。

研究问题

CLBP是否引起特定于步行和GT的神经肌肉和运动学改变？

方法

11位具有非特异性CLBP的个体和11位健康对照者对外部视觉提示做出了步行和GT突然发作。获得了胸部，腰部和骨盆的3D运动学特征，并计算了运动范围（ROM）和受试者内部节段运动的变异性。记录腰部和腹部肌肉的肌电图活动，以计算双侧以及背腹肌的共激活。

结果

与健康对照组相比，CLBP组报告在步行和GT期间腰段的横向ROM更大。在GT期间，CLBP的胸腔矢状ROM高于健康参与者。在步行时，CLBP组在横断面上观察到较大的整体运动变异性，而GT则产生较大的腰部额叶运动变异性。与GTBP停止刺激后的健康参与者相比，CLBP参与者显示出更高的双侧腰椎共激活。

意义

这些结果表明，CLBP可以在步行和GT期间引起上身的更广泛，更可变的运动，尤其是在横向平面和腰部水平。上身运动控制的改变似乎取决于任务，运动平面和分段水平。因此，从业者在计划进行CLBP人群运动控制模式恢复的具体培训干预措施筛查之前应考虑这些发现。