A systematic review of movement and muscular activity biomarkers to discriminate non-specific chronic low back pain patients from an asymptomatic population

Abstract

The identification of relevant and valid biomarkers to distinguish patients with non-specific chronic low back pain (NSCLBP) from an asymptomatic population in terms of musculoskeletal factors could contribute to patient follow-up and to evaluate therapeutic strategies. Several parameters related to movement and/or muscular activity impairments have been proposed in the literature in that respect. In this article, we propose a systematic and comprehensive review of these parameters (i.e. potential biomarkers) and related measurement properties. This systematic review (PROSPERO registration number: CRD42020144877) was conducted in Medline, Embase, and Web of Knowledge databases until July 2019. In the included studies, all movements or muscular activity parameters having demonstrated at least a moderate level of construct validity were defined as biomarkers, and their measurement properties were assessed. In total, 92 studies were included. This allowed to identify 121 movement and 150 muscular activity biomarkers. An extensive measurement properties assessment was found in 31 movement and 14 muscular activity biomarkers. On the whole, these biomarkers support the primary biomechanical concepts proposed for low back pain. However, a consensus concerning a robust and standardised biomechanical approach to assess low back pain is needed.

Patients With Chronic Low Back Pain Have an Individual Movement Signature: A Comparison of Angular Amplitude, Angular Velocity and Muscle Activity Across Multiple Functional Tasks

“…Overall, based on the present findings and previous reports (Shum et al, 2005;Laird et al, 2014;Christe et al, 2016bChriste et al, , 2020Papi et al, 2018;Moissenet et al, 2021), reduced lumbar amplitude and angular velocity seems to be key characteristics of patients with CLBP. Furthermore, the consistent reduced sagittal-plane lumbar angular amplitude and velocity across all the functional tasks suggest that these spinal movement alterations generalize across a wide range of daily-life activities.…”

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“…that each individual has a consistent spinal movement across tasks. These results questioned the need to analyze multiple tasks involving primarily sagittal-plane movement independently and the need to investigate new primarily sagittal-plane functional tasks in future studies, as those may lead to redundant data, therefore complexifying the procedure without gaining information to improve our understanding of spinal movement in CLBP (Papi et al, 2018;Moissenet et al, 2021). These findings also suggest that spinal movement is probably more influenced by individual factors than by the tasks.…”

“…Alterations in spinal movement have been suggested as one of the key physical factors in the persistence of chronic low back pain (CLBP) (Marras et al, 1995;O'Sullivan, 2005;Dubois et al, 2014), however, the understanding of spinal movement behavior in CLBP remains limited. The abundance of measures used to describe spinal movement, as outlined by two recent systematic reviews (Papi et al, 2018;Moissenet et al, 2021), is undoubtedly one of the reasons limiting a better understanding. Consequently, to advance the field, there is a need to determine if that many measures are needed or if it would be possible to focus on a selection of measures.…”

“…So far, CLBP spinal movement has been assessed during a range of different functional tasks (Shum et al, 2007;Christe et al, 2016bChriste et al, , 2020Lima et al, 2018;Matheve et al, 2019). However, these prior works mainly assessed one task at a time, or when multiple tasks were assessed, the influence of the task on spinal movement was not analyzed (Papi et al, 2018;Moissenet et al, 2021). Yet, individual consistency in spinal angular amplitudes across different functional tasks has been demonstrated in pain-free participants (Alqhtani et al, 2015;Seerden et al, 2019), suggesting that it may also be the case for individuals with CLBP and for angular velocity and muscle activity measures.…”

“…Following previous work in asymptomatic people and a pilot study in patients with CLBP (Alqhtani et al, 2015;Christe et al, 2016a;Seerden et al, 2019), it was hypothesized that the spinal movement measures would be positively correlated among the functional tasks. It was also hypothesized that there would be no relevant performance difference among functional tasks (Dankaerts et al, 2009;Laird et al, 2014;Christe et al, 2016bChriste et al, , 2020Moissenet et al, 2021);…”