Evidence of splinting in low back pain? A systematic review of perturbation studies

Prins, Maarten R.; Griffioen, M.; Veeger, Thom T J; Kiers, Henri; Meijer, Onno G.; Wurff, Peter van der; Bruijn, Sjoerd M.; Dieën, Jaap H. van

doi:10.1007/s00586-017-5287-0

Cited by 25 publications

(15 citation statements)

References 41 publications

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“…These findings are noteworthy for two reasons. Firstly, although ‘trunk stiffening’ has been reported to result from similarly unpredictable perturbation scenarios in LBP patients [ 50 ], a recent systematic review agrees that there is a lack of convincing evidence to support this [ 51 ]. Secondly, it has been shown that LBP patients move differently due to the anticipation or avoidance of pain provoking postures [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Symptomatic individuals with Lumbar Disc Degeneration use different anticipatory and compensatory kinematic strategies to asymptomatic controls in response to postural perturbation

Deane¹,

Lim²,

Phillips³

et al. 2022

Gait & Posture

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Section: Discussionmentioning

confidence: 99%

Symptomatic individuals with Lumbar Disc Degeneration use different anticipatory and compensatory kinematic strategies to asymptomatic controls in response to postural perturbation

Deane¹,

Lim²,

Phillips³

et al. 2022

Gait & Posture

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“…There is considerable evidence on the observed changes in muscle activation of patients with CLBP [36]. Tight control which involves increased trunk muscle activation and enhanced muscle co-contraction, might enhance control over trunk posture and movement [35].…”

Section: Discussionmentioning

confidence: 99%

Effect of Level of Sensitization on Gait in Chronic Low Back Pain: Insights from a Machine Learning Approach

Zheng

Reneman

et al. 2021

Preprint

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Background: Despite central sensitization (CS) often presents in patients with chronic low back pain (CLBP), there is a lack of quantitative and qualitative analysis of the effect of CS on gait performance. The study aimed to investigate the daily-living gait performance of patients with CLBP with low and high CS levels (CLBP- and CLBP+, respectively). Method：Forty-two patients with CLBP were included. CS was assessed by Central Sensitization Inventory (CSI). Patients were classified according to low or high CSI score (23 CLBP- and 19 CLBP+). Patients wore a 3D accelerometer for about one week. From each patient, 4 days of accelerometer-data were randomly selected. For each day data, continuous gait cycles were extracted using a Fast Fourier Transform-based and a zero-cross method. For all gait cycles in one day, 36 gait outcomes representing variables related to pace, regularity, smoothness, local stability and predictability of gait were calculated. A Random Forest classifier was trained to classify CLBP- and CLBP+ groups based on gait outcomes and SHapley Additive exPlanations (SHAP) method was used to explain the differences between groups in gait outcomes. Results：The Random Forest classifier could accurately recognize the CLBP- and CLBP+ groups (accuracy = 84.4%, F1-score = 82.6%). SHAP reported that the most differences between CLBP- and CLBP+ groups were: index of harmonicity-vertical and harmonic ratio-mediolateral (gait smoothness), stride frequency variability- mediolateral/anteroposterior, stride length variability (gait variability), stride regularity-mediolateral (gait regularity), maximal Lyapunov exponent-vertical/mediolateral and maximal Lyapunov exponent per stride-vertical (gait stability), and sample entropy-anteroposterior (gait predictability). Conclusions： CLBP- and CLBP+ presented different motor control strategies. CLBP- presented a more “loose” control, including higher gait smoothness and stability. CLBP+ presented a more “tight” control, including a more regular, less variable and more predictable gait pattern.

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“…Studies combining kinematic and electromyographic experiments with musculoskeletal modeling report higher lumbar spine loading in LBP patients, which can be mainly explained by postural adaptations and increased trunk muscle activity ( 22 , 23 ). Postural control studies with LBP patients revealed a delay in trunk muscle activity onset in response to both predictable and unpredictable perturbations ( 24 , 25 ). These findings indicate that LBP patients experience a variety of motor control impairments, likely due to interaction deficiencies between sensory and motor systems that are responsible for goal-oriented spine posture, stability and movement ( 26 , 27 ).…”

Section: Biomechanical Mechanismsmentioning

confidence: 99%

Identifying Motor Control Strategies and Their Role in Low Back Pain: A Cross-Disciplinary Approach Bridging Neurosciences With Movement Biomechanics

et al. 2021

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Persistent low back pain (LBP) is a major health issue, and its treatment remains challenging due to a lack of pathophysiological understanding. A better understanding of LBP pathophysiology has been recognized as a research priority, however research on contributing mechanisms to LBP is often limited by siloed research within different disciplines. Novel cross-disciplinary approaches are necessary to fill important knowledge gaps in LBP research. This becomes particularly apparent when considering new theories about a potential role of changes in movement behavior (motor control) in the development and persistence of LBP. First evidence points toward the existence of different motor control strategy phenotypes, which are suggested to have pain-provoking effects in some individuals driven by interactions between neuroplastic, psychological and biomechanical factors. Yet, these phenotypes and their role in LBP need further validation, which can be systematically tested using an appropriate cross-disciplinary approach. Therefore, we propose a novel approach, connecting methods from neuroscience and biomechanics research including state-of-the-art optical motion capture, musculoskeletal modeling, functional magnetic resonance imaging and assessments of psychological factors. Ultimately, this cross-disciplinary approach might lead to the identification of different motor control strategy phenotypes with the potential to translate into clinical research for better treatment options.

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Evidence of splinting in low back pain? A systematic review of perturbation studies

Cited by 25 publications

References 41 publications

Symptomatic individuals with Lumbar Disc Degeneration use different anticipatory and compensatory kinematic strategies to asymptomatic controls in response to postural perturbation

Symptomatic individuals with Lumbar Disc Degeneration use different anticipatory and compensatory kinematic strategies to asymptomatic controls in response to postural perturbation

Effect of Level of Sensitization on Gait in Chronic Low Back Pain: Insights from a Machine Learning Approach

Identifying Motor Control Strategies and Their Role in Low Back Pain: A Cross-Disciplinary Approach Bridging Neurosciences With Movement Biomechanics

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