Journal of Rehabilitation Sciences & Research

Stance Phase Characteristics and Asymmetry in Females with Low Back Pain

Document Type : Original Articles

Authors

Morteza Sadeghi
Hamed Esmaeili

Department of sport injuries and corrective exercises, faculty of sport sciences, University of Isfahan, Isfahan, Iran

https://doi.org/10.30476/jrsr.2023.95942.1303
Abstract
Background:This study aimed to investigate stance phase characteristics and asymmetry in females with non-specific low back pain (LBPP) which they adopt different strategies in walking to reduce pain and enhance walking quality. The results of this research can provide new insight into gait characteristics for individuals with LBPP by examining temporal characteristics and asymmetry in their stance phase during walking.
Method: In this cross-sectional study, 36 females were purposefully recruited and divided into two groups: one consisting of 18 individuals with low back pain (LBPP) and the other without LBPP. Data were collected using the Footscan system and analyzed with the Footscan Gait 7 gait generation software. Independent t-tests were employed to compare the outcomes between the two groups.
Results: The results indicated that the right (p=0.001) and left (p=0.001) foot progression angles in the low back pain group were higher than those in the healthy group. Additionally, the low back pain group exhibited higher asymmetry in the timings of the initial contact phase (p=0.02) and forefoot contact phase (p=0.02), as well as in foot progression angle asymmetry (p=0.009) compared to the healthy group.
Conclusion:Given the higher foot progression angle and observed asymmetries in individuals with low back pain, rehabilitative exercises need to consider these differences when evaluating and planning rehabilitation procedures.
 

Keywords

Asymmetry
Gait
Low back pain
Stance
Progression angle
Rehabilitation
  1. Chuter V, Spink M, Searle A, Ho A. The effectiveness of shoe insoles for the prevention and treatment of low back pain: a systematic review and meta-analysis of randomised controlled trials. BMC musculoskeletal disorders. 2014;15(1):1-8.
  2. Pergolizzi JV, LeQuang JA. Rehabilitation for low back pain: A narrative review for managing pain and improving function in acute and chronic conditions. Pain and therapy. 2020;9(1):83-96.
  3. da Fonseca JL, Magini M, de Freitas TH. Laboratory gait analysis in patients with low back pain before and after a Pilates intervention. Journal of sport rehabilitation. 2009 1;18(2):269-82.
  4. Zeinali-Davarani S, Hemami H, Barin K, Shirazi-Adl A, Parnianpour M. Dynamic stability of spine using stability-based optimization and muscle spindle reflex. IEEE Transactions on Neural Systems and Rehabilitation Engineering. 2008 12;16(1):106-18.
  5. Zahraee MH, Karimi MT, Mostamand J, Fatoye F. Analysis of asymmetry of the forces applied on the lower limb in subjects with nonspecific chronic low back pain. BioMed research international. 2014;2014.
  6. Rosenbaum D, Becker HP. Plantar pressure distribution measurements. Technical background and clinical applications. Foot and ankle surgery. 1997;3(1):1-4.
  7. Yazdani S, Dizji E, Alizadeh F, Hassanlouei H. Effect of chronic idiopathic low back pain on the kinetic gait characteristics in different foot masks. Journal of Biomechanics. 2018 5; 79:243-7.
  8. Simmonds MJ, Lee CE, Etnyre BR, Morris GS. The influence of pain distribution on walking velocity and horizontal ground reaction forces in patients with low back pain. Pain research and treatment. 2012;2012.
  9. Anbarian M, Esmaeili H. Effects of running-induced fatigue on plantar pressure distribution in novice runners with different foot types. Gait & posture. 2016; 48:52-6.
  10. Askari Z, Esmaeili H. Effect of trunk muscles fatigue on plantar pressure distribution in novice runners. Journal of Biomechanics. 2021; 122:110487.
  11. Sadeghi H, Allard P, Prince F, Labelle H. Symmetry and limb dominance in able-bodied gait: a review. Gait & posture. 2000;12(1):34-45.
  12. Kim, Eun-Joo, Yu-Jeong Cho, and Mi-Yeon Song. "Foot Pressure Analysis of Chronic Low Back Pain Patients by Foot Analyzer." Journal of Korean Medicine Rehabilitation19.4 (2009): 115-126.
  13. Lee JH, Fell DW, Kim K. Plantar pressure distribution during walking: comparison of subjects with and without chronic low back pain. Journal of Physical Therapy Science. 2011;23(6):923-6.
  14. Kuai S, Zhou W, Liao Z, Ji R, Guo D, Zhang R, Liu W. Influences of lumbar disc herniation on the kinematics in multi-segmental spine, pelvis, and lower extremities during five activities of daily living. BMC Musculoskeletal Disorders. 2017;18(1):1-3.
  15. Laird RA, Keating JL, Kent P. Subgroups of lumbo-pelvic flexion kinematics are present in people with and without persistent low back pain. BMC musculoskeletal disorders. 2018;19(1):1-3.
  16. 16. Müller R, Ertelt T, Blickhan R. Low back pain affects trunk as well as lower limb movements during walking and running. Journal of biomechanics. 2015;48(6):1009-14.
  17. 17. Song AY, Jo HJ, Sung PS, Kim YH. Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain. Physiotherapy. 2012;98(2):160-6.

18. van der Hulst M, Vollenbroek-Hutten MM, Rietman JS, Hermens HJ. Lumbar and abdominal muscle activity during walking in subjects with chronic low back pain: support of the “guarding” hypothesis?. Journal of Electromyography and Kinesiology. 2010;20(1):31-8.

  1.  Murray MP, Mollinger LA, Gardner GM, Sepic SB. Kinematic and EMG patterns during slow, free, and fast walking. Journal of Orthopaedic Research. 1984;2(3):272-80.
  2. Koblauch H, Heilskov-Hansen T, Alkjær T, Simonsen EB, Henriksen M. The effect of foot progression angle on knee joint compression force during walking. Journal of applied biomechanics. 2013; 29(3):329-35.
  3. Alexander KM, Kinney LaPier TL. Differences in static balance and weight distribution between normal subjects and subjects with chronic unilateral low back pain. Journal of orthopaedic & sports physical therapy. 1998;28(6):378-83.
  4. Lamoth CJ, Meijer OG, Daffertshofer A, Wuisman PI, Beek PJ. Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control. European Spine Journal. 2006;15(1):23-40.
  5. Lim HS, Roh SY, Lee SM. The relationship between pelvic tilt angle and disability associated with low back pain. Journal of Physical Therapy Science. 2013;25(1):65-8.
  6. van der Hulst M, Vollenbroek-Hutten MM, Rietman JS, Hermens HJ. Lumbar and abdominal muscle activity during walking in subjects with chronic low back pain: support of the “guarding” hypothesis? Journal of Electromyography and Kinesiology. 2010;20(1):31-8.
  7. Jung SH, Hwang UJ, Ahn SH, Kim HA, Kim JH, Kwon OY. Lumbopelvic motor control function between patients with chronic low back pain and healthy controls: a useful distinguishing tool: The STROBE study. Medicine. 2020 ;99(15).
  8. Zheng X, Reneman MF, Echeita JA, Preuper RH, Kruitbosch H, Otten E, Lamoth CJ. Association between central sensitization and gait in chronic low back pain: Insights from a machine learning approach. Computers in biology and medicine. 2022; 144:105329.
  9. Fayez ES, Elsayed EN. Foot Pressure Asymmetry in Patients with Mechanical Low Back Pain. Med J Cairo Univ. 2012;80(2):7-10.
  10. Rahimi A, Arab AM, Nourbakhsh MR, Hosseini SM, Forghany S. Lower limb kinematics in individuals with chronic low back pain during walking. Journal of Electromyography and Kinesiology. 2020; 51:102404.
  11. Andrew RJ. Origins of asymmetry in the CNS. Seminars in cell & developmental biology; 2009; 20(4): 485-490

 

Journal of Rehabilitation Sciences & Research
Volume 10, Issue 4
Autumn 2023
Pages 188-193

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