Document Type : Original Articles
Authors
Department of sport injuries and corrective exercises, faculty of sport sciences, University of Isfahan, Isfahan, Iran
Abstract
Background:Patients with low back pain (LBPP) take different strategy during walking in order to reduce pain and enhance postural control. Investigating stance temporal characteristics and asymmetry provide new insight for LBPP gait analysis. The purpose of this study was to investigate stance phase characteristics and asymmetry in females with non-specific low back pain.
Method. In this cross-sectional study, 36 females were recruited purposefully and divided into two groups of 18 people with and without low back pain. Data collected by footscan system and analyzed by footscan gait 7 gait generation. Independent t –test was used to compare outcomes of the groups.
Results. The results showed that right (p=0.001) and left (p=0.001) foot progression angle in low back pain group was higher than healthy group. Also, asymmetry of the initial contact phase (p=0.02) and forefoot contact phase (p=0.02) timings, and foot progression angle asymmetry was higher in low back pain group (p=0.009).
Conclusion. Regarding to higher progression angle and asymmetries observed in LBPP, rehabilitative exercises must consider these differences to in evaluating rehabilitation procedure.
Keywords
- 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 Dec;15(1):1-8.
- 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 Jun;9(1):83-96.
- 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 May 1;18(2):269-82..
- 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 Feb 12;16(1):106-18.
- 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 Oct;2014.
- Rosenbaum D, BECKER HP. Plantar pressure distribution measurements. Technical background and clinical applications. Foot and ankle surgery. 1997 Mar;3(1):1-4.
- 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 Oct 5;79:243-7.
- 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.
- Anbarian M, Esmaeili H. Effects of running-induced fatigue on plantar pressure distribution in novice runners with different foot types. Gait & posture. 2016 Jul 1;48:52-6.
- Askari Z, Esmaeili H. Effect of trunk muscles fatigue on plantar pressure distribution in novice runners. Journal of Biomechanics. 2021 Jun 9;122:110487.
- Sadeghi H, Allard P, Prince F, Labelle H. Symmetry and limb dominance in able-bodied gait: a review. Gait & posture. 2000 Sep 1;12(1):34-45.
- 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..
- 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.
- 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 Dec;18(1):1-3.
- 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 Dec;19(1):1-3.
- 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 Apr 13;48(6):1009-14.
- 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 Jun 1;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 Feb 1;20(1):31-8.
- 19. 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.
- 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 Jun 1;29(3):329-35.
- 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 Dec;28(6):378-83.
- 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 Feb;15(1):23-40.
- 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.
- 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 Feb 1;20(1):31-8.
- 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 Apr;99(15).
- 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 May 1;144:105329.
- Fayez ES, Elsayed EN. Foot Pressure Asymmetry in Patients with Mechanical Low Back Pain. Med J Cairo Univ. 2012 Dec 7;80(2):7-10.
- 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 Apr 1;51:102404.
- Andrew RJ. Origins of asymmetry in the CNS. InSeminars in cell & developmental biology 2009 Jun 1 (Vol. 20, No. 4, pp. 485-490). Academic Press.
)