Abstract
PurposeTo identify impaired trunk movement during work-related activity in individuals with low back pain (LBP) and investigate whether abnormalities were caused by generalized fear of movement-related pain.MethodsThis cross-sectional study was conducted at a hospital in Japan. We recruited 35 participants with LBP (LBP group; 26 males, 9 females) and 20 healthy controls (HC group) via posters at our hospital. The task required lifting an object. We used a 3D motion capture system to calculate the peak angular velocity of trunk flexion and extension during a lifting task. Pain-related factors for the LBP group were assessed using the visual analogue scale (VAS) for pain intensity over the past 4 weeks and during the task, the Tampa Scale for Kinesiophobia (TSK), the Pain Catastrophizing Scale (PCS), and the Pain Anxiety Symptoms Scale-20 (PASS-20). We compared kinematic variables between groups with a generalized linear mixed model and investigated the relationship between kinematic variables, VAS scores, and psychological factors by performing a mediation analysis.ResultsThe peak angular velocity of trunk extension showed significant main effects on the group factors (LBP group vs. HC group) and their interactions; the value of the kinematic variable was lower at Trial 1 in the LBP group. No LBP participant reported pain during the experiment. The mediation analysis revealed that the relationship between the VAS score for pain intensity over the past 4 weeks and the peak angular velocity of trunk extension in the first trial was completely mediated by the TSK (complete mediation model, 95% bootstrapped CI: 0.07–0.56).ConclusionIndividuals with LBP had reduced trunk extension during a lifting task. Generalized fear of movement-related pain may contribute to such impaired trunk movement. Our findings suggest that intervention to ameliorate fear of movement may be needed to improve LBP-associated disability.
Highlights
Occupational low back pain (LBP) is a serious health problem in many industrialized countries [1]; it has a negative impact on work disability and labor productivity and causes great losses to the social economy [2]
The peak angular velocity of trunk extension showed significant main effects on the group factors (LBP group vs. HC group) and their interactions; the value of the kinematic variable was lower at Trial 1 in the LBP group
The mediation analysis revealed that the relationship between the visual analogue scale (VAS) score for pain intensity over the past 4 weeks and the peak angular velocity of trunk extension in the first trial was completely mediated by the Tampa Scale for Kinesiophobia (TSK)
Summary
Occupational low back pain (LBP) is a serious health problem in many industrialized countries [1]; it has a negative impact on work disability and labor productivity and causes great losses to the social economy [2]. LBP is the most frequent occupational health problem, with 80%– 90% of workers worldwide experiencing some degree of occupational LBP [3]. The risk factors for occupational LBP include both ’motor’ factors (e.g., high physical demands of work, physical dysfunction, and impaired movement) [5], and ’psychosocial’ factors (e.g., fear, anxiety, and catastrophic thinking) [10, 11]. A relationship has been observed between occupational LBP and the physical demands of work, and the rehabilitation for LBP has focused on the ’motor’ aspect. Ergonomic interventions alone have been shown to be insufficient [12]
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