Abstract
Low back pain (LBP) is the most frequent cause of adult disability. One of the main reasons can be a herniated disc (lumbar disc herniation—LDH), potentially disturbing spinal movement patterns. Its influence on gait and lumbopelvic biomechanics still remains unclear. Little to no evidence was found on lumbopelvic kinematics and gait in young LDH adults. The purpose of this study was to analyze the lumbopelvic biomechanics in young adult individuals with lumbar disc herniation diagnosed by MRI. Forty-three participants (18–35 years) were divided into two groups: an LDH group (n = 19) and a control group (n = 24). All participants underwent dynamic lumbopelvic and gait measures by a G-Walk wearable device in a 6-m walking test (6MWT). The Oswestry Disability Index (ODI) questionnaire was used for subjective disability assessment. The LDH group showed higher speed (p = 0.02), lower symmetry of pelvis tilt (p = 0.01), and lower pelvis rotation (p = 0.04) compared to the healthy controls. Correlation calculations showed significance between pelvis obliquity and pelvis rotation (r = 0.53) but only in healthy controls. The lumbopelvic biomechanics shows differences in pelvis tilt and symmetry index of rotation parameters between LDH and healthy controls. In conclusion, LDH affects the gait kinematics, causing three-dimensional disorders and lack of synergy. This is probably due to pain avoidance behaviors and the compensation mechanisms of the adjacent body region.
Highlights
Low back pain (LBP) is the most frequent cause of adult disability, with 90% of cases considered nonspecific low back pain due to an unclear pathological background [1]
Several inclusion criteria were set including being aged between 18 and 35 years; reported pain of at least 2/10 on the Numeric Rating Scale (NPRS), which resulted in subjective disability within daily living activities; single-segment lumbar herniated disc confirmed by magnetic resonance imaging (MRI); and no acute stage of the pathology
There were no significant differences in kinematic parameters of gait between males and females in both groups (p > 0.05)
Summary
Low back pain (LBP) is the most frequent cause of adult disability, with 90% of cases considered nonspecific low back pain (nLBP) due to an unclear pathological background [1]. LBP has been present in over 70% of adults in their lives at least once [2]. Its prevalence is increasing in young adults, causing the risk of earlier degeneration and, as a result, more frequent surgical treatment in a mature society. The pathological background of LBP can be multifactorial. While the intervertebral disc’s biomechanics have been widely investigated, their influent on patient outcomes regarding the progression of migrated prolapse remains unclear. Our previous studies confirmed that young adults’ outcomes may vary with different stages of the disease [4,5,6]
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