Abstract

An abundance of literature has investigated the association between low back pain (LBP) and physical ability or function. It has been shown that LBP patients display reduced range of motion, decreased balance ability, impaired proprioception, and lower strength compared to asymptomatic persons. The aim of this study was to investigate the differences between LBP patients and healthy controls in terms of several physical abilities. Based on the premised that different biomechanical and physiological causes and consequences could be related to different types of LBP, a secondary exploratory attempt of the study was to examine the differences between LBP subgroups based on the pain location (local or referred) or type of pathology (discogenic or degenerative) on the level of impairment of function and ability. Participants performed range of motion tests, trunk maximal voluntary contraction force tests, a sitting balance assessment, the timed up-and-go test, the chair rise test, and the trunk reposition error test. Compared to the control group, symptomatic patients on average showed 45.7% lower trunk extension (p < 0.001, η2 = 0.33) and 27.7 % lower trunk flexion force (p < 0.001, η2 = 0.37) during maximal voluntary contraction. LBP patients exhibited decreased sitting balance ability and lower scores in mobility tests (all p < 0.001). There were no differences between groups in Schober’s test and trunk repositioning error (p > 0.05). No differences were observed among the LBP subgroups. The exploratory analyses are limited by the sample size and uncertain validity of the diagnostic procedures within this study. Further studies with appropriate diagnostic procedures and perhaps a different subgrouping of the LBP patients are needed to elucidate if different types of LBP are related to altered biomechanics, physiology, and function.

Highlights

  • Lifetime prevalence of low back pain (LBP) is reported to be as high as 84% [1]

  • It was reported that the dynamic lumbar range of motion (ROM) was 10–15% smaller in chronic LBP patients compared to asymptomatic controls [5]

  • Post hoc pairwise tests did not reveal any statistically significant differences between LBP subgroups (LP compared to LRP and DIS compared to DEG) (p = 0.2–0.9)

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Summary

Introduction

Lifetime prevalence of low back pain (LBP) is reported to be as high as 84% [1]. The total annual costs of LBP in the United States of America exceed 100 billion dollars, with two thirds of these costs being indirect due to lost wages and reduced productivity [2]. Lumbar LBP patients were shown to have reduced lumbar ROM compared to asymptomatic persons in a systematic review by Laird et al [4]. It was reported that the dynamic lumbar ROM was 10–15% smaller in chronic LBP patients compared to asymptomatic controls [5]. This reduction was negatively correlated with self-reported pain and kinesiophobia (defined as fear of pain with movement and assessed by Tampa Scale for Kinesiophobia) [5]. LBP patients seem to increase their hip ROM in the sagittal plane, compensating for decreased lumbar flexion [6]. Despite the fact that asymmetries in spinal ROM are common in general population, more pronounced asymmetries were observed in LBP patients [8]

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