Abstract
BackgroundPersons with low back pain fail to show the same transition as healthy individuals from in-phase to anti-phase rotation of the thorax and pelvis as walking speed increases. The purpose of this study was to determine if the relative phase of the thorax and pelvis during walking was a reliable (within day test-retest) and valid measure for persons with thoracic pain.MethodsThe time series motion of the spine over C7, T8 and sacrum were measured at five treadmill walking speeds (0.67, 0.89, 1.12, 1.34, 1.56 m/s) in 19 persons with thoracic spine pain and 19 healthy control subjects. After a 20 minute rest, all tests were repeated. The average relative phases of the transverse plane rotation between C7-T8, C7-sacrum and T8-sacrum during a one-minute walk were calculated. The standard error of measurement (SEM) and the intra-class correlation coefficient (ICC) were used to estimate test-retest reliability. Three-way repeated measures analyses of variance were performed to determine the influence of group, walking speed and session on the relative phases.ResultsThe minimum transverse plane motion amplitudes, across all participants and speeds, for the C7-T8, C7-sacrum, and T8-sacrum were 2.9, 5.1 and 2.8 degrees, respectively. The C7-T8 relative phase changed little with speed. The C7-sacrum and T8-sacrum relative phases showed increases as subjects walked faster, but both groups had similar patterns of change. Only the C7-T8 relative phase at 0.67 and 0.89 m/s exhibited good reliability (ICC > 0.80, SEM 4.2-5.7, no significant time effects) for both groups. The C7-T8 and T8-sacrum relative phases demonstrated significant group by speed effects.ConclusionsThe C7-T8 relative phase showed reasonable reliability and some discrimination between groups, but changes in response to walking speed were small. The T8-sacrum relative phase showed some discriminative ability, but reliability was not adequate.
Highlights
Persons with low back pain fail to show the same transition as healthy individuals from in-phase to anti-phase rotation of the thorax and pelvis as walking speed increases
A systematic review by Briggs and colleagues [4] estimated that the 12-month prevalence for thoracic spine pain in the general adult population is 15.0-34.8%, partially dependent on the operational definition of thoracic spine pain used in the various studies
There were no changes in the pain visual analogue scale (VAS) of the case subjects from pre to post testing in either session (Session 1: 2.4 ±1.8 to 2.2±2.0 cm; Session 2: 1.8±1.8 to 2.1±1.8 cm)
Summary
Persons with low back pain fail to show the same transition as healthy individuals from in-phase to anti-phase rotation of the thorax and pelvis as walking speed increases. Thoracic spine pain is commonly reported in the general population [1,2], and is more prevalent in females and adolescents [3,4]. There are no standardized measures for the outcome evaluation of persons with thoracic spine pain. The coordination of these rotations differed in the two groups They concluded that coordination patterns might be useful in measuring the ‘quality of movement’ in persons with back pain. It would be useful to have a standardized, objective measure to evaluate change in persons with thoracic pain. Such a measure must be reliable and be different in healthy persons and those with thoracic pain
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