Movement patterns in non-specific chronic low back pain
Investigation of the differences between patients (with and without movement fear) and normal subjects

Patients with non-specific chronic low back pain (CLBP) complaints form a major problem in western society and increase costs of health care, worker’s compensation and jurisdiction claims. Although the transition of acute to chronic pain is complex and not well understood, it is generally accepted that bio psychosocial factors play an important role. However, the complex interaction between different physical, psychological and social factors is not clarified yet. Understanding underlying mechanisms in chronic low back pain could improve diagnostic and treatment possibilities.

One of the interesting fields of study is the relationship between movement, muscle activity and pain. CLBP patients may have difficulty in controlling muscular activity, leading to protective and guarded movements. For example, in walking CLBP patients show various changes in back muscle activity and trunk- pelvis coordination.

The goal of this cross sectional study is to describe differences in muscle and trunk coordination between CLBP patients and healthy controls during walking. Back muscle activity will be recorded with surface Electromyography (sEMG) and trunk- pelvis coordination with an optical 3D system. Relationships with other variables, such as pain, level of disability and fear of movement, will be explored.

Results of this study show differences in movement and activity patterns in CLBP. sEMG activity is higher during stride than in controls. However, coordination between single and double support is comparable in both groups. This may suggest an adaptive response in stabilizing the spine.

The results may provide new possibilities for treatment, such as ambulant myofeedback training to normalize back muscle activity. However, longitudinal studies will be needed to understand if movement abnormalities are adaptive or maladaptive in nature.

This project has been sponsored by:

the Joris foundation	Dutch Ministry of Healthcare (ZON-MW Agiko stipenium)	Het Roessingh Center for Rehabilitation	Menzis

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