Locomotion behavior of chronic Non-Specific Low Back Pain (cNSLBP) participants while walking through apertures

• Published in: Gait & posture Vol. 104; pp. 140 - 146
• Main Authors: Bilhaut, Agathe, Ménard, Mathieu, Roze, Olivier, Crétual, Armel, Olivier, Anne-Hélène
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01-07-2023; Elsevier
• Subjects: Actions; Affordances; Biomechanics; Chronic pain; Cognitive Sciences; Engineering Sciences; Human locomotion; Kinematics; Life Sciences; Low back pain; Mechanics; Neurons and Cognition; Human locomotion; Affordances; Actions; Low back pain; Chronic pain; Kinematics; Human Locomotion; Affordance; Low Back Pain; Chronic Pain
• ISSN: 0966-6362; 1879-2219
• DOI: 10.1016/j.gaitpost.2023.06.015

Chronic Non-Specific Low Back Pain (cNSLBP) has been identified as one of the leading global causes of disability and is characterized by symptoms without clear patho-anatomical origin. The majority of clinical trials assess cNSLBP using scales or questionnaires, reporting an influence of cognitive, emotional and behavioral factors. However, few studies have explored the effect of chronic pain in daily life tasks such as walking and avoiding obstacles, which involves perceptual-motor processes to interact with the environment.
Are action strategies in a horizontal aperture crossing paradigm affected by cNSLBP and which factors influence these decisions ?
15 asymptomatic adults (AA) and 15 cNSLBP participants walked along a 14 m long path, crossing through apertures ranging from 0.9 to 1.8 times their shoulder width. Their movement was measured using the Qualisys system, and pain perception was evaluated by self-administered questionnaires.
The cNSLBP participants stopped rotating their shoulders for a smaller aperture relative to their shoulder width (1.18) than the AA participants (1.33). In addition, these participants walked slower, which gave them more time to make the movement adaptations necessary to cross the aperture. No correlation was found between the variables related to pain perception and the critical point but the levels of pain were low with a small variability.
This study shows that during a horizontal aperture crossing task requiring shoulder rotation to pass through small apertures, cNSLBP participants appear to exhibit a riskier adaptive strategy than AA participants by minimizing rotations that could induce pain. This task thus makes it possible to discriminate between cNSLBP participants and pain-free participants without measuring the level of pain. The identification number registered in the clinical trials is NCT05337995.
•Investigation of cNSLBP movement strategies in an ecological context.•Horizontal aperture crossing paradigm discriminated the influence of cNSLBP.•cNSLBP participants stopped turning their shoulder at a smaller opening.•Pain perception scores were not correlated with the critical point but were low.