Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20190063
Brazilian Journal of Pain
Original Article

Chronic low back pain and walking speed: effects on the spatiotemporal parameters and in gait variability

Dor lombar crônica e velocidade de caminhada: efeitos nos parâmetros espaço-temporais e na variabilidade da marcha

Alberito Rodrigo Carvalho; Ronaldo Valdir Briani; Welds Rodrigo Ribeiro Bertor; José Roberto Svistalski; Alexandro Andrade; Leonardo Alexandre Peyré-Tartaruga

Downloads: 0
Views: 223

Abstract

BACKGROUND AND OBJECTIVES: Walking is described as one of the abilities most affected by chronic low back pain. This study aimed to determine if chronic nonspecific low back pain and walking speed affect the spatiotemporal parameters (stride length, swing time, contact time, stride time, stride frequency and walking ratio) and the coefficients of variation of stride length and contact time.

METHODS: Ten participants with chronic nonspecific low back pain (low back pain - LG) and ten healthy participants in the control group (CG) walked on the treadmill at preferred self-selected speed, slower and faster than the preferred speed. Spatiotemporal parameters and coefficients of variation were determined by kinematic analysis. Main effects (group and speed) and their interactions were tested using generalized estimating equations method.

RESULTS: Our results showed that there were no significant differences between groups or significant interaction between group and speed factors. There was a speed effect. Stride frequency and length increased while contact and stride time decreased as the speed increased. The walking ratio (stride length/stride frequency) was relatively consistent across speeds (~1.6 m·stride-1.s) without statistical differences. The coefficients of variation were below 5%.

CONCLUSION: The chronic nonspecific low back pain did not affect the gait spatiotemporal profile, at least for those patients classified as chronic nonspecific low back pain according to the signs and symptoms criteria. Although the preferred speed has affected the spatiotemporal parameters, both groups patients were able to adjust their kinematic parameters to each task demand.

Keywords

Gait, Biomechanical phenomena, Locomotion, Spine

Resumo

JUSTIFICATIVA E OBJETIVOS: A caminhada é descrita como uma das habilidades mais afetadas pela dor lombar crônica. Este estudo objetivou determinar se a dor lombar crônica não específica e a velocidade de caminhada afetam os parâmetros espaço-temporais (comprimento da passada, tempo de balanço, tempo de contato, tempo da passada, frequência da passada e razão de caminhada) e os coeficientes de variação do comprimento da passada e do tempo de contato.

MÉTODOS: Dez participantes com dor lombar crônica não específica (grupo dor lombar GL) e 10 participantes saudáveis (grupo controle - GC) caminharam na esteira na velocidade preferida autosselecionada, e em velocidades mais lenta e mais rápida que a velocidade preferida. Parâmetros espaço-temporais e coeficientes de variação foram determinados por cinemetria. Os efeitos principais (grupo e velocidade) e as suas interações foram testadas pelo método de equações de Estimativas Generalizadas.

RESULTADOS: Não houve diferenças entre os grupos ou interação entre os fatores (grupo e velocidade). Houve efeito da velocidade. A frequência e o comprimento de passada aumentaram, enquanto o tempo de contato e de passada diminuíram à medida que a velocidade aumentou. A razão de caminhada (comprimento da passada/frequência da passada) foi relativamente consistente entre as velocidades (~1,6 m·passada-1·s) sem diferenças estatísticas. Os coeficientes de variação ficaram abaixo dos 5%.

CONCLUSÃO: A dor lombar crônica não específica não afetou os parâmetros espaço-temporais da caminhada, pelo menos para os pacientes classificados com dor lombar crônica não específica pelos critérios de sinais e sintomas. Embora a velocidade preferida tenha afetado os parâmetros espaço-temporais, os pacientes de ambos os grupos foram hábeis para ajustar seus parâmetros cinemáticos às demandas da tarefa.

Palavras-chave

Coluna vertebral, Fenômenos biomecânicos, Locomoção, Marcha

References

Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J. 2008;8(1):8-20.

Meucci RD, Fassa AG, Faria NM. Prevalence of chronic low back pain: systematic review. Rev Saude Publica. 2015;49.

Negrini S, Fusco C, Atanasio S, Romano M, Zaina F. Low back pain: state of art. Eur J Pain Suppl. 2008;2(^sSuppl. Supp 1):52-6.

Welch E. Low back pain. InnovAiT. 2012;5(1):13-21.

Bertor WRR, Fracaro GA, Silva LI, Zílio M, Aragão FA, Carvalho AR. Subclassificação da lombalgia crônica e nível de incapacidade: efeito no desempenho funcional e força muscular. Conscientiae Saúde. 2013;12(4):563-71.

Fracaro GA, Bertor WR, Silva LI, Brandl L, Zanini GM, Zílio M. Comparison of psycho-social and functional performance variables in a group of chronic low back pain patients. Rev Dor. 2013;14(2):119-23.

Andrew Walsh D, Jane Kelly S, Sebastian Johnson P, Rajkumar S, Bennetts K. Performance problems of patients with chronic low-back pain and the measurement of patient-centered outcome. Spine. 2004;29(1):87-93.

Simmonds MJ, Lee CE, Etnyre BR, Morris GS. The influence of pain distribution on walking velocity and horizontal ground reaction forces in patients with low back pain. Pain Res Treat. 2012;2012:214980.

Saibene F, Minetti AE. Biomechanical and physiological aspects of legged locomotion in humans. Eur J Appl Physiol. 2003;88(4-5):297-316.

Motl RW, Dlugonski D, Suh Y, Weikert M, Fernhall B, Goldman M. Accelerometry and its association with objective markers of walking limitations in ambulatory adults with multiple sclerosis. Arch Phys Med Rehabil. 2010;91(12):1942-7.

Sibley KM, Tang A, Brooks D, McIlroy WE. Effects of extended effortful activity on spatio-temporal parameters of gait in individuals with stroke. Gait Posture. 2008;27(3):387-92.

Belda-Lois JM, Mena-del Horno S, Bermejo-Bosch I, Moreno JC, Pons JL, Farina D. Rehabilitation of gait after stroke: a review towards a top-down approach. J Neuroeng Rehabil. 2011;8(1):66.

Shambrook J, Mcnee P, Harris EC, Kim M, Sampson M, Palmer KT. Clinical presentation of low back pain and association with risk factors according to findings on magnetic resonance imaging. Pain. 2012;152(7):1659-65.

de Laat KF, Tuladhar AM, van Norden AGW, Norris DG, Zwiers MP, de Leeuw FE. Loss of white matter integrity is associated with gait disorders in cerebral small vessel disease. Brain. 2011;134(1):73-83.

Wood PB. Variations in brain gray matter associated with chronic pain. Curr Rheumatol Rep. 2010;12(6):462-9.

Oliveira HB, Rosa RG, Gomeñuka NA, Peyré-Tartaruga LA. Estabilidade dinâmica da caminhada de indivíduos hemiparéticos: a influência da velocidade. Rev Educ Física/UEM. 2013;24(4):559-65.

Hicks GE, Sions JM, Coyle PC, Pohlig RT. Altered spatiotemporal characteristics of gait in older adults with chronic low back pain. Gait Posture. 2017;55:172-6.

Chou R, Qaseem A, Snow V, Casey D, Cross TJ, Shekelle P. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478-91.

Dingwell JB, Marin LC. Kinematic variability and local dynamic stability of upper body motions when walking at different speeds. J Biomech. 2006;39(3):444-52.

Zeni JA, Higginson JS. Gait parameters and stride-to-stride variability during familiarization to walking on a split-belt treadmill. Clin Biomech. 2010;25(4):383-6.

Racic V, Pavic A, Brownjohn JMW. Experimental identification and analytical modelling of human walking forces: literature review. J Sound Vib. 2009;326(1-2):1-49.

Thomas EE, De Vito G, Macaluso A. Physiological costs and temporo-spatial parameters of walking on a treadmill vary with body weight unloading and speed in both healthy young and older women. Eur J Appl Physiol. 2007;100(3):293-9.

Stoquart G, Detrembleur C, Lejeune T. Effect of speed on kinematic, kinetic, electromyographic and energetic reference values during treadmill walking. Clin Neurophysiol. 2008;38(2):105-16.

Osaki Y, Kunin M, Cohen B, Raphan T. Relative contribution of walking velocity and stepping frequency to the neural control of locomotion. Exp Brain Res. 2008;185(1):121-35.

Danion F, Varraine E, Bonnard M, Pailhous J. Stride variability in human gait: the effect of stride frequency and stride length. Gait Posture. 2003;18(1):69-77.

Sekiya N, Nagasaki H. Reproducibility of the walking patterns of normal young adults: test-retest reliability of the walk ratio (step-length / step-rate). Gait Posture. 1998;7(1):225-7.

Beauchet O, Allali G, Annweiler C, Bridenbaugh S, Assal F, Kressig RW. Gait variability among healthy adults: low and high stride-to-stride Variability are both a reflection of gait stability. Gerontology. 2009;55(6):702-6.

Beauchet O, Annweiler C, Lecordroch Y, Allali G, Dubost V, Herrmann FR. Walking speed-related changes in stride time variability: effects of decreased speed. J Neuroeng Rehabil. 2009;6:32.

Newell D, van der Laan M. Measures of complexity during walking in chronic non-specific low back pain patients. Clin Chiropr. 2010;13(1):8-14.

Carvalho AR, Andrade A, Peyré-Tartaruga LA. Possible changes in energy-minimizer mechanisms of locomotion due to chronic low back pain - a literature review. Rev Bras Reumatol. 2015;55(1):55-61.

Henchoz Y, Soldini N, Peyrot N, Malatesta D. Energetics and mechanics of walking in patients with chronic low back pain and healthy matched controls. Eur J Appl Physiol. 2015;115(11):2433-43.

Carvalho AR, Ribeiro Bertor WR, Briani RV, Zanini GM, Silva LI, Andrade A. Effect of nonspecific chronic low back pain on walking economy: an observational study. J Mot Behav. 2016;48(3):218-26.

Rabey M, Beales D, Slater H, O'Sullivan P. Multidimensional pain profiles in four cases of chronic non-specific axial low back pain: an examination of the limitations of contemporary classification systems. Man Ther. 2015;20(1):138-47.

Sitthipornvorakul E, Klinsophon T, Sihawong R, Janwantanakul P. The effects of walking intervention in patients with chronic low back pain: a meta-analysis of randomized controlled trials. Musculoskelet Sci Pract. 2018;34:38-46.

Lawford BJ, Walters J, Ferrar K. Does walking improve disability status, function, or quality of life in adults with chronic low back pain? A systematic review. Clin Rehabil. 2016;30(6):523-36.


Submitted date:
07/03/2019

Accepted date:
09/16/2019

5f248df30e88254715e56d7e brjp Articles

BrJP

Share this page
Page Sections