Quality of Fundamental Movement Patterns in Chronic Low Back Pain Patients A Quasi-experimental Cross-sectional Study

Abstract

Background: Chronic back pain may be associated with alterations of motor control and maladaptive movement. However, instruments that systematically screen fundamental movement patterns are rare. Using a newly developed functional movement analysis, this study aims to examine whether persons with chronic unspecific low back pain display altered quality of fundamental movement patterns and whether asymmetry exists between body sides. Subjects/Methods: 20 patients with chronic back pain (female = 8, male = 12; 49.4 +/- 11.3 years) and 20 healthy controls (female = 12, male = 8; 47.7 +/- 10.7 years) completed the functional movement analysis. It consists of 11 items screening movements of daily life. 8 of them were to complete left and right. The overall score and the number of observed asymmetries (in items to complete left and right) constituted the primary outcomes. A preliminary analysis of reliability (4 raters, 4 subjects) with pilot character was conducted using intra-class correlation (ICC). To compare differences in means, independent t-tests were performed. In case of significance, we calculated the effect size (Cohen's d). Results: The reliability analysis showed an ICC (2.1) of 0.82 (95 % CI: 0.72 - 0.90). Patients with chronic low back pain (31.95 +/- 5.82) scored significantly lower than healthy subjects (44.01 +/- 5.27; p < 0.001, d = 2.17). Additionally, patients averaged 3.8 +/- 1.28 asymmetries while pain-free participants only demonstrated 1.4 +/- 0.94 (p < 0.001; d = 2.14). Conclusion: Faulty and dysbalanced movement patterns appear to be linked to chronic low back pain. Nonetheless, given an existing relation, it remains unclear whether the detected deficiencies are causes or consequences of pain. Further studies about the reliability of the presented screening tool are needed.