Association between movement speed and instability catch kinematics and the differences between individuals with and without chronic low back pain

Abstract

Studies reported the existence of instability catch (IC) during trunk flexion in patients with chronic low back pain (CLBP). However, different movement speeds can cause different neuromuscular demands resulting in altered kinematic patterns. In addition, kinematic characterization corresponding to clinical observation of IC is still limited. Therefore, this study aimed to determine 1) the association between movement speed and kinematic parameters representing IC during trunk flexion, and 2) the differences in kinematic parameters between individuals with and without CLBP. Fifteen no low back pain (NoLBP) and 15 CLBP individuals were recruited. Inertial measurement units (IMU) were attached to T3, L1, and S2 spinous processes. Participants performed active trunk flexion, while IMU data were simultaneously collected. Total trunk, lumbar, and pelvic mean angular velocity (T_MV, L_MV, and P_MV), as well as number, peak-to-peak, and area of sudden deceleration and acceleration (Num, P2P, and Area), were derived. Pearson’s correlation was used to determine the association between movement speed (T_MV) and other kinematic parameters (L_MV, P_MV, Num, P2P, and Area). An ANCOVA was performed to determine the difference in kinematic parameters between groups using movement speed as a covariate. Significant associations (P<0.05) were found between movement speed and other kinematic parameters, except for Area. Results showed the L_MV significantly differed from the P_MV (P=0.002) in the CLBP group, while a significant between-group difference (P=0.037) was found in the P_MV. Additionally, significant between-group differences (P<0.05) in P2P and Area were observed. The associations between movement speed and kinematic parameters suggest that movement speed changes can alter kinematic patterns. Therefore, clinicians may challenge lumbopelvic neuromuscular control by modifying movement speed to elicit greater change in kinematic patterns. In addition, the NoLBP group used shared lumbar and pelvic contributions, while the CLBP group used less pelvic contribution. Finally, P2P and Area appeared to offer the greatest sensitivity to differentiate between the groups. Overall, these findings may enhance the understanding of the mechanism underlying IC in CLBP.