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Walking Patterns in Patients with Low Back Pain

We tend to think of the spine as rigid and unmoving. But in fact the spine is moving whenever we're up and about. Though we stand upright while walking, the parts of the spine are still in motion. Walking is actually a product of thousands of small spinal movements. These authors wanted to see whether low back pain changed the pattern of these spinal movements.

Thirty-four patients with low back pain participated in the study. These patients had experienced low back pain on at least half the days of the past 12 months. On a scale of one to 10, their average pain rating was a four. They had moderate limitations in their daily activities due to low back pain.

The patients walked on a treadmill for several minutes at 4.5 km/hour. During this time, movement in the upper and lower areas of their low backs was recorded by ultrasound. Three kinds of spinal movements were recorded: forward to back, side to side, and rotation. Twenty-two hospital personnel who didn't have low back pain were also monitored on the treadmill, to act as a comparison group.

Patients with low back pain took shorter steps than the other group. The authors think that people with back problems may develop more rigid or cautious walking styles to avoid pain.

Overall, there were no major differences between the two groups in kinds of movement while walking. The size, pattern, and timing of spinal movements were basically the same for both groups.

However, patients with low back pain showed an inconsistent stride. For these patients, one step could be very different from the next. This variability reflected actual fluctuations in amount of spinal movement.

The authors think that low back pain reduces patients' control over movement. Low back pain may actually impair the sensory information systems that regulate movement. With more variation during their strides, patients with low back pain expended more energy. This makes it hard to maintain a consistent, effective gait.

The authors feel that studies of movement offer important information about low back pain. Variations in how people with low back pain walk should be considered by those treating patients with back problems.

Lutz Vogt, PhD, et al. Influences of Nonspecific Low Back Pain on Three-Dimensional Lumbar Spine Kinematics in Locomotion. In Spine. September 1, 2001. Vol. 26. No. 17. Pp. 1910-1919.


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