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Regional spinal kinematics and muscle activity in non-specific chronic low back pain during functional tasks: evaluation of a sub-classification approach

Hemming, Rebecca ORCID: 2015. Regional spinal kinematics and muscle activity in non-specific chronic low back pain during functional tasks: evaluation of a sub-classification approach. PhD Thesis, Cardiff University.
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Background: Differences in regional lumbar angles in sitting have been observed between subclassified groups of NSCLBP patients. However, differences during standing posture, range of movement and functional tasks, as well as differences in thoracic kinematics, have not been explored to date, despite classification-based cognitive functional therapy (CB-CFT) approaches being proposed to be effective for these subgroups. Methods: Spinal kinematics and trunk muscle activity of 27 Flexion Pattern (FP), 23 Active Extension Pattern (AEP) and 28 healthy controls were recorded (using 3D motion analysis (Vicon®) and surface electromyography) during: usual sitting, usual standing, flexion, extension, sit-to-stand -to-sit, reach up, stepping up and down, lifting and replacing a box and bending (and return) to pick up a pen tasks. Midpoint regional sagittal spinal angles and normalised amplitude sEMG for trunk muscles bilaterally were compared between groups. Statistical analysis was conducted using one-way ANOVAs (kinematics) and Kruskal-Wallis (muscle activity) tests. Results: Significant differences were observed between the AEP and FP groups in the upper lumber and lower thoracic spine during most postures and tasks. Some significant differences were also observed between the FP and control groups in these regions. Additionally, significant differences in the total lumbar spine between AEP and FP groups were occasionally evident. No differences in any other spinal region (or between AEP and control groups) were observed. Some significant differences (p<0.05) in unilateral muscle activity were also observed between the NSCLBP and healthy control groups. Conclusion: The study findings further validate the classification approach (O’Sullivan, 2005). It highlighted that kinematic differences were observed to consistently occur in the thoraco-lumbar region during both static postures and functional tasks. Sub-division of regional spinal angles is key to identifying sub-group differences. These findings can inform novel CB-CFT interventions and highlights the need for targeted thoraco-lumbar spinal movement re-education strategies in NSCLBP subgroups.

Item Type: Thesis (PhD)
Date Type: Publication
Status: Unpublished
Schools: Healthcare Sciences
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Spine; Lumbar; Thoracic; Classification; Non-specific chronic low back pain; Functional activity; Kinematics; Muscle activity
Funders: Arthritis Research UK (PhD Studentship), Presidents Scholarship, Cardiff University
Date of First Compliant Deposit: 28 April 2016
Date of Acceptance: April 2016
Last Modified: 01 Nov 2022 10:04

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