Annals of Biomedical Engineering

, Volume 46, Issue 3, pp 488–497 | Cite as

Trunk Reaction Time and Kinematic Changes Following Slip Perturbations in Subjects with Recurrent Low Back Pain

  • Paul S. SungEmail author
  • Pamela Danial


Postural responses following slip perturbations are critical to fall prevention strategies. It is unclear how postural reactions with a handheld task can validly be transferred to treadmill-induced slip perturbations in subjects with recurrent low back pain (LBP). The purpose of this study was to investigate trunk reaction times and trunk flexion angle as well as velocity following the slips between subjects with and without LBP. There were 29 subjects with LBP and 40 control subjects who participated in the study. Three levels of consecutive treadmill-induced slip perturbations were introduced at level 1 (duration: 0.10 s, velocity: 0.24 m/s, displacement: 1.20 cm), level 2 (0.12 s, 0.72 m/s, 4.32 cm), and level 3 (0.12 s, 1.37 m/s, 8.22 cm). The trunk reaction time, swing/step times, and trunk flexion angle as well as velocity at heel strike/toe-off were compared between the groups. There were significantly longer trunk reaction times (t = − 2.03, p = 0.04), swing times (t = − 2.63, p = 0.01), and step times (t = − 2.53, p = 0.01) in the LBP group at the level 1 slip perturbation. The groups demonstrated a significant interaction between the levels and trunk flexion angles (F = 4.72, p = 0.03), but there was no interaction between the levels and trunk flexion velocities (F = 0.07, p = 0.79). The LBP group demonstrated longer reaction times at the level 1 perturbation due to a possible pain recurrence. However, this compensatory tolerance was limited at the level 3 perturbation due to increased trunk flexion angle at heel strike and toe-off in the LBP group. Clinicians may consider a compensatory strategy to improve reaction time and minimize trunk flexion following slip perturbations in patients with LBP.


Kinematic Slip Perturbations Low back pain Motor learning Compensation 



Low back pain


Body mass index


Visual analog scale


Oswestry Disability Index


Analysis of variance


Pearson correlation coefficient



This work was supported by Herbert H. and Grace A. Dow College of Health Professions at Central Michigan University (ION 42041-15647 and FRCE 48151).

Ethical Approval

Institutional Review Board at Central Michigan University (955053-3).


Central Michigan University (ION 42041-15647 and FRCE 48151).

Conflict of interest



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Copyright information

© Biomedical Engineering Society 2018

Authors and Affiliations

  1. 1.Doctoral Program in Physical Therapy/Motion Analysis Center, Herbert H. and Grace A. Dow College of Health ProfessionsCentral Michigan UniversityMt. PleasantUSA

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