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Reduced instantaneous center of rotation movement in patients with low back pain

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Abstract

Purpose

The instantaneous center of rotation (ICR) can be used to investigate movement coordination and control in patients with low back pain (LBP). Tracking of the ICR in LBP patients has not been systematically investigated. This study aimed to (1) determine the within-session measurement error of ICR parameters, and (2) characterize the change in ICR among three groups of participants (no history of LBP = HC; history of LBP = HLBP; and current LBP = LBP).

Methods

Ninety-three participants (HC = 31; HLBP = 33; and LBP = 29) were recruited. Participants performed two sets of three repetitions of an active forward bend, while their lumbar and pelvic movements were recorded with an electromagnetic tracking system. Total ICR displacement and the radius of the bounding sphere containing the ICR were derived during the forward bending and the return to upright phases. Intra-class correlation coefficients (ICC3,3) and minimal detectable difference (MDD) were used to determine measurement error and interpret findings of the group analysis. One-way ANOVAs and post hoc Bonferroni comparisons were used to determine differences among groups.

Results

ICC3,3 demonstrated excellent within-session test–retest reliability of the ICR parameters (ICC3,3 = 0.86–0.97). The MDD values were 0.20–3.40 mm. Comparisons between the HC and LBP groups and between the HLBP and LBP groups showed significant differences (p < 0.05) for all ICR parameters, with medium effect sizes (0.51–0.66), except for total displacement during forward bending between the HC and LBP groups.

Conclusion

Less ICR displacement and variability in patients with LBP may indicate coping strategies to stiffen the lumbar spine. This could result from patients with LBP adopting a strategy of increased muscle activation to provide spinal stability during functional tasks.

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Acknowledgements

This research was conducted at the Rehabilitation Sciences Spine Research Laboratories of Drexel University, Philadelphia, PA and Physiotherapy Associates, West Chester, PA. The study was approved by the IRB Committee of Drexel University.

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Authors and Affiliations

  1. Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, Salaya, Nakhon Pathom, Thailand

    Peemongkon Wattananon & Nattaporn Intawachirarat

  2. Rehabilitation Sciences Spine Research Lab, Drexel University, Philadelphia, PA, USA

    Marco Cannella, Won Sung & Sheri P. Silfies

  3. Good Shepherd Penn Partners, Penn Therapy and Fitness, Philadelphia, PA, USA

    Won Sung

  4. Physical Therapy and Rehabilitation Sciences Department, Drexel University, Philadelphia, PA, USA

    Sheri P. Silfies

Authors
  1. Peemongkon Wattananon
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  2. Nattaporn Intawachirarat
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  3. Marco Cannella
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  4. Won Sung
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  5. Sheri P. Silfies
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Corresponding author

Correspondence to Peemongkon Wattananon.

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Conflict of interest

All authors declared that there was no potential conflict of interest.

Funding

This study was funded in part by the Orthopaedic Section of the American Physical Therapy Association (Silfies) and the Mahidol University Talent Management Program (Wattananon).

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Wattananon, P., Intawachirarat, N., Cannella, M. et al. Reduced instantaneous center of rotation movement in patients with low back pain. Eur Spine J 27, 154–162 (2018). https://doi.org/10.1007/s00586-017-5054-2

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  • DOI: https://doi.org/10.1007/s00586-017-5054-2

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