Whole-spine kinematics during functional tasks in individuals with chronic low back pain compared with asymptomatic controls: A three-dimensional analysis.

BACKGROUND

While previous studies have extensively examined differences in lumbar spine kinematics in individuals with chronic low back pain (CLBP), movement patterns of the cervical and thoracic spine have been addressed to a limited extent.

OBJECTIVE

To compare cervical, thoracic, and lumbar kinematic patterns during functional tasks between individuals with CLBP and asymptomatic controls, and to investigate relationships between whole-spine kinematics.

METHODS

A total of 23 individuals with CLBP and 23 asymptomatic controls were included. Whole-spine kinematics were assessed using inertial measurement units during sit-to-stand, box lifting, step-up, and walking. Minimum and maximum joint angles, functional ranges of motion, and inter-segmental correlations were analyzed across cervical, thoracic, and lumbar regions.

RESULTS

During sit-to-stand, greater transverse plane rotation at L3-L4 and reduced frontal plane motion at T12-L1 were observed in the CLBP group (p = .04). During box lifting, greater frontal plane motion at the T1-C7 segment (p = .04) and increased transverse plane rotation at the T1-C7 and atlanto-occipital segments were found (p = .002-.001). In the step-up task, sagittal plane motion at cervical segments was reduced in individuals with CLBP (p = .03-0.04). During walking, altered frontal and sagittal plane kinematics were observed at lumbar and cervical segments (p = .04-.007). Strong associations were consistently observed between lumbar and thoracic segment motions across tasks in both groups (r > 0.80), whereas lumbar-cervical associations were task- and plane-specific and generally stronger in individuals with CLBP. However, after false discovery rate correction, only the findings related to lifting task remained statistically significant, while the other kinematic differences did not retain significance; correlation results remained significant after correction.

CONCLUSION

Individuals with CLBP may exhibit task-dependent and segment-specific changes in spinal kinematics during daily activities. Further research is needed to better understand the distribution and relevance of these kinematic differences across spinal segments.