Spinal segments do not move together predictably during daily activities

Enrica Papi; Anthony M J Bull; Alison H McGregor

doi:10.1016/j.gaitpost.2018.10.031

Spinal segments do not move together predictably during daily activities

Gait Posture. 2019 Jan:67:277-283. doi: 10.1016/j.gaitpost.2018.10.031. Epub 2018 Oct 29.

Authors

Enrica Papi¹, Anthony M J Bull², Alison H McGregor³

Affiliations

¹ Department of Surgery and Cancer, Imperial College London, London, UK; Department of Bioengineering, Imperial College London, London, UK. Electronic address: e.papi@imperial.ac.uk.
² Department of Bioengineering, Imperial College London, London, UK.
³ Department of Surgery and Cancer, Imperial College London, London, UK.

Abstract

Background: Considering the thoracic, lumbar spine or whole spine as rigid segments has been the norm until recent studies highlighted the importance of more detailed modelling. A better understanding of the requirement for spine multi-segmental analysis could guide planning of future studies and avoid missing clinically-relevant information.

Research question: This study aims to assess the correlation between adjacent spine segments movement thereby evaluating segmental redundancy in both healthy and participants with low back pain (LBP).

Methods: A 3D motion capture system tracked the movement of upper and lower thoracic and lumbar spine segments in twenty healthy and twenty participants with LBP. Tasks performed included walking, sit-to-stand and lifting, repeated 3 times. 3D angular kinematics were calculated for each spine segment. Segmental redundancy was evaluated through cross-correlation (R_xy) analysis of kinematics time series and correlation of range of motion (R_ROM) of adjacent spine segments.

Results: The upper/lower lumbar pairing showed weak correlations in the LBP group for all tasks and anatomical planes (R_xyrange:0.02-0.36) but moderate and strong correlations during walking (R_xy _frontalplane:0.4) and lifting (R_xy _sagittalplane:0.64) in the healthy group. The lower thoracic/upper lumbar pairing had weak correlations for both groups during lifting and sit-to-stand in the frontal plane and for walking (R_xy:0.01) in the sagittal plane only. The upper/lower thoracic pairing had moderate correlations during sit-to-stand in sagittal and transverse plane in patients with LBP (R_xy _sagittalplane:0.41; R_xy _transverse plane:-0.42) but weak in healthy (R_xy _sagittalplane:0.23; R_xy _transverseplane:-0.34); the contrary was observed during lifting. The majority of R_ROM values (55/72) demonstrated weak correlations.

Significance: The results suggest that multi-segmental analysis of the spine is necessary if spine movement characteristics are to be fully understood. We cannot establish a priori where redundancy occurs based on healthy data, therefore extra consideration should be made when planning studies with pathological cohorts.

Keywords: Cross-correlation; Kinematics; Low back pain; Motion analysis; Multi-segment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living*
Adult
Biomechanical Phenomena
Female
Humans
Imaging, Three-Dimensional / methods
Low Back Pain / physiopathology*
Male
Middle Aged
Range of Motion, Articular / physiology*
Spine / physiopathology*
Walking / physiology
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding