A Novel Biomechanical Device Improves Gait Pattern in Patient With Chronic Nonspecific Low Back Pain

被引:27
作者
Elbaz, Avi [2 ]
Mirovsky, Yigal [1 ]
Mor, Amit [2 ]
Enosh, Shavit [2 ]
Debbi, Eytan [2 ]
Segal, Ganit [2 ]
Barzilay, Yair [3 ]
Debi, Ronen [1 ]
机构
[1] Assaf Harofeh Med Ctr, Dept Orthoped Surg, IL-70600 Zerifin, Israel
[2] APOS Res Grp, Herzliyya, Israel
[3] Hadassah Med Ctr, Dept Orthoped Surg, IL-91120 Jerusalem, Israel
关键词
gait; nonspecific low back pain; core stability; POSTURAL RESPONSES; TRUNK MUSCLES; MOTOR CONTROL; WALKING; FORCE; COORDINATION; PERTURBATION; ACTIVATION; MOVEMENTS; DIAGNOSIS;
D O I
10.1097/BRS.0b013e3181a98d3f
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. A retrospective study on patients with chronic nonspecific low back pain (NSLBP). Objective. To describe the gait stride characteristics of patients with chronic NSLBP, and to examine the effect of a novel biomechanical device on the gait stride characteristics of these patients. Summary of Background Data. Patient with NSLBP alters their gait patterns. This is considered a protective mechanism as patients try to avoid extensive hip and spine ranges of motion and minimize forces and moments acting on the body. In addition, there are changes in the neuromuscular control system in patients with LBP that could possibly be attributed to the effects of pain on motor control. Methods. Nineteen patients underwent a gait test, using an electronic walkway, at baseline and after 12 weeks of treatment. Spatiotemporal parameters were used to identify changes in gait pattern. A novel biomechanical device comprised of 4 modular elements attached to foot-worn platforms was used in the study. The modules are 2 convex shaped biomechanical elements attached to each foot, one is located under the hindfoot region and the other is located under the forefoot region. The device was individually calibrated to each patient. The patients were instructed to walk with the calibrated biomechanical device on a daily basis for a period of 12 weeks. Results. Significant differences were found at baseline and after 12 weeks in normalized velocity (P = 0.03), cadence (P < 0.01), left normalized step length (P = 0.02), right normalized step length (P = 0.02), right swing (P < 0.01), right stance (P < 0.01), left single limb support (P = 0.01), left double limb support (P = 0.02), and right double limb support (P = 0.02). Conclusion. Patients with NSLBP treated with the novel biomechanical device for 3 months increased walking speed through longer step length and eliminated asymmetrical differences.
引用
收藏
页码:E507 / E512
页数:6
相关论文
共 42 条
[1]   Chronic back pain is associated with decreased prefrontal and thalamic gray matter density [J].
Apkarian, AV ;
Sosa, Y ;
Sonty, S ;
Levy, RM ;
Harden, RN ;
Parrish, TB ;
Gitelman, DR .
JOURNAL OF NEUROSCIENCE, 2004, 24 (46) :10410-10415
[2]   The effect of foot wedging on electromyographic activity in the erector spinae and gluteus medius muscles during walking [J].
Bird, AR ;
Bendrups, AP ;
Payne, CB .
GAIT & POSTURE, 2003, 18 (02) :81-91
[3]   Active trunk extensor contributions to dynamic posteroanterior lumbar spinal stiffness [J].
Colloca, CJ ;
Keller, TS .
JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS, 2004, 27 (04) :229-237
[4]   Changes in coordination of postural control during dynamic stance in chronic low back pain patients [J].
della Volpe, R. ;
Popa, T. ;
Ginanneschi, F. ;
Spidalieri, R. ;
Mazzocchio, R. ;
Rossi, A. .
GAIT & POSTURE, 2006, 24 (03) :349-355
[5]   WHAT CAN THE HISTORY AND PHYSICAL-EXAMINATION TELL US ABOUT LOW-BACK-PAIN [J].
DEYO, RA ;
RAINVILLE, J ;
KENT, DL .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1992, 268 (06) :760-765
[6]  
Fitzgerald GK, 2000, PHYS THER, V80, P128, DOI 10.1093/ptj/80.2.128
[7]   Attenuation of spinal transients at heel strike using viscoelastic heel insoles: an in vivo study [J].
Folman, Y ;
Wosk, J ;
Shabat, S ;
Gepstein, R .
PREVENTIVE MEDICINE, 2004, 39 (02) :351-354
[8]   THE DEVELOPMENT OF A BATTERY OF MEASURES FOR ASSESSING PHYSICAL FUNCTIONING OF CHRONIC PAIN PATIENTS [J].
HARDING, VR ;
WILLIAMS, ACD ;
RICHARDSON, PH ;
NICHOLAS, MK ;
JACKSON, JL ;
RICHARDSON, IH ;
PITHER, CE .
PAIN, 1994, 58 (03) :367-375
[9]   Meta-analysis: Exercise therapy for nonspecific low back pain [J].
Hayden, JA ;
van Tulder, MW ;
Malmivaara, AV ;
Koes, BW .
ANNALS OF INTERNAL MEDICINE, 2005, 142 (09) :765-775
[10]  
Hides J A, 2001, Spine (Phila Pa 1976), V26, pE243, DOI 10.1097/00007632-200106010-00004