title: Lumbar motion changes in chronic low back pain patients: a secondary analysis of data from a randomized clinical trial.
abstract: BACKGROUND
  Several therapies have been used in the treatment of chronic low back pain (LBP), including various exercise strategies and spinal manipulative therapy (SMT). A common belief is that spinal motion changes in particular ways in direct response to specific interventions, such as exercise or spinal manipulation.
  
  
  OBJECTIVE
  The purpose of this study was to assess changes in lumbar region motion for more than 12 weeks by evaluating four motion parameters in the sagittal plane and two in the horizontal plane in LBP patients treated with either exercise therapy or spinal manipulation.
  
  
  METHODS
  Secondary analysis of a subset of participants from a randomized clinical trial.
  
  
  METHODS
  One hundred ninety-nine study participants with LBP of more than 6 weeks' duration who had spinal motion measures obtained before and after the period of intervention.
  
  
  METHODS
  Lumbar region spinal kinematics sampled using a six-degree-of-freedom instrumented spatial linkage system.
  
  
  METHODS
  Trained therapists collected regional lumbar spinal motion data at baseline and 12 weeks of follow-up. The lumbar region spinal motion data were analyzed as a total cohort and relative to treatment modality (high dose, supervised low-tech trunk exercise, SMT, and a short course of home exercise and self-care advice). The study was supported by grants from Health Resources and Services Administration, Danish Agency for Science Technology and Innovation, Danish Chiropractors Research Foundation, and the University of Southern Denmark. No conflicts of interest reported.
  
  
  RESULTS
  For the cohort as a whole, lumbar region motion parameters were altered over the 12-week period, except for the jerk index parameter. The group receiving spinal manipulation changed significantly in all, and the exercise groups in half, the motion parameters included in the analysis. The spinal manipulation group changed to a smoother motion pattern (reduced jerk index), whereas the exercise groups did not.
  
  
  CONCLUSIONS
  This study provides evidence that spinal motion changes can occur in chronic LBP patients over a 12-week period and that these changes are associated with the type of treatment.
authors.affiliation: Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark. Electronic address: rmieritz@health.sdu.dk.
authors.forename: Rune M
authors.initials: RM
authors.lastname: Mieritz
authors.affiliation: Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark; Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230, Odense M, Denmark.
authors.forename: Jan
authors.initials: J
authors.lastname: Hartvigsen
authors.affiliation: Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada; National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100, Copenhagen, Denmark.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Boyle
authors.affiliation: Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark; National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100, Copenhagen, Denmark.
authors.forename: Markus D
authors.initials: MD
authors.lastname: Jakobsen
authors.affiliation: Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Aagaard
authors.affiliation: Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230, Odense M, Denmark; Wolfe Harris Center for Clinical Studies, Northwestern Health Sciences University, 2501 W. 84th St, Bloomington, MN 55431, USA.
authors.forename: Gert
authors.initials: G
authors.lastname: Bronfort
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena / Q000502:physiology; D059350:Chronic Pain / Q000503:physiopathology* / Q000628:therapy; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology* / Q000628:therapy; D008161:Lumbosacral Region / Q000503:physiopathology*; D008297:Male; D020393:Manipulation, Spinal; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D012648:Self Care; D014481:United States
keywords: Biomechanics; Exercise; Low back pain; Manipulation; Measurement; Motion analysis; Nonsurgical; Spine