title: Pain intensity attenuates movement control of the lumbar spine in low back pain.
abstract: BACKGROUND
  Pain intensity attenuates muscular activity, proprioception, and tactile acuity, with consequent changes of joint kinematics. People suffering from low back pain (LBP) frequently show movement control impairments of the lumbar spine in sagittal plane. This cross-sectional, observational study investigated if the intensity of LBP attenuates lumbar movement control. The hypothesis was that lumbar movement control becomes more limited with increased pain intensity.
  
  
  METHODS
  The effect of LBP intensity, measured with a numeric rating scale (NRS), on lumbar movement control was tested using three movement control tests. The lumbar range of motion (ROM), the ratio of lumbar and hip ROM as indicators of direction specific movement control, and the recurrence and determinism of repetitive lumbar movement patterns were assessed in ninety-four persons suffering from LBP of different intensity and measured with an inertial measurement unit system. Generalized linear models were fitted for each outcome.
  
  
  RESULTS
  Lumbar ROM (+ 0.03°, p = 0.24) and ratio of lumbar and hip ROM (0.01, p = 0.84) were unaffected by LBP intensity. Each one point increase on the NRS resulted in a decrease of recurrence and determinism of lumbar movement patterns (-3.11 to -0.06, p ⩽ 0.05).
  
  
  CONCLUSIONS
  Our results indicate changes in movement control in people suffering from LBP. Whether decreased recurrence and determinism of lumbar movement patterns are intensifiers of LBP intensity or a consequence thereof should be addressed in a future prospective study.
authors.affiliation: Zurich University of Applied Sciences, Department of Health, Institute of Physiotherapy, Technikumstrasse 71, 8400 Winterthur, Switzerland; University of Tampere, School of Medicine, Kalevantie 4, 33014 University of Tampere, Finland. Electronic address: christoph.bauer@zhaw.ch.
authors.forename: C M
authors.initials: CM
authors.lastname: Bauer
authors.affiliation: Zurich University of Applied Sciences, Department of Health, Institute of Physiotherapy, Technikumstrasse 71, 8400 Winterthur, Switzerland.
authors.forename: F M
authors.initials: FM
authors.lastname: Rast
authors.affiliation: Zurich University of Applied Sciences, Department of Health, Institute of Physiotherapy, Technikumstrasse 71, 8400 Winterthur, Switzerland.
authors.forename: M J
authors.initials: MJ
authors.lastname: Ernst
authors.affiliation: Zurich University of Applied Sciences, Department of Health, Institute of Physiotherapy, Technikumstrasse 71, 8400 Winterthur, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Oetiker
authors.affiliation: Zurich University of Applied Sciences, Department of Health, Institute of Physiotherapy, Technikumstrasse 71, 8400 Winterthur, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Meichtry
authors.affiliation: Zurich University of Applied Sciences, Department of Health, Institute of Physiotherapy, Technikumstrasse 71, 8400 Winterthur, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Kool
authors.affiliation: University of Eastern Finland, Department of Applied Physics, P.O. Box 1627, 70211 Kuopio, Finland. Electronic address: saara.rissanen@uef.fi.
authors.forename: S M
authors.initials: SM
authors.lastname: Rissanen
authors.affiliation: UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland. Electronic address: jaana.h.suni@uta.fi.
authors.forename: J H
authors.initials: JH
authors.lastname: Suni
authors.affiliation: University of Tampere, School of Medicine, Kalevantie 4, 33014 University of Tampere, Finland; Pirkanmaa Hospital District, Physical and Rehabilitation Medicine Outpatient Clinic, Box 2000, 33521 Tampere, Finland. Electronic address: markku.kankaanpaa@pshp.fi.
authors.forename: M
authors.initials: M
authors.lastname: Kankaanpää
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology*; D008159:Lumbar Vertebrae / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009068:Movement; D018482:Muscle, Skeletal / Q000502:physiology; D004856:Postural Balance; D016059:Range of Motion, Articular
keywords: Biomechanical phenomena; Low back pain; Movement disorders; Recurrence quantification analysis