title: Effects of noxious stimulation to the back or calf muscles on gait stability.
abstract: Gait stability is the ability to deal with small perturbations that naturally occur during walking. Changes in motor control caused by pain could affect this ability. This study investigated whether nociceptive stimulation (hypertonic saline injection) in a low back (LBP) or calf (CalfP) muscle affects gait stability. Sixteen participants walked on a treadmill at 0.94ms(-1) and 1.67ms(-1), while thorax kinematics were recorded using 3D-motion capture. From 110 strides, stability (local divergence exponent, LDE), stride-to-stride variability and root mean squares (RMS) of thorax linear velocities were calculated along the three movement axes. At 0.94ms(-1), independent of movement axes, gait stability was lower (higher LDE) and stride-to-stride variability was higher, during LBP and CalfP than no pain. This was more pronounced during CalfP, likely explained by the biomechanical function of calf muscles in gait, as supported by greater mediolateral RMS and stance time asymmetry than in LBP and no pain. At 1.67ms(-1), independent of movement axes, gait stability was greater and stride-to-stride variability was smaller with LBP than no pain and CalfP, whereas CalfP was not different from no pain. Opposite effects of LBP on gait stability between speeds suggests a more protective strategy at the faster speed. Although mediolateral RMS was greater and participants had more asymmetric stance times with CalfP than LBP and no pain, limited effect of CalfP at the faster speed could relate to greater kinematic constraints and smaller effects of calf muscle activity on propulsion at this speed. In conclusion, pain effects on gait stability depend on pain location and walking speed.
authors.affiliation: The University of Queensland, Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health & Rehabilitation Sciences, Brisbane, Queensland 4072, Australia. Electronic address: w.vandenhoorn@uq.edu.au.
authors.forename: Wolbert
authors.initials: W
authors.lastname: van den Hoorn
authors.affiliation: The University of Queensland, Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health & Rehabilitation Sciences, Brisbane, Queensland 4072, Australia; University of Nantes, Laboratory "Motricité, Interactions, Performance" (EA 4334), Nantes, France.
authors.forename: François
authors.initials: F
authors.lastname: Hug
authors.affiliation: The University of Queensland, Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health & Rehabilitation Sciences, Brisbane, Queensland 4072, Australia.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Hodges
authors.affiliation: MOVE Research Institute Amsterdam, Department of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands; Department of Orthopaedic Surgery, First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, PR China.
authors.forename: Sjoerd M
authors.initials: SM
authors.lastname: Bruijn
authors.affiliation: MOVE Research Institute Amsterdam, Department of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Jaap H
authors.initials: JH
authors.lastname: van Dieën
mesh_terms: D001415:Back; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait; D006801:Humans; D007866:Leg / Q000503:physiopathology; D017116:Low Back Pain / Q000503:physiopathology; D008297:Male; D009068:Movement; D018482:Muscle, Skeletal / Q000503:physiopathology*; D063806:Myalgia / Q000503:physiopathology; D004856:Postural Balance; D013909:Thorax / Q000503:physiopathology; D016138:Walking; D055815:Young Adult
keywords: Experimental pain; Local divergence exponent; Low back pain; Lyapunov exponent; Movement variability; Walking