The Effect of Chronic Low Back Pain on Trunk Accuracy in a Multidirectional Isometric Tracking Task

Study Design. A cross-sectional study to quantify trunk motor control during multidirectional isometric tracking tasks. Objective. To investigate the effect of chronic low back pain (LBP) on trunk neuromuscular performance while participants performed isometric exertions of trunk muscles to track targets in different angles with various magnitudes. Summary of Background Data. Tracking tasks especially in multidirectional activities are among the common research methods to quantify human motor control in different conditions. However, little information is available on trunk motor control during these tasks. There is no study investigating trunk accuracy during multidirectional isometric tracking tasks in patients with LBP. Materials and Methods. Twelve patients with chronic LBP and 16 asymptomatic participants performed isometric target tracking tasks in 12 different directions with varying magnitude, from 0% to 80% of individual maximum voluntary exertion, in upright standing posture. The tracking system included a moving target object that moved on a straight line in a predefined angle with the rate of 6% maximum voluntary exertion/s. Trunk accuracy was quantified by computing constant error and variable error during each trial. A mixed model repeated measure analysis of variance was conducted to assess statistical analysis. Results. Patients with chronic LBP track the target object with higher error compared with healthy controls across almost all of the target angles (P < 0.01). Trunk accuracy decreased significantly in higher level of exertions (P < 0.01). Conclusion. The results provided additional evidence of a change in trunk control strategies in patients with chronic LBP. Decreased accuracy of trunk during isometric tracking tasks especially in higher levels of asymmetric exertions may explain higher risk of low back injuries in these activities. Level of Evidence: 4

[1]  W. Marras,et al.  The Role of Complex, Simultaneous Trunk Motions in the Risk of Occupation‐Related Low Back Disorders , 1998, Spine.

[2]  M. Djupsjöbacka,et al.  Acuity of goal-directed arm movements to visible targets in chronic neck pain. , 2008, Journal of rehabilitation medicine.

[3]  W. G. Allread,et al.  The Role of Dynamic Three-Dimensional Trunk Motion in Occupationally-Related Low Back Disorders: The Effects of Workplace Factors, Trunk Position, and Trunk Motion Characteristics on Risk of Injury , 1993, Spine.

[4]  M. Parnianpour,et al.  Trunk biomechanics during maximum isometric axial torque exertions in upright standing. , 2008, Clinical biomechanics.

[5]  J. Geurts,et al.  Clinical course of non‐specific low back pain: A systematic review of prospective cohort studies set in primary care , 2013, European journal of pain.

[6]  M Parnianpour,et al.  Functional roles of abdominal and back muscles during isometric axial rotation of the trunk , 2001, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[7]  Steven A. Lavender,et al.  Coactivation of the Trunk Muscles during Asymmetric Loading of the Torso , 1992, Human factors.

[8]  Les Irwig,et al.  Red flags to screen for malignancy and fracture in patients with low back pain: systematic review , 2013, BMJ.

[9]  Carolynn Patten,et al.  Reliability and responsiveness of elbow trajectory tracking in chronic poststroke hemiparesis. , 2003, Journal of rehabilitation research and development.

[10]  M. Nordin,et al.  Capability and recruitment patterns of trunk during isometric uniaxial and biaxial upright exertion. , 2008, Clinical biomechanics.

[11]  Christopher R France,et al.  The Influence of Pain-Related Fear on Peak Muscle Activity and Force Generation During Maximal Isometric Trunk Exertions , 2008, Spine.

[12]  T. Bajd,et al.  Force tracking system for the assessment of grip force control in patients with neuromuscular diseases. , 2004, Clinical biomechanics.

[13]  W. E. Hoogendoorn,et al.  Flexion and Rotation of the Trunk and Lifting at Work Are Risk Factors for Low Back Pain: Results of a Prospective Cohort Study , 2000, Spine.

[14]  Gudny Lilja Oddsdottir,et al.  “The Fly”: A New Clinical Assessment and Treatment Method for Deficits of Movement Control in the Cervical Spine: Reliability and Validity , 2010, Spine.

[15]  G B Andersson,et al.  Trunk muscle activation and cocontraction while resisting applied moments in a twisted posture. , 1993, Ergonomics.

[16]  M. Ferreira,et al.  A literature review reveals that trials evaluating treatment of non-specific low back pain use inconsistent criteria to identify serious pathologies and nerve root involvement , 2012, The Journal of manual & manipulative therapy.

[17]  H. Aalto,et al.  Psychomotor Speed and Postural Control in Chronic Low Back Pain Patients: A Controlled Follow‐Up Study , 1996, Spine.

[18]  Yijung Chung,et al.  Effect of the knee joint tracking training in closed kinetic chain condition for stroke patients. , 2006, Restorative neurology and neuroscience.

[19]  K. Uğurbil,et al.  Analysis of fMRI and finger tracking training in subjects with chronic stroke. , 2002, Brain : a journal of neurology.

[20]  Michiel P de Looze,et al.  Position sense acuity of the upper extremity and tracking performance in subjects with non-specific neck and upper extremity pain and healthy controls. , 2010, Journal of rehabilitation medicine.

[21]  M. Parnianpour,et al.  The Effect of Angle and Level of Exertion on Trunk Neuromuscular Performance During Multidirectional Isometric Activities , 2009, Spine.

[22]  J. Kelsey,et al.  An epidemiologic study of lifting and twisting on the job and risk for acute prolapsed lumbar intervertebral disc , 1984, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[23]  Idsart Kingma,et al.  Precision control of trunk movement in low back pain patients. , 2013, Human movement science.

[24]  Normand Teasdale,et al.  Repositioning accuracy and movement parameters in low back pain subjects and healthy control subjects , 2005, European Spine Journal.

[25]  Thomas S Buchanan,et al.  Specificity of muscle action after anterior cruciate ligament injury , 2003, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[26]  Miguel A Perez,et al.  Lower Torso Muscle Activation Patterns for High-Magnitude Static Exertions: Gender Differences and the Effects of Twisting , 2002, Spine.

[27]  H. Alaranta,et al.  Mechanisms explaining the association between low back trouble and deficits in information processing. A controlled study with follow-up. , 1999, Spine.

[28]  A Meghdari,et al.  Design and evaluation of a novel triaxial isometric trunk muscle strength measurement system , 2009, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[29]  J. Carey,et al.  Effect of aerobic exercise on tracking performance in elderly people: a pilot study. , 2001, Physical therapy.