Christe Guillaume, Aussems Camille, Jolles Brigitte M, Favre Julien
Department of Physiotherapy, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.
Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Front Bioeng Biotechnol. 2021 Nov 15;9:767974. doi: 10.3389/fbioe.2021.767974. eCollection 2021.
Despite a large body of evidence demonstrating spinal movement alterations in individuals with chronic low back pain (CLBP), there is still a lack of understanding of the role of spinal movement behavior on LBP symptoms development or recovery. One reason for this may be that spinal movement has been studied during various functional tasks without knowing if the tasks are interchangeable, limiting data consolidation steps. The first objective of this cross-sectional study was to analyze the influence of the functional tasks on the information carried by spinal movement measures. To this end, we first analyzed the relationships in spinal movement between various functional tasks in patients with CLBP using Pearson correlations. Second, we compared the performance of spinal movement measures to differentiate patients with CLBP from asymptomatic controls among tasks. The second objective of the study was to develop task-independent measures of spinal movement and determine the construct validity of the approach. Five functional tasks primarily involving sagittal-plane movement were recorded for 52 patients with CLBP and 20 asymptomatic controls. Twelve measures were used to describe the sagittal-plane angular amplitude and velocity at the lower and upper lumbar spine as well as the activity of the erector spinae. Correlations between tasks were statistically significant in 91 out of 99 cases (0.31 ≤ r ≤ 0.96, all < 0.05). The area under the curve (AUC) to differentiate groups did not differ substantially between tasks in most of the comparisons (82% had a difference in AUC of ≤0.1). The task-independent measures of spinal movement demonstrated equivalent or higher performance to differentiate groups than functional tasks alone. In conclusion, these findings support the existence of an individual spinal movement signature in patients with CLBP, and a limited influence of the tasks on the information carried by the movement measures, at least for the twelve common sagittal-plane measures analysed in this study. Therefore, this work brought critical insight for the interpretation of data in literature reporting differing tasks and for the design of future studies. The results also supported the construct validity of task-independent measures of spinal movement and encouraged its consideration in the future.
尽管有大量证据表明慢性下腰痛（CLBP）患者存在脊柱运动改变，但对于脊柱运动行为在LBP症状发展或恢复中的作用仍缺乏了解。造成这种情况的一个原因可能是，在各种功能任务中对脊柱运动进行了研究，但却不知道这些任务是否可互换，这限制了数据整合步骤。这项横断面研究的首要目标是分析功能任务对脊柱运动测量所携带信息的影响。为此，我们首先使用Pearson相关性分析了CLBP患者各种功能任务之间脊柱运动的关系。其次，我们比较了脊柱运动测量在不同任务中区分CLBP患者与无症状对照组的表现。该研究的第二个目标是开发与任务无关的脊柱运动测量方法，并确定该方法的结构效度。记录了52例CLBP患者和20例无症状对照组主要涉及矢状面运动的五项功能任务。使用十二种测量方法来描述下腰椎和上腰椎的矢状面角幅度和速度以及竖脊肌的活动。99例中的91例任务之间的相关性具有统计学意义（0.31≤r≤0.96，均P<0.05）。在大多数比较中，区分组的曲线下面积（AUC）在不同任务之间没有实质性差异（82%的AUC差异≤0.1）。与任务无关的脊柱运动测量方法在区分组方面表现出与单独的功能任务相当或更高的性能。总之，这些发现支持CLBP患者存在个体脊柱运动特征，并且任务对运动测量所携带信息的影响有限，至少对于本研究中分析的十二种常见矢状面测量方法是如此。因此，这项工作为解释报告不同任务的文献中的数据以及未来研究的设计带来了关键见解。结果还支持了与任务无关的脊柱运动测量方法的结构效度，并鼓励在未来加以考虑。
