Nguyen Toan, Behrens Martin, Broscheid Kim-Charline, Bielitzki Robert, Weber Saskia, Libnow Saskia, Malczewski Victoria, Baldauf Lukas, Milberger Xenia, Jassmann Lena, Wustmann Anne, Meiler Katharina, Drange Steffen, Franke Jörg, Schega Lutz
Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany.
Department of Orthopaedic Surgery, Klinikum Magdeburg gGmbH, Magdeburg, Germany.
Front Med (Lausanne). 2023 May 5;10:1147907. doi: 10.3389/fmed.2023.1147907. eCollection 2023.
Activities of daily living, such as walking, are impaired in chronic low back pain (CLBP) patients compared to healthy individuals. Thereby, pain intensity, psychosocial factors, cognitive functioning and prefrontal cortex (PFC) activity during walking might be related to gait performance during single and dual task walking (STW, DTW). However, to the best of our knowledge, these associations have not yet been explored in a large sample of CLBP patients.
Gait kinematics (inertial measurement units) and PFC activity (functional near-infrared spectroscopy) during STW and DTW were measured in 108 CLBP patients (79 females, 29 males). Additionally, pain intensity, kinesiophobia, pain coping strategies, depression and executive functioning were quantified and correlation coefficients were calculated to determine the associations between parameters.
The gait parameters showed small correlations with acute pain intensity, pain coping strategies and depression. Stride length and velocity during STW and DTW were (slightly to moderately) positively correlated with executive function test performance. Specific small to moderate correlations were found between the gait parameters and dorsolateral PFC activity during STW and DTW.
Patients with higher acute pain intensity and better coping skills demonstrated slower and less variable gait, which might reflect a pain minimization strategy. Psychosocial factors seem to play no or only a minor role, while good executive functions might be a prerequisite for a better gait performance in CLBP patients. The specific associations between gait parameters and PFC activity during walking indicate that the availability and utilization of brain resources are crucial for a good gait performance.
与健康个体相比，慢性下腰痛（CLBP）患者的日常生活活动，如行走，会受到损害。因此，行走过程中的疼痛强度、心理社会因素、认知功能和前额叶皮质（PFC）活动可能与单任务和双任务行走（STW、DTW）期间的步态表现有关。然而，据我们所知，尚未在大量CLBP患者样本中探索这些关联。
对108例CLBP患者（79例女性，29例男性）在STW和DTW期间的步态运动学（惯性测量单元）和PFC活动（功能性近红外光谱）进行了测量。此外，对疼痛强度、运动恐惧、疼痛应对策略、抑郁和执行功能进行了量化，并计算了相关系数以确定参数之间的关联。
步态参数与急性疼痛强度、疼痛应对策略和抑郁呈低度相关。STW和DTW期间的步长和速度与执行功能测试表现呈（轻度至中度）正相关。在STW和DTW期间，步态参数与背外侧PFC活动之间发现了特定的低度至中度相关性。
急性疼痛强度较高且应对技能较好的患者表现出较慢且变异性较小的步态，这可能反映了一种疼痛最小化策略。心理社会因素似乎没有作用或仅起次要作用，而良好的执行功能可能是CLBP患者步态表现更好的先决条件。行走期间步态参数与PFC活动之间的特定关联表明，大脑资源的可用性和利用对于良好的步态表现至关重要。
