Movement Patterns during Functional Activities in People with Chronic Low Back Pain
Date of Award
Doctor of Philosophy (PhD)
Chair and Committee
Linda Van Dillen
Babak Bazrgari, Michael Harris, Joshua Jackson, Catherine Lang
People with chronic LBP display an altered movement pattern where the lumbar spine moves more readily than other joints that can contribute to the activity. The pattern is of particular clinical relevance because across multiple studies the magnitude of altered pattern is associated with LBP and function. One session of motor skill training (MST) during functional activities can improve the altered pattern. However, of the few studies investigating MST for people with LBP, none have examined the short-term or long-term effects of MST on the altered pattern. Additionally, no study has systematically examined if person-specific characteristics moderate the altered pattern at baseline or the ability to improve the pattern over time. Third, there has been no testing of whether people with LBP display a consistent pattern across functional activities. The primary purposes of this dissertation were to examine: 1) the short- and long-term effects of two exercise-based treatments on the altered pattern in people with chronic LBP, 2) the role of person-specific characteristics in the altered pattern and change in the pattern with treatment, and 3) if people with chronic LBP display a similar movement pattern across multiple functional activities. In chapter 2, we examined the short- and long-term effects of MST and strength and flexibility exercise (SFE) on the altered movement pattern during a functional activity test of pick up an object. We found that MST directed at the performance of functional activities is superior to SFE in the ability to improve and maintain improvements in an altered pattern. In chapter 3, we tested if person-specific characteristics moderate the baseline and change over time in the altered pattern within MST and SFE. We found that gender and age were associated with the pattern at baseline. Also, age and the magnitude of altered movement before treatment were associated with the change over time in movement within MST. In chapter 4 we examined if people with chronic LBP move consistently across multiple functional activity tests. We found a significant but small to medium positive relationship of the pattern across multiple functional activity tests The findings of this dissertation further the understanding of movement patterns in people with chronic LBP. The short-term and long-term effects of exercise-based treatments on movement in people in chronic LBP were identified. Person-specific characteristics were explored as moderators of the movement pattern. Small relationships were observed of a movement pattern across multiple functional tests. Further studies are needed to understand if the effectiveness of MST for improving movement patterns generalizes to people with non-chronic LBP. Additional work is necessary to fully confirm that people with LBP display a similar movement pattern across functional activities.
Hooker, Quenten Lowell, "Movement Patterns during Functional Activities in People with Chronic Low Back Pain" (2021). WUSM Theses and Dissertations – All Programs. 17.