Altered spatiotemporal characteristics of gait in older adults with chronic low back pain.
Gregory E Hicks, J Megan Sions, Peter C Coyle and 1 others
PMID 28458149WHAT IT FOUND
Older adults with chronic low back pain walked slower and negotiated stairs slower than matched pain-free peers.
When walking fast, they used a wider step base, and wider steps plus double support time were associated with slower stair performance.
Key findings
01Older adults with chronic low back pain walked slower at self-selected and fast speeds and had slower stair ascent and descent than pain-free peers after BMI adjustment.
02During fast walking, participants with chronic low back pain used a wider base of support, and this difference remained after adjustment for gait speed.
03In participants with chronic low back pain, step width and double limb support time were associated with stair ascent and descent times.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was cross-sectional, so it cannot show how gait changes over time or that chronic low back pain caused the observed gait differences. The sample was racially homogeneous, which limits generalizability beyond community-dwelling older white adults. The chronic low back pain group had higher BMI, which may have contributed to slower walking and wider steps, although BMI was controlled in the analyses. Many differences in spatiotemporal gait parameters at self-selected speed were no longer significant after adjusting for gait speed, so they may not be independent of walking speed. Dynamic balance was not formally assessed, so the relationship between step width and balance is not established.
Declared interests
The authors reported no conflicts of interest. The work was supported by grants R21HD057274, K12HD055931, T32HD007490 and R01AG0412202 from NIH institutes. The authors stated the content is solely their responsibility.
The easy way to misread this
Do not conclude that chronic low back pain causes slower gait or that treating pain will improve gait. The study was cross-sectional, and many differences disappeared after adjusting for walking speed, so it shows association, not cause.