Symptomatic individuals with Lumbar Disc Degeneration use different anticipatory and compensatory kinematic strategies to asymptomatic controls in response to postural perturbation.
Janet A Deane, Adrian K P Lim, Andrew T M Phillips and 1 others
PMID 33980472WHAT IT FOUND
People with painful lumbar disc degeneration used smaller hip and knee movements and larger lumbar movements during a predictable forward push, and reported more anxiety, depression, disability and lower quality of life.
Key findings
01During predicted perturbations, participants with painful lumbar disc degeneration had smaller integrated hip and knee displacements than pain-free participants with lumbar disc degeneration.
02During predicted perturbations, compensatory lumbar displacement was higher in the painful group, while no significant spinal differences appeared during unpredicted perturbations.
03The painful group had higher depression, anxiety and disability scores and lower quality of life scores than the pain-free group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was an observational group comparison, so it cannot show that painful lumbar disc degeneration caused the movement differences, or that changing the movement pattern would improve symptoms. All participants had lumbar disc degeneration without neural compression on MRI, so the results may not apply to people with radiculopathy, other causes of low back pain, or no disc degeneration. The markers were skin-mounted and the model assumed rigid body segments, so soft tissue artefact could have affected measured joint movement. The perturbation was 40 mm in 0.2 s and designed to permit feet-in-place responses; other directions, accelerations, surfaces or functional tasks may show different differences. BMI was higher in the painful group, although the paper says it did not correlate with the kinematic findings. The self-report differences were group comparisons, not evidence that anxiety, depression, disability or quality of life caused the kinematic differences.
Declared interests
The authors report no declarations of interest.
The easy way to misread this
Do not read the movement differences as proof that painful lumbar disc degeneration causes the strategy or that motor retraining will help; this study did not test treatment and cannot show causation.