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Although the application of nonlinear tools including recurrence quantification analysis (RQA) has increasingly grown in the recent years especially in balance-disordered populations, there have been few studies which determine their measurement properties. Therefore, a methodological study was performed to estimate the intersession and intrasession reliability of some dynamic features provided by RQA for nonlinear analysis of center of pressure (COP) signals recorded during quiet standing in a sample of patients with musculoskeletal disorders (MSDs) including low back pain (LBP), anterior cruciate ligament (ACL) injury and functional ankle instability (FAI). The subjects completed postural... 

As balance is the foundation for all voluntary motor skills, considerable research has been conducted to evaluate postural control in patients with low back pain (LBP). Although reliability is a population-specific property, to the authors' knowledge, there has been no study to determine the test-retest reliability of the center of pressure (COP) measures in the general population of LBP patients. As many as 11 patients with a history of nonspecific LBP randomly completed postural measurements with three levels of difficulty (rigid surface-eyes open, rigid surface-eyes closed, and foam surface-eyes closed) in two sessions. The COP data were used to calculate standard deviation of amplitude,... 

Recurrence quantification analysis (RQA), a nonlinear method of postural analysis, was used to explore the effects of dual-tasking on postural performance in people with nonspecific low back pain (LBP) compared with healthy participants. Postural performance was quantified by RQA % recurrence, % determinism, entropy and trend. People with nonspecific LBP (n = 22) and unimpaired individuals (n = 22) randomly performed quiet standing tasks with three levels of difficulty (rigid-surface eyes open, rigid-surface eyes closed and foam-surface eyes closed). These tasks were performed in isolation or concurrently with an easy or difficult cognitive task. Increasing postural difficulty was associated... 

Multiple joint interactions are critical to produce stable coordinated movements and can be influenced by low back pain and task conditions. Inter-segmental coordination pattern and variability were assessed in subjects with and without chronic nonspecific low back pain (CNSLBP). Kinematic data were collected from 22 CNSLBP and 22 healthy volunteers during repeated trunk flexion-extension in various conditions of symmetry, velocity, and loading; each at two levels. Sagittal plane angular data were time normalized and used to calculate continuous relative phase for each data point. Mean absolute relative phase (MARP) and deviation phase (DP) were derived to quantify lumbar-pelvis and... 

Background Motor control exercise was claimed to improve spinal stability in patients with chronic non-specific back pain, but to investigate the effectiveness of this exercise, other outcome measures have been used rather than spinal stability itself. The aim of our study is to assess motor control exercise effects on spinal stability using a biomechanical model. Methods Fifty-one patients were assigned to either motor control or general exercises. Before and after trainings, participants were tested for spinal stability at seven isometric tasks. Electromyography signals were recorded from ten superficial muscles, and a hybrid EMG-driven musculoskeletal model estimated spinal stability... 

This paper presents a novel approach for evaluating LBP in various settings. The proposed system uses cost-effective inertial sensors, in conjunction with pattern recognition techniques, for identifying sensitive classifiers towards discriminate identification of LB patients. 24 healthy individuals and 28 low back pain patients performed trunk motion tasks in five different directions for validation. Four combinations of these motions were selected based on literature, and the corresponding kinematic data was collected. Upon filtering (4th order, low pass Butterworth filter) and normalizing the data, Principal Component Analysis was used for feature extraction, while Support Vector Machine... 

Inter-segmental coordination can be influenced by chronic low back pain (CLBP). The sagittal plane lower extremities inter-segmental coordination pattern and variability, in conjunction with the pelvis and trunk, were assessed in subjects with and without non-specific CLBP during free-speed walking. Kinematic data were collected from 10 non-specific CLBP and 10 non-CLBP control volunteers while the subjects were walking at their preferred speed. Sagittal plane time-normalized segmental angles and velocities were used to calculate continuous relative phase for each data point. Mean absolute relative phase (MARP) and deviation phase (DP) were derived to quantify the trunk-pelvis and bilateral... 

Background Wearing lumbosacral orthosis (LSO) is one of the most common treatments prescribed for conservative management of low back pain. Although the results of randomized controlled trials suggest effectiveness of LSO in reducing pain and disability in these patients, there is a concern that prolonged use of LSO may lead to trunk muscle weakness and atrophy. Purpose The present review aimed to evaluate available evidence in literature to determine whether LSO results in trunk muscle weakness or atrophy. Study Design This is a systematic review. Methods A systematic search of electronic databases including PubMed, Scopus, ScienceDirect, and Medline (via Ovid) followed by hand search of... 

Background: Poor balance performance and impaired postural control have been frequently reported in patients with low back pain.However, postural control is rarely monitored during the course of treatment even though poor postural control may contribute tochronicity and recurrence of symptoms. Therefore, the present study aimed at investigating the effect of a nonextensible lumbosacralorthosis (LSO) versus routine physical therapy on postural stability of patients with nonspecific chronic low back pain.Methods: This was a randomized controlled trial conducted between November 2015 and May 2016 at the outpatient physical therapyclinic of the School of Rehabilitation Sciences. Patients with... 

Motor abundance allows reliability of motor performance despite its variability. The nature of this variability provides important information on the flexibility of control strategies. This feature of control may be affected by low back pain (LPB) and trunk flexion/extension conditions. Goal equivalent manifold (GEM) analysis was used to quantify the ability to exploit motor abundance during repeated trunk flexion/extension in healthy individuals and people with chronic non-specific LBP (CNSLBP). Kinematic data were collected from 22 healthy volunteers and 22 CNSLBP patients during metronomically timed, repeated trunk flexion/extension in three conditions of symmetry, velocity, and loading;... 

Background: Chronic low back pain (CLBP) disability has been particularly frustrating because its treatment has been a great therapeutic challenge. Disability has been suggested to depend on different factors that should be found and considered in the medical management. The inter-segmental coordination is often impaired in CLBP subjects; however, to the best of our knowledge, there is no evidence about the relationship between the existence of coordination problems and disability in CLBP patients. Objective: To evaluate the correlation between sagittal plane trunk-pelvis intersegmental coordination parameters during walking and disability level in CLBP patients. Methods: Kinematic data were... 

Reliability is a population-specific property, but to the authors' knowledge there has been no study to determine the test-retest reliability of the postural stability measures such as center of pressure (COP) measures in the population of patients with musculoskeletal disorders (MSDs), while their clinical applications have been presented in literature. So, 33 patients with low back pain (LBP), anterior cruciate ligament (ACL) injury and functional ankle instability (FAI) randomly completed postural measurements with three levels of difficulty (rigid surface-eyes open, rigid surface-eyes closed, and foam surface-eyes closed) in two sessions. COP data were used to calculate standard... 

STUDY DESIGN.: To quantify trunk muscle capability and controllability in different angles and levels of isometric exertion using a torque tracking system. OBJECTIVE.: To investigate the effect of biaxial isometric exertions on the maximum capability of trunk and to examine the effect of angle and level of isometric exertion on trunk controllability during the tracking task in upright posture. SUMMARY OF BACKGROUND DATA.: Combined motions of trunk at varying exertion levels occur in most daily and occupational activities and are important risk factors of low back pain. Few studies have investigated trunk capability and controllability during multidirectional activities with different... 

The study design is a prospective, case-control. The aim of this study was to develop a reliable measurement technique for the assessment of lumbar spine kinematics using digital video fluoroscopy in a group of patients with low back pain (LBP) and a control group. Lumbar segmental instability (LSI) is one subgroup of nonspecific LBP the diagnosis of which has not been clarified. The diagnosis of LSI has traditionally relied on the use of lateral functional (flexion-extension) radiographs but use of this method has proven unsatisfactory. Fifteen patients with chronic low back pain suspected to have LSI and 15 matched healthy subjects were recruited. Pulsed digital videofluoroscopy was used...