Is there evidence to use kinematic/kinetic measures clinically in low back pain patients? A systematic review

Enrica Papi, Anthony M J Bull, Alison H McGregor, Enrica Papi, Anthony M J Bull, Alison H McGregor

Abstract

Background: Currently, there is a widespread reliance on self-reported questionnaires to assess low back pain patients. However, it has been suggested that objective measures of low back pain patients' functional status should be used to aid clinical assessment. The aim of this study is to systematically review which kinematic /kinetic parameters have been used to assess low back pain patients against healthy controls and to propose clinical kinematic/kinetic measures.

Methods: PubMed, Embase and Scopus databases were searched for relevant studies. Reference lists of selected studies and hand searches were performed. Studies had to compare people with and without non-specific low back pain while performing functional tasks and report body segment/joint kinematic and/or kinetic data. Two reviewers independently identified relevant papers.

Findings: Sixty-two studies were included. Common biases identified were lack of assessor blinding and sample size calculation, use of samples of convenience, and poor experimental protocol standardization. Studies had small sample sizes. Range of motion maneuvers were the main task performed (33/62). Kinematic/kinetic data of different individual or combination of body segments/joints were reported among the studies, commonest was to assess the hip joint and lumbar segment motion (13/62). Only one study described full body movement. The most commonly reported outcome was range of motion. Statistically significant differences between controls and low back pain groups were reported for different outcomes among the studies. Moreover, when the same outcome was reported disagreements were noted.

Interpretation: The literature to date offers limited and inconsistent evidence of kinematic/kinetic measures in low back pain patients that could be used clinically.

Keywords: Functional assessment; Low back pain; Motion analysis; Movement; Objective measure.

Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram illustrating the review process (Moher et al., 2009).
Fig. 2
Fig. 2
(a) Overall sample size, (b) participants mean age (top) and age variability expressed as standard deviation (SD) per number of selected articles. In brackets corresponding % of articles is shown.
Fig. 3
Fig. 3
(a) Tasks evaluated and (b) equipment used per number of selected articles. In brackets corresponding % of articles is shown.
Fig. 4
Fig. 4
(a) Body segment/joint analysed and (b) outcome measures reported per number of selected articles. In brackets corresponding % of articles is show.

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