Influences of lumbar disc herniation on the kinematics in multi-segmental spine, pelvis, and lower extremities during five activities of daily living

Shengzheng Kuai, Wenyu Zhou, Zhenhua Liao, Run Ji, Daiqi Guo, Rui Zhang, Weiqiang Liu, Shengzheng Kuai, Wenyu Zhou, Zhenhua Liao, Run Ji, Daiqi Guo, Rui Zhang, Weiqiang Liu

Abstract

Background: Low back pain (LBP) is a common problem that can contribute to motor dysfunction. Previous studies reporting the changes in kinematic characteristics caused by LBP present conflicting results. This study aimed to apply the multisegmental spinal model to investigate the kinematic changes in patients with lumbar disc herniation (LDH) during five activities of daily living (ADLs).

Methods: Twenty-six healthy subjects and 7 LDH patients participated in this study and performed level walking, stair climbing, trunk flexion, and ipsilateral and contralateral pickups. The angular displacement of the thorax, upper lumbar (ULx), lower lumbar (LLx), pelvis, hip, and knee was calculated using a modified full-gait-model in the AnyBody modeling system.

Results: In the patient group, the ULx almost showed no sagittal angular displacement while the LLx remained part of the sagittal angular displacement during trunk flexion and the two pickups. In the two pickups, pelvic tilt and lower extremities' flexion increased to compensate for the deficiency in lumbar motion. LDH patients exhibited significantly less pelvic rotation during stair climbing and greater pelvic rotation in other ADLs, except in contralateral pickup. In addition, LDH patients demonstrated more antiphase movement in the transverse plane between ULx and LLx, during level walking and stair climbing, between thorax and pelvis in the two pickups.

Conclusions: LDH patients mainly restrict the motion of LLx and ULx in the spinal region during the five ADLs. Pelvic rotation is an important method to compensate for the limited lumbar motion. Furthermore, pelvic tilt and lower extremities' flexion increased when ADLs were quite difficult for LDH patients.

Keywords: Computing model; Kinematics; Lumbar disc herniation; Multi-segmental spine.

Figures

Fig. 1
Fig. 1
The location of marker placement. T3, T7- the third and seventh thoracic vertebra; L1, L3, L5- the first, third and fifth lumbar vertebra; LPSIS- left posterior superior iliac spine; RPSIS- right posterior superior iliac spine; IC- iliac crest; RTHI- right thigh; RSHA- right shank
Fig. 2
Fig. 2
Schematic of the test procedure
Fig. 3
Fig. 3
The default spinerhythm in the AnyBody modeling system. FE- Flexion/Extension; LB- Lateral Bending; Rot- Rotation
Fig. 4
Fig. 4
Schematic of the determination of the segmental motion for the third lumbar vertebra
Fig. 5
Fig. 5
The difference between LDH patients and healthy people in ROM of the thorax, ULx, LLx, pelvis and lower extremities in three planes during five activities of daily living. FE- Flexion/Extension; LB- Lateral Bending; Rot- Rotation; TT- Tilt; OQ- Oblique; AA- Abduction/Adduction. *represents P-value < 0.05; **represents P-value < 0.01
Fig. 6
Fig. 6
Time-series kinematic waveform data for the thorax, ULx, LLx, pelvis, hip and knee in the sagittal plane, frontal plane and transverse plane during level walking. The green thick line and shaded regions are the means and one standard deviation bands for the control group. The pink thick line and shaded regions are the means and one standard deviation bands for the LDH group
Fig. 7
Fig. 7
Time-series kinematic waveform data for the thorax, ULx, LLx, pelvis, hip and knee in the sagittal plane, frontal plane and transverse plane during stair climbing. The green thick line and shaded regions are the means and one standard deviation bands for the control group. The pink thick line and shaded regions are the means and one standard deviation bands for the LDH group
Fig. 8
Fig. 8
Time-series kinematic waveform data for the thorax, ULx, LLx, pelvis, hip and knee in the sagittal plane, frontal plane and transverse plane during trunk flexion. The green thick line and shaded regions are the means and one standard deviation bands for the control group. The pink thick line and shaded regions are the means and one standard deviation bands for the LDH group
Fig. 9
Fig. 9
Time-series kinematic waveform data for the thorax, ULx, LLx, pelvis, hip and knee in the sagittal plane, frontal plane and transverse plane during ipsilateral pickup. The green thick line and shaded regions are the means and one standard deviation bands for the control group. The pink thick line and shaded regions are the means and one standard deviation bands for the LDH group
Fig. 10
Fig. 10
Time-series kinematic waveform data for the thorax, ULx, LLx, pelvis, hip and knee in the sagittal plane, frontal plane and transverse plane during contralateral pickup. The green thick line and shaded regions are the means and one standard deviation bands for the control group. The pink thick line and shaded regions are the means and one standard deviation bands for the LDH group

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