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Effects of Flexible and Semirigid Lumbosacral Orthosis on Lower-Limb Joint Angles during Gait in Patients with Chronic Low Back Pain: A Cross-Sectional Study

  • Im, Sang-Cheol (Department of Rehabilitation Sciences, Graduate School, Daegu University) ;
  • Kim, Kyoung (Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University)
  • Received : 2021.08.10
  • Accepted : 2021.10.20
  • Published : 2021.11.30

Abstract

PURPOSE: Lumbosacral orthosis (LSO) is often used to help manage low back pain because it is economical and effective. This study examined the effects of flexible and semirigid LSOs on the lower-limb joint angles in walking in patients with chronic low back pain. METHODS: The effects of the lumbosacral orthosis during gait on the sagittal, frontal, horizontal planes and the change in lower limb angle were examined in fourteen chronic low back pain patients who walked without wearing a LSO, wearing a flexible LSO, and wearing a semirigid LSO in random order for three-dimensional motion analysis. RESULTS: The flexion of the hip and knee joints decreased more significantly during walking with an LSO than without one. The genu valgum angles were reduced in the stance phase more during walking with an LSO than without one. The external rotation of the knee joints in the stance phase increased more during walking with an LSO than without one. CONCLUSION: The angles of the lower-limb joints of patients with chronic low back pain are affected by walking with an LSO, and the effects increased as the LSO stiffened.

Keywords

References

  1. Punnett L, Pruss-Utun A, Nelson DI, et al. Estimating the global burden of low back pain attributable to combined occupational exposures. Am J Ind Med. 2005;48(6):459-69. https://doi.org/10.1002/ajim.20232
  2. Alexanderson KA, Borg KE, Hensing GK. Sickness absence with low-back, shoulder, or neck diagnoses: an 11-year follow-up regarding gender differences in sickness absence and disability pension. Work (Reading, Mass). 2005;25(2):115-24.
  3. Lahiri S, Markkanen P, Levenstein C. The cost effectiveness of occupational health interventions: preventing occupational back pain. Am J Ind Med. 2005;48(6):515-29. https://doi.org/10.1002/ajim.20193
  4. Cromwell R, Schultz AB, Beck R, et al. Loads on the lumbar trunk during level walking. J Orthop Res. 1989;7(3):371-7. https://doi.org/10.1002/jor.1100070309
  5. Taylor S, Frost H, Taylor A, et al. Reliability and responsiveness of the shuttle walking test in patients with chronic low back pain. Physiother Res Int. 2001;6(3):170-8. https://doi.org/10.1002/pri.225
  6. Vogt L, Pfeifer K, Portscher M, et al. Influences of nonspecific low back pain on three-dimensional lumbar spine kinematics in locomotion. Spine. 2001;26(17):1910-9. https://doi.org/10.1097/00007632-200109010-00019
  7. Al-Obaidi SM, Al-Zoabi B, Al-Shuwaie N, et al. The influence of pain and pain-related fear and disability beliefs on walking velocity in chronic low back pain. Int J Rehabil Res. 2003;26(2):101-8. https://doi.org/10.1097/00004356-200306000-00004
  8. Taylor N, Goldie P, Evans O. Movements of the pelvis and lumbar spine during walking in people with acute low back pain. Physiother Res Int. 2004;9(2):74-84. https://doi.org/10.1002/pri.304
  9. Vogt L, Pfeifer K, Banzer W. Neuromuscular control of walking with chronic low-back pain. Man Ther. 2003;8(1):21-8. https://doi.org/10.1054/math.2002.0476
  10. Kim K, Ko JY, Lee SY. A study on the characteristics of gait in patients with chronic low back pain. J Korean Soc Phys Ther. 2009;21(2):79-85.
  11. Agabegi SS, Asghar FA, Herkowitz HN. Spinal orthoses. J Am Acad Orthop Surg. 2010;18(11):657-67. https://doi.org/10.5435/00124635-201011000-00003
  12. Reyna JR Jr., Leggett SH, Kenney K, et al. The effect of lumbar belts on isolated lumbar muscle. Strength and dynamic capacity. Spine. 1995;20(1):68-73. https://doi.org/10.1097/00007632-199501000-00013
  13. Zoia C, Bongetta D, Alicino C, et al. Usefulness of corset adoption after single-level lumbar discectomy: a randomized controlled trial. J Neurosurg Spine. 2018;28(5):481-5. https://doi.org/10.3171/2017.8.SPINE17370
  14. Brumagne S, Cordo P, Lysens R, et al. The role of paraspinal muscle spindles in lumbosacral position sense in individuals with and without low back pain. Spine. 2000;25(8):989-94 https://doi.org/10.1097/00007632-200004150-00015
  15. Newcomer KL, Laskowski ER, Yu B, et al. Differences in repositioning error among patients with low back pain compared with control subjects. Spine. 2000;25(19):2488-93 https://doi.org/10.1097/00007632-200010010-00011
  16. O'Sullivan PB, Burnett A, Floyd AN, et al. Lumbar repositioning deficit in a specific low back pain population. Spine. 2003;28(10):1074-9 https://doi.org/10.1097/01.BRS.0000061990.56113.6F
  17. Panjabi MM. A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction. Eur Spine J. 2006;15(5):668-76. https://doi.org/10.1007/s00586-005-0925-3
  18. Boucher JA, Roy N, Preuss R, et al. The effect of two lumbar belt designs on trunk repositioning sense in people with and without low back pain. Ann Phys Rehabil Med. 2017;60(5):306-11. https://doi.org/10.1016/j.rehab.2017.03.002
  19. Calmels P, Fayolle-Minon I. An update on orthotic devices for the lumbar spine based on a review of the literature. Rev Rhum Engl Ed. 1996;63(4):285-91.
  20. Lariviere C, Caron JM, Preuss R, et al. The effect of different lumbar belt designs on the lumbopelvic rhythm in healthy subjects. BMC Musculoskelet Disord. 2014;15:307. https://doi.org/10.1186/1471-2474-15-307
  21. van Poppel MN, de Looze MP, Koes BW, et al. Mechanisms of action of lumbar supports: a systematic review. Spine. 2000;25(16):2103-13. https://doi.org/10.1097/00007632-200008150-00016
  22. Morrisette DC, Cholewicki J, Logan S, et al. A randomized clinical trial comparing extensible and inextensible lumbosacral orthoses and standard care alone in the management of lower back pain. Spine. 2014;39(21):1733-42. https://doi.org/10.1097/BRS.0000000000000521
  23. Fidler MW, Plasmans CM. The effect of four types of support on the segmental mobility of the lumbosacral spine. J Bone Joint Surg Am. 1983;65(7):943-7. https://doi.org/10.2106/00004623-198365070-00009
  24. Lantz SA, Schultz AB. Lumbar spine orthosis wearing. I. Restriction of gross body motions. Spine. 1986;11(8):834-7. https://doi.org/10.1097/00007632-198610000-00019
  25. Buchalter D, Kahanovitz N, Viola K, et al. Three-dimensional spinal motion measurements. Part 2: A noninvasive assessment of lumbar brace immobilization of the spine. J Spinal Disord. 1988;1(4):284-6. https://doi.org/10.1097/00002517-198800140-00001
  26. Grew ND, Deane G. The physical effect of lumbar spinal supports. Prosthet Orthot Int. 1982;6(2):79-87. https://doi.org/10.3109/03093648209166772
  27. Tuong NH, Dansereau J, Maurais G, et al. Three-dimensional evaluation of lumbar orthosis effects on spinal behavior. J Rehabil Res Dev. 1998;35(1):34-42.
  28. Kramers-de Quervain IA, Muller R, Stacoff A, et al. Gait analysis in patients with idiopathic scoliosis. Eur Spine J. 2004;13(5):449-56.
  29. Wong MS, Cheng CY, Ng BK, et al. The effect of rigid versus flexible spinal orthosis on the gait pattern of patients with adolescent idiopathic scoliosis. Gait Posture. 2008;27(2):189-95. https://doi.org/10.1016/j.gaitpost.2007.03.007
  30. Konz R, Fatone S, Gard S. Effect of restricted spinal motion on gait. J Rehabil Res Dev. 2006;43(2):161-70. https://doi.org/10.1682/JRRD.2004.11.0146
  31. Song HN, Kim YM, Kim K. A kinematic analysis of the lower limb with regard to restricted spinal motion during gait. J Phys Ther Sci. 2017;29(1):81-4. https://doi.org/10.1589/jpts.29.81
  32. Cholewicki J, Lee AS, Peter Reeves N, et al. Comparison of trunk stiffness provided by different design characteristics of lumbosacral orthoses. Clin Biomech. 2010;25(2):110-4. https://doi.org/10.1016/j.clinbiomech.2009.10.010
  33. Lariviere C, Ludvig D, Kearney R, et al. Identification of intrinsic and reflexive contributions to low-back stiffness: medium-term reliability and construct validity. J Biomech. 2015;48(2):254-61. https://doi.org/10.1016/j.jbiomech.2014.11.036
  34. Feipel V, De Mesmaeker T, Klein P, et al. Three-dimensional kinematics of the lumbar spine during treadmill walking at different speeds. Eur Spine J. 2001;10(1):16-22. https://doi.org/10.1007/s005860000199
  35. Smeathers JE. Transient vibrations caused by heel strike. Proc Inst Mech Eng H. 1989;203(4):181-6. https://doi.org/10.1243/PIME_PROC_1989_203_036_01
  36. Hines MG, Tillin NA, Luo J, et al. Passive elastic contribution of hip extensors to joint moments during walking in people with low back pain. Clin Biomech. 2018;60:134-40. https://doi.org/10.1016/j.clinbiomech.2018.10.012
  37. Hicks GE, Sions JM, Coyle PC, et al. Altered spatiotemporal characteristics of gait in older adults with chronic low back pain. Gait Posture. 2017;55:172-6. https://doi.org/10.1016/j.gaitpost.2017.04.027
  38. Perry J, Burnfield JM, Jeong S, et al. Gait analysis: normal and pathological function. Korea. Young Moon. 2012.