Researcher(s)
- Taryn Fields, Human Physiology, University of Delaware
Faculty Mentor(s)
- Katie Butera, Department of Physical Therapy, University of Delaware
Abstract
Low back pain (LBP) is the leading cause of disability, affecting 619 million people worldwide. Prior research indicates that individuals with LBP walk differently compared to healthy populations, demonstrating greater joint angle variability, muscle activation/movement asymmetry, slower gait speed, and shorter stride length. Yet, it is still unclear how different pain experiences affect walking within the LBP population. For instance, pain intensity during movement (movement-evoked pain; MEP) may differentially alter walking. Therefore, our objective was to assess relationships between MEP and stride lengths among individuals with LBP. We hypothesized that those with higher MEP would demonstrate shorter strides.
Our sample included 27 individuals with LBP, ages 18-59 (21 females/6 males; average age=38.44). Self-selected stride lengths (SSSL) and fastest-comfortable stride lengths (FCSL) were recorded during 3 walking trials on a GaitRite mat; SSSL and FCSL were normalized by height. Participants also completed functional tests (10-meter walk, 400-meter walk, 30-second chair rise, 30-second repetitive box lift). Two aggregate MEP scores were generated by summing pain ratings (0=no pain, 100=worst pain) collected during each test: walking MEP (10-meter-walk, 400-meter-walk) and functional MEP (all physical performance tests). Pearson correlations determined relationships between MEP and stride length (alpha=0.05).
Average SSSL was 137.82+12.90cm. Average FCSL was 166.30 +10.85cm. Average walking MEP was 49.70 +49.67. Average functional MEP was 91.48 +87.81. There was a moderate, negative relationship between shorter SSSL and higher walking MEP (r=-0.51, p=0.01) and higher functional MEP (r=-0.50, p=0.01). There was a moderate, negative relationship between shorter FCSL and higher walking MEP (r=-0.43, p=0.03) and higher functional MEP (r=-0.39, p=0.04).
Findings confirmed our hypothesis that as MEP increases, stride length decreases. Participants may have been more guarded and controlled their movement to avoid aggravating their LBP. Additionally, there was a slightly stronger relationship between MEP and stride length during the self-selected condition. We speculate that when participants walked faster, they were more focused on speed than LBP. Further research to understand relationships between pain and walking changes in adults with LBP will aid clinicians in planning walking rehabilitation for this population.