Predicting Lumbar Range of Motion in Chronic Low Back Pain

Lumbar range of motion in individuals with chronic low back pain may be predicted by task-specific, but not general, measures of pain-related fear, according to a study published in the European Journal of Pain.

Investigators examined the lumbar range of motion of 55 patients with chronic nonspecific low back pain and 54 healthy participants (age 18 to 65). Healthy participants were on average younger and more likely to be women. Participants were assessed for kinematic measurements while performing a simple lifting task. For general measures of pain-related fear, study participants were evaluated using the Photograph Daily Activities Series-Short Electronic Version, and the Tampa Scale for Kinesiophobia and its Activity Avoidance and Somatic Focus subscales.

For task-specific measures, participants were asked to respond to photographs of everyday activities, in particular to a photograph that depicted a person lifting a heavy object with a bent back. This picture revealed the most significant correlation between lumbar range of motion and pain-related fear (correlation factor, P = −0.43; P =.0009). The only other picture that indicated high correlation with the lumbar range of motion depicted a person shoveling dirt with a bent back (P = −0.34; P =.01).

On average, patients with chronic low back pain used less range of motion than healthy participants (P ≤.1 for all), except for a subgroup of patients with chronic low back pain who had low scores on one of the task-specific measures of pain-related fear (P =.22).

Study limitations include potential issues stemming from subdivision of population based on scores on measures of pain-related fear.

”We recommend to use task-specific measures of pain-related fear when assessing the relationship with movement behavior. Furthermore, it would be of interest to investigate whether reducing task-specific fear changes protective movement behavior, and whether these potential changes mediate the improvements in pain and disability,” noted the study authors.

Reference

Matheve T, De Baets L, Bogaerts K, Timmermans A. Lumbar range of motion in chronic low back pain is predicted by task-specific, but not by general measures of pain-related fear. [published online February 21, 2019]. Eur J Pain. doi:10.1002/ejp.01384