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Aberrant Lumbopelvic Movements Predict Prospective Functional Decline in Older Adults with Chronic Low Back Pain

Published:September 18, 2021DOI:https://doi.org/10.1016/j.apmr.2021.08.014

      Highlights

      • Aberrant movements had an independent negative effect on 12-month physical function.
      • Aberrant movements had an indirect effect on 12-month function through baseline function.
      • Aberrant movements appear to be predictive of functional decline in this population.

      Abstract

      Objective

      To investigate if clinically observable aberrant lumbopelvic movements are associated with physical function at 12-month follow-up in older adults with chronic low back pain (CLBP), both directly and indirectly through baseline physical function.

      Design

      Secondary analysis of a yearlong prospective cohort study.

      Setting

      Clinical Research Laboratory.

      Participants

      Community-dwelling older adults with CLBP (N=250).

      Interventions

      Not applicable.

      Main Outcome Measures

      Data from 239 participants were analyzed. Participants were screened at baseline for aberrant lumbopelvic movements during active trunk flexion; total observable aberrant movements were recorded and summed (range 0-4). Latent constructs of physical function were developed from an array of perception-based and performance-based outcome measures at baseline and 12 months, respectively. Structural Equation Modeling was used to assess the direct effect of baseline aberrant movement score on the latent construct of 12-month physical function, and its indirect effect through baseline physical function.

      Results

      Aberrant movements were present in most participants (64.7%) and had a significant negative total effect on 12-month physical function (γ= -0.278, P<.001). Aberrant movement score's direct effect and indirect effect, through baseline functioning, were significantly negatively associated with physical function at 12-months, after adjusting for covariates (γ=-0.068, P=.038; γ= -0.210, P<.001, respectively).

      Conclusions

      Aberrant lumbopelvic movements are associated with decreased physical function at 12-month follow-up in older adults with CLBP, independent of baseline physical function and covariates. Future studies should evaluate if screening for aberrant movements may inform prognostic and interventional efforts in this patient population.

      Keywords

      List of abbreviations:

      CLBP (chronic low back pain), F8WT (Figure-of-8 Walk Test), LBP (low back pain), QBPDS (Quebec Back Pain Disability Scale), TUG (timed Up and Go)
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