By: Steve Siwy for Back1A team of researchers based at Ohio University have received a $1.55 million grant from the National Institutes of Health to conduct a study of changes in the movement patterns of patients suffering from recurrent lower back pain. People with lower back pain may sometimes restrict or alter their movements when, for example, reaching or bending, in order to compensate for the pain.
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Just How Common is Lower Back Pain?
According to the AAOS, after the common cold, problems associated with lower back pain are the biggest cause of missed work for adults under 45 years of age.
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This may lead to a lower-back pain patient developing habitual “maladaptive” movement patterns, which may then increase her chances of reinjuring her back.According to the American Association of Orthopaedic Surgeons (AAOS), four out of five adults will at some point in their lives suffer from significant low back pain. The Ohio University researchers say that in as many as 50 percent of low back pain cases, the pain will reoccur within a year. Since the Ohio University study focuses on patients’ reactions to pain, it will include a look at possible psychological factors involved in re-injury risk. They will examine the ways in which psychological behaviors, specifically those related to the fear of movement or re-injury (called “kinesiophobia”), can affect recovery from an episode of low back pain.
In the first phase of the study, subjects currently suffering from low back pain will be asked to perform reaching exercises, while sensors on their arm, leg, back, and trunk muscles measure their movements. They will then receive questionnaires to fill out, which will be used to assess their level of kinesiophobia. Three months after the initial testing, researchers will then conduct a follow-up with the test subjects.
The second phase of the study will take a larger group of subjects who have recently recovered from an episode of low back pain, and have the subjects perform four sets of exercises in the lab. These subjects will be monitored for a year.
The aim of the study is to develop a means for doctors to assess their patients, and determine which are at the highest risk for re-injuring their backs. They hope it will also help doctors ascertain whether a patient will respond more to psychological or physical treatments. "Once we have identified the relationship between dysfunctional movement patterns and levels of kinesiophobia,” said Thomas in a press release, “our long-term goal is to provide treatment guidelines based on each patient's unique motor coordination profile and kinesiophobia score."
Previous studies have shown that patients with a high level of kinesiophobia tend also to have a greater chance of re-injuring their backs. This study, which employs a standardized method developed by Thomas to detect changes in the motor coordination of low back pain patients, will examine the ways in which pain avoidance affects a patient’s movement habits. This may help doctors identify which types of changes in movement would place a patient at more risk for re-injuring his back.
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