People with low back pain walk differently

People suffering from acute or persistent low back pain commonly have altered biomechanics. Many studies have compared walking or running gait biomechanics in individuals with and without low back pain. Despite substantial research, the research studies present inconsistent results.

Researchers from Chapman University in California conducted
a new systematic review to answer the question whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.

The authors conducted a search in the scientific literature on studies that reported biomechanical characteristics of individuals with and without LBP during steady-state or perturbed walking and running. They included 97 studies. Two studies investigated acute pain and the rest investigated persistent pain. Nine studies investigated running gait.

The studies show that:

• Individuals with persistent LBP walked slower and shorter stride lengths than back-healthy controls.
• There were no significant differences in the amplitude of motion in the thoracic or lumbar spine, pelvis, or hips in individuals with LBP.
• During walking, coordination of motion between the thorax and the lumbar spine/pelvis was significantly more in-phase in the persistent LBP groups.
• Individuals with persistent LBP exhibited greater amplitude of activation in the paraspinal muscles.
• There were no consistent differences in running biomechanics between groups.

The review demonstrated that people with persistent low back pain walk more slowly and take smaller steps compared to back-healthy people. People with persistent low back pain also have altered coordination patterns between the trunk and pelvis and increased paraspinal muscle activation during walking.