Gait Characteristics and Dynamic Balance during Walking and Obstacle Crossing in Late Middle-aged Persons with Chronic Low Back Pain

• Main Authors: Pei-TzuChiang, 江珮孜
• Other Authors: Yi-Ju Tsai
• Format: Others
• Language: en_US
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/00456024777324649316

碩士 === 國立成功大學 === 物理治療研究所 === 101 === Background and purpose: Tripping over obstacle is one of the most common reasons among the causes of falls in the elderly. Recent studies further revealed that, compared to the healthy elders, a higher fall risk and prevalence of fall was observed among the elders with low back pain. High incidence and prevalence of LBP were reported in older population, which may not only cause pain and disability, but also accompany the problem of balance impairment. The elders with low back pain might suthus have altered movement patterns and dynamic imbalance during walking and obstacle crossing. However, to date there are no studies investigating the dynamic balance control during walking and obstacle crossing in patients with low back pain, especially in the late middle-aged persons. From the perspective of prevention, if the imbalance problem of the patient of LBP could be understood, a more effective intervention may be designed and implied before many physical function becomes irrevesible. Therefore, the purpose of this study was to investigate the differences of dynamic balance and the kinematic parameters during walking and obstacle crossing in the late middle-aged adults with and without chronic low back pain. Methods: 15 late middle-aged adults with chronic low back pain and 16 healthy late middle-aged adults were recruited to walk and cross an obstacle with 30% of their leg lengths at their self-selected speed. The total body kinematic and ground reaction force data were recorded using a three-dimensional motion analysis system and a force plate. In addition, bilateral low extremity muscle strength and performance of functional balance tests were assessed. Result: Smaller A/P and greater M/L COM-COP inclination angles and COM-COP distances were found in the CLBP group during obstacle crossing. Moreover, an increased trunk flexion and ankle dorsi flexion angle during obstacle crossing as well as a decrease of horizontal clearance of bilateral limb after obstacle negotiating were found in CLBP group. Similar tendencies in sagittal plane were found during walking. Furthermore, the lower extremity muscle strength and functional balance performances were worse in the CLBP group than the control group. Conclusion: The results suggest that middle aged adults with chronic low back pain have an altered walking and obstacle crossing strategy that might be associated with poor dynamic balance. Also, the conservative strategy during the both tasks may be related to the symptom and severity of low back pain.