Comparación del comportamiento cinemático de la pelvis durante la marcha en jóvenes con y sin dolor lumbar crónico: Un análisis cinemático con G-Walk
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El objetivo de este estudio es comparar las adaptaciones biomecánicas en la marcha de jóvenes con y sin dolor lumbar crónico (DLC). Se reclutaron 30 participantes (15 personas por grupo, con DLC y grupo control). Las variables biomecánicas analizadas incluyeron inclinación pélvica, oblicuidad y rotación, complementadas con un índice de simetría de movimiento durante la marcha, utilizando el sistema de análisis G-Walk. Los resultados mostraron diferencias estadísticamente significativas en la inclinación pélvica mínima derecha (grupo DLC = 16 (6) vs. grupo control: 12 (7,1), p = 0,01) y en los rangos de inclinación pélvica derecha e izquierda, siendo menores en el grupo con DLC (4,2 ± 1,1 vs. 6,0 ± 1,8, p = 0,004; 4,4 ± 1,4 vs. 6,0 ± 1,7, p = 0,01, respectivamente). También se observaron diferencias en la rotación pélvica mínima derecha y máxima izquierda: (–2,8 (2,8) vs. –5,2 (3,3), p = 0,011; 2,9 (2,3) vs. 5,2 (3,1), p = 0,006, respectivamente) y en el rango de rotación pélvica derecha (7,4 ± 2,7 vs. 9,2 ± 2,7, p = 0,03). Adicionalmente, los porcentajes de simetría de la oblicuidad y la rotación pélvica fueron significativamente menores en el grupo DLC (oblicuidad grupo DLC = 92,7 ± 7,2 % vs. grupo control = 96,9 ± 2,3 %, p = 0,047; rotación grupo DLC = 90,9 ± 13,3 % vs. grupo control = 97,0 ± 2,7%, p = 0,01). En conclusión, los hallazgos encontrados podrían sugerir adaptaciones cinemáticas a nivel de la pelvis vinculada al DLC.
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Rheumatology TL. The global epidemic of low back pain. Lancet Rheumatol. 2023; 5: e305. https://doi.org/10.1016/S2665-9913(23)00133-9.
Santos C, Donoso R, Ganga M, Eugenin O, Lira F, Santelices JP. Dolor lumbar: revisión y evidencia de tratamiento. Rev Médica Clínica Las Condes. 2020; 31: 387- 395. https://doi.org/10.1016/j.rmclc.2020.03.008.
Garcia JBS, Hernandez-Castro JJ, Nunez RG, Pazos MA, Aguirre JO, Jreige A, et al. Prevalence of low back pain in Latin America: a systematic literature review. Pain Physician. 2014; 17: 379-391.
Gonzalez GZ, da Silva T, Avanzi MA, Macedo GT, Alves SS, Indini LS, et al. Low back pain prevalence in Sao Paulo, Brazil: A cross-sectional study. Braz J Phys Ther. 2021; 25: 837-845. https://doi.org/10.1016/j.bjpt.2021.07.004.
Ge L, Wang C, Zhou H, Yu Q , Li X. Effects of low back pain on balance performance in elderly people: a systematic review and meta-analysis. Eur Rev Aging Phys Act. 2021; 18: 8. https://doi.org/10.1186/s11556-021-00263-z.
Altuğ F, Kavlak E, Kurtca MP, Ünal A, Cavlak U. Comparison of pain intensity, emotional status and disability level in patients with chronic neck and low back pain. J Back Musculoskelet Rehabil. 2015; 28: 505-508. https://doi.org/10.3233/BMR140548.
Papi E, Bull AMJ, McGregor AH. Spinal segments do not move together predictably during daily activities. Gait Posture. 2019; 67: 277-283. https://doi.org/10.1016/j.gaitpost.2018.10.031.
Esteve R, Ramirez C. Modelo de Miedo-Evitación del Dolor: evolución y nuevas propuestas. Rev Psicol Salud. 2013; 1:102-130. https://doi.org/10.21134/pssa.v1i1.372.
John JN, Ugwu EC, Okezue OC, Ekechukwu END, Mgbeojedo UG, John DO, et al. Kinesiophobia and associated factors among patients with chronic non-specific low back pain. Disabil Rehabil. 2023; 45: 2651-2659. https://doi.org/10.1080/09638288.2022.2103747.
Christensen L, Veierød MB, Vøllestad NK, Jakobsen VE, Stuge B, Cabri J, et al. Kinematic and spatiotemporal gait characteristics in pregnant women with pelvic girdle pain, asymptomatic pregnant and non-pregnant women. Clin Biomech. 2019; 68: 45-52. https://doi.org/10.1016/j.clinbiomech.2019.05.030.
Stansfield B, Hawkins K, Adams S, Church D. Spatiotemporal and kinematic characteristics of gait initiation across a wide speed range. Gait Posture. 2018; 61: 331-338. https://doi.org/10.1016/j.gaitpost.2018.02.003.
Herssens N, Verbecque E, Hallemans A, Vereeck L, Van Rompaey V, Saeys W. Do spatiotemporal parameters and gait variability differ across the lifespan of healthy adults? A systematic review. Gait Posture. 2018; 64: 181-190. https://doi.org/10.1016/j.gaitpost.2018.06.012.
Cimolin V, Vismara L, Galli M, Zaina F, Negrini S, Capodaglio P. Effects of obesity and chronic low back pain on gait. J Neuroengineering Rehabil. 2011; 8: 55. https://doi.org/10.1186/1743-0003-8-55.
Smith JA, Stabbert H, Bagwell JJ, Teng H-L, Wade V, Lee S-P. Do people with low back pain walk differently? A systematic review and meta-analysis. J Sport Health Sci. 2022; 11: 450-465. https://doi.org/10.1016/j.jshs.2022.02.001.
Tsigkanos C, Demestiha T, Spiliopoulou C, Tsigkanos G. Gait kinematics in Low Back Pain: A non-linear approach. J Back Musculoskelet Rehabil. 2021; 34: 707-714. https://doi.org/10.3233/BMR-200260.
Koch C, Hänsel F. Chronic Non-specific Low Back Pain and Motor Control During Gait. Front Psychol. 2018; 9: 2236. https://doi.org/10.3389/fpsyg.2018.02236.
Hicks GE, Sions JM, Coyle PC, Pohlig RT. Altered spatiotemporal characteristics of gait in older adults with chronic low back pain. Gait Posture. 2017; 55: 172-176. https://doi.org/10.1016/j.gaitpost.2017.04.027.
Demirel A, Onan D, Oz M, Ozel Aslıyuce Y, Ulger O. Moderate disability has negative effect on spatiotemporal parameters in patients with chronic low back pain. Gait Posture 2020; 79: 251-255. https://doi.org/10.1016/j.gaitpost.2020.05.015.
Van Dieën JH, Reeves NP, Kawchuk G, Van Dillen LR, Hodges PW. Motor Control Changes in Low Back Pain: Divergence in Presentations and Mechanisms. J Orthop Sports Phys Ther. 2019; 49: 370-379. https://doi.org/10.2519/jospt.2019.7917.
Stevens ML, Lin CC-W, Maher CG. The Roland Morris Disability Questionnaire. J Physiother. 2016; 62: 116. https://doi.org/10.1016/j.jphys.2015.10.003.
Kovacs FM. El uso del cuestionario de Roland-Morris en los pacientes con lumbalgia asistidos en Atención Primaria. Med Fam SEMERGEN. 2005; 31: 333-335. https://doi.org/10.1016/S1138-3593(05)72944-0.
BTS Bioengineering Corp. G-Walk User Manual ENG version 7.0.0 2016.
D’Addio G, Donisi L, Pagano G, Improta G, Biancardi A, Cesarelli M. Agreement between Opal and G-Walk Wearable Inertial Systems in Gait Analysis on Normal and Pathological Subjects. 2019 41st Annu. Int. Conf. IEEE Eng. Med. Biol. Soc. EMBC, Berlin, Germany: IEEE; 2019: 3286-3289. https://doi.org/10.1109/EMBC.2019.8857841.
Kang H. Sample size determination and power analysis using the G*Power software. J Educ Eval Health Prof 2021; 18. https://doi.org/10.3352/jeehp.2021.18.17.
Jiménez-del-Barrio S, Mingo-Gómez MT, Estébanez-de-Miguel E, Saiz-Cantero E, del-Salvador-Miguélez AI, Ceballos-Laita L. Adaptations in pelvis, hip and knee kinematics during gait and muscle extensibility in low back pain patients: A cross-sectional study. J Back Musculoskelet Rehabil 2020; 33: 49-56. https://doi.org/10.3233/BMR-191528.
Ebrahimi S, Kamali F, Razeghi M, Haghpanah SA. Comparison of the trunk-pelvis and lower extremities sagittal plane inter-segmental coordination and variability during walking in persons with and without chronic low back pain. Hum Mov Sci.2017; 52: 55-66. https://doi.org/10.1016/j.humov.2017.01.004.
Yiengprugsawan V, Hoy D, Buchbinder R, Bain C, Seubsman S, Sleigh AC. Low back pain and limitations of daily living in Asia: longitudinal findings in the Thai cohort study. BMC Musculoskelet Disord. 2017; 18: 19. https://doi.org/10.1186/s12891-016-1380-5.
Sung PS, Danial P. A Kinematic Symmetry Index of Gait Patterns Between Older Adults With and Without Low Back Pain. Spine 2017; 42: E1350-1356. https://doi.org/10.1097/BRS.0000000000002161.
Gombatto SP, Brock T, DeLork A, Jones G, Madden E, Rinere C. Lumbar spine kinematics during walking in people with and people without low back pain. Gait Posture. 2015; 42: 539-544. https://doi.org/10.1016/j.gaitpost.2015.08.010.
Banks JJ, Umberger BR, Boyer KA, Caldwell GE. Lower back kinetic demands during induced lower limb gait asymmetries. Gait Posture. 2022; 98: 101-108. https://doi.org/10.1016/j.gaitpost.2022.09.001.
Rum L, Brasiliano P, Vannozzi G, Laudani L, Macaluso A. Non-specific chronic low back pain elicits kinematic and neuromuscular changes in walking and gait termination. Gait Posture. 2021; 84: 238-244. https://doi.org/10.1016/j.gaitpost.2020.12.005.
Seay JF, Van Emmerik REA, Hamill J. Influence of Low Back Pain Status on PelvisTrunk Coordination During Walking and Running. Spine 2011; 36: E1070. https://doi.org/10.1097/BRS.0b013e3182015f7c.
Steele J, Bruce-Low S, Smith D, Jessop D, Osborne N. Lumbar kinematic variability during gait in chronic low back pain and associations with pain, disability and isolated lumbar extension strength. Clin Biomech. 2014; 29: 1131-1138. https://doi.org/10.1016/j.clinbiomech.2014.09.013.