A comparison of trunk control in people with no history, standing-induced, and recurrent low back pain during trunk extension

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Objectives: This study compares people with recurrent low back pain (rLBP) and people with pre-clinical low back pain (standing-induced low back pain developers; PDs) to each other and back-healthy controls (non-pain developers; NPDs). Movement variability and muscular co-activity related to coordination are important for both rLBP and PDs, and these two groups also have altered static spine extension. Methods: Eleven participants with recurrent low back pain, and twenty-one asymptomatic participants, categorized as PDs (11) and NPDs (10) through an established standing protocol, volunteered for this study. Three phases of standing extension motion (lean, hold, and return to neutral) were analyzed. Root mean square angular jerk was calculated from trunk and pelvis kinematics, co-activation of the trunk and hip musculature were assessed in four-muscle sets. Results: Root-mean-square jerk was greater when returning to neutral than when leaning back during standing extension in all three groups. People with rLBP had reduced co-activity in their trunk extensors, people classified as PD had more co-activity in their hip extensors compared with the other groups, and anterior trunk co-activity was phase-dependent, and similar between groups. Discussion: Movement control alterations with low back pain may start as an over-protective co-activation strategy in those with standing-induced LBP and progress to an under-protective strategy in those with recurrent low back pain. Level of Evidence: 3.

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