Mechanical Perturbations of the Walking Surface Reveal Unaltered Axial Trunk Stiffness in Chronic Low Back Pain Patients

INTRODUCTION Patients with chronic low back pain (CLBP) often demonstrate altered timing of thorax rotations in the transverse plane during gait. Increased axial trunk stiffness has been claimed to cause this movement pattern. OBJECTIVES The objective of this study was to assess whether axial trunk stiffness is increased in gait in CLBP patients. METHODS 15 CLBP patients and 15 healthy controls walked on a treadmill that imposed rotational perturbations in the transverse plane. The effect of these perturbations on transverse pelvis, thorax and trunk (thorax relative to pelvis) rotations was evaluated in terms of residual rotations, i.e., the deviation of these movements from the unperturbed patterns. In view of the heterogeneity of the CLBP group, we additionally performed a subgroup comparison between seven patients and seven controls with maximal between-group contrast for timing of thorax rotations. RESULTS Rotations of the walking surface had a clear effect on transverse pelvis, thorax and trunk rotations in all groups. No significant between-group differences on residual transverse pelvis, thorax and trunk rotations were observed. CONCLUSION Axial trunk stiffness in gait does not appear to be increased in CLBP. Altered timing of thorax rotations in CLBP does not seem to be a result of increased axial trunk stiffness.