Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance
Chronic low back pain (cLBP) rates among younger individuals are rising. Although pain and disability are often less severe, underlying changes in trunk behavior may be responsible for recurrence. We examine the biomarker capacity of a simple Trunk Compliance Index (TCI) to distinguish individuals w...
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| Published in | Scientific reports Vol. 11; no. 1; p. 7592 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
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London
Nature Publishing Group UK
07.04.2021
Nature Publishing Group Nature Portfolio |
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| Abstract | Chronic low back pain (cLBP) rates among younger individuals are rising. Although pain and disability are often less severe, underlying changes in trunk behavior may be responsible for recurrence. We examine the biomarker capacity of a simple Trunk Compliance Index (TCI) to distinguish individuals with and without cLBP. A random subset (n = 49) of the RELIEF RCT were matched to healthy controls for sex, age, height and weight. We measured TCI (as displacement/ weight-normalized perturbation force) using anthropometrically-matched, suddenly-applied pulling perturbations to the trunk segment, randomized across three planes of motion (antero-posterior, medio-lateral, and rotational). Mean differences between cLBP, sex and perturbation direction were assessed with repeated-measures analysis of variance. Discriminatory accuracy of TCI was assessed using Receiver Operator Characteristic (ROC) analysis. Baseline characteristics between groups were equivalent (
x̅
[range]): sex (57% female / group), age (23.0 [18–45], 22.8 [18–45]), height, cm (173.0 [156.5–205], 171.3 [121.2–197], weight, kg (71.8 [44.5–116.6], 71.7 [46.8–117.5]) with cLBP associated with significantly lower TCI for 5 of 6 directions (range mean difference, − 5.35: − 1.49, range 95% CI [− 6.46: − 2.18 to − 4.35: − 0.30]. Classification via ROC showed that composite TCI had high discriminatory potential (area under curve [95% CI], 0.90 [0.84–0.96]), driven by TCI from antero-posterior perturbations (area under curve [95% CI], 0.99 [0.97–1.00]). Consistent reductions in TCI suggests global changes in trunk mechanics that may go undetected in classic clinical examination. Evaluation of TCI in younger adults with mild pain and disability may serve as a biomarker for chronicity, leading to improved preventative measures in cLBP.
Trial Registration and Funding RELIEF is registered with clinicaltrials.gov (NCT01854892) and funded by the NIH National Center for Complementary & Integrative Health (R01AT006978). |
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| AbstractList | Abstract
Chronic low back pain (cLBP) rates among younger individuals are rising. Although pain and disability are often less severe, underlying changes in trunk behavior may be responsible for recurrence. We examine the biomarker capacity of a simple Trunk Compliance Index (TCI) to distinguish individuals with and without cLBP. A random subset (n = 49) of the RELIEF RCT were matched to healthy controls for sex, age, height and weight. We measured TCI (as displacement/ weight-normalized perturbation force) using anthropometrically-matched, suddenly-applied pulling perturbations to the trunk segment, randomized across three planes of motion (antero-posterior, medio-lateral, and rotational). Mean differences between cLBP, sex and perturbation direction were assessed with repeated-measures analysis of variance. Discriminatory accuracy of TCI was assessed using Receiver Operator Characteristic (ROC) analysis. Baseline characteristics between groups were equivalent (
x̅
[range]): sex (57% female / group), age (23.0 [18–45], 22.8 [18–45]), height, cm (173.0 [156.5–205], 171.3 [121.2–197], weight, kg (71.8 [44.5–116.6], 71.7 [46.8–117.5]) with cLBP associated with significantly lower TCI for 5 of 6 directions (range mean difference, − 5.35: − 1.49, range 95% CI [− 6.46: − 2.18 to − 4.35: − 0.30]. Classification via ROC showed that composite TCI had high discriminatory potential (area under curve [95% CI], 0.90 [0.84–0.96]), driven by TCI from antero-posterior perturbations (area under curve [95% CI], 0.99 [0.97–1.00]). Consistent reductions in TCI suggests global changes in trunk mechanics that may go undetected in classic clinical examination. Evaluation of TCI in younger adults with mild pain and disability may serve as a biomarker for chronicity, leading to improved preventative measures in cLBP.
Trial Registration and Funding RELIEF is registered with clinicaltrials.gov (NCT01854892) and funded by the NIH National Center for Complementary & Integrative Health (R01AT006978). Chronic low back pain (cLBP) rates among younger individuals are rising. Although pain and disability are often less severe, underlying changes in trunk behavior may be responsible for recurrence. We examine the biomarker capacity of a simple Trunk Compliance Index (TCI) to distinguish individuals with and without cLBP. A random subset (n = 49) of the RELIEF RCT were matched to healthy controls for sex, age, height and weight. We measured TCI (as displacement/ weight-normalized perturbation force) using anthropometrically-matched, suddenly-applied pulling perturbations to the trunk segment, randomized across three planes of motion (antero-posterior, medio-lateral, and rotational). Mean differences between cLBP, sex and perturbation direction were assessed with repeated-measures analysis of variance. Discriminatory accuracy of TCI was assessed using Receiver Operator Characteristic (ROC) analysis. Baseline characteristics between groups were equivalent (x̅ [range]): sex (57% female / group), age (23.0 [18-45], 22.8 [18-45]), height, cm (173.0 [156.5-205], 171.3 [121.2-197], weight, kg (71.8 [44.5-116.6], 71.7 [46.8-117.5]) with cLBP associated with significantly lower TCI for 5 of 6 directions (range mean difference, - 5.35: - 1.49, range 95% CI [- 6.46: - 2.18 to - 4.35: - 0.30]. Classification via ROC showed that composite TCI had high discriminatory potential (area under curve [95% CI], 0.90 [0.84-0.96]), driven by TCI from antero-posterior perturbations (area under curve [95% CI], 0.99 [0.97-1.00]). Consistent reductions in TCI suggests global changes in trunk mechanics that may go undetected in classic clinical examination. Evaluation of TCI in younger adults with mild pain and disability may serve as a biomarker for chronicity, leading to improved preventative measures in cLBP.Trial Registration and Funding RELIEF is registered with clinicaltrials.gov (NCT01854892) and funded by the NIH National Center for Complementary & Integrative Health (R01AT006978). Abstract Chronic low back pain (cLBP) rates among younger individuals are rising. Although pain and disability are often less severe, underlying changes in trunk behavior may be responsible for recurrence. We examine the biomarker capacity of a simple Trunk Compliance Index (TCI) to distinguish individuals with and without cLBP. A random subset (n = 49) of the RELIEF RCT were matched to healthy controls for sex, age, height and weight. We measured TCI (as displacement/ weight-normalized perturbation force) using anthropometrically-matched, suddenly-applied pulling perturbations to the trunk segment, randomized across three planes of motion (antero-posterior, medio-lateral, and rotational). Mean differences between cLBP, sex and perturbation direction were assessed with repeated-measures analysis of variance. Discriminatory accuracy of TCI was assessed using Receiver Operator Characteristic (ROC) analysis. Baseline characteristics between groups were equivalent (x̅ [range]): sex (57% female / group), age (23.0 [18–45], 22.8 [18–45]), height, cm (173.0 [156.5–205], 171.3 [121.2–197], weight, kg (71.8 [44.5–116.6], 71.7 [46.8–117.5]) with cLBP associated with significantly lower TCI for 5 of 6 directions (range mean difference, − 5.35: − 1.49, range 95% CI [− 6.46: − 2.18 to − 4.35: − 0.30]. Classification via ROC showed that composite TCI had high discriminatory potential (area under curve [95% CI], 0.90 [0.84–0.96]), driven by TCI from antero-posterior perturbations (area under curve [95% CI], 0.99 [0.97–1.00]). Consistent reductions in TCI suggests global changes in trunk mechanics that may go undetected in classic clinical examination. Evaluation of TCI in younger adults with mild pain and disability may serve as a biomarker for chronicity, leading to improved preventative measures in cLBP. Trial Registration and Funding RELIEF is registered with clinicaltrials.gov (NCT01854892) and funded by the NIH National Center for Complementary & Integrative Health (R01AT006978). Chronic low back pain (cLBP) rates among younger individuals are rising. Although pain and disability are often less severe, underlying changes in trunk behavior may be responsible for recurrence. We examine the biomarker capacity of a simple Trunk Compliance Index (TCI) to distinguish individuals with and without cLBP. A random subset (n = 49) of the RELIEF RCT were matched to healthy controls for sex, age, height and weight. We measured TCI (as displacement/ weight-normalized perturbation force) using anthropometrically-matched, suddenly-applied pulling perturbations to the trunk segment, randomized across three planes of motion (antero-posterior, medio-lateral, and rotational). Mean differences between cLBP, sex and perturbation direction were assessed with repeated-measures analysis of variance. Discriminatory accuracy of TCI was assessed using Receiver Operator Characteristic (ROC) analysis. Baseline characteristics between groups were equivalent ( x̅ [range]): sex (57% female / group), age (23.0 [18–45], 22.8 [18–45]), height, cm (173.0 [156.5–205], 171.3 [121.2–197], weight, kg (71.8 [44.5–116.6], 71.7 [46.8–117.5]) with cLBP associated with significantly lower TCI for 5 of 6 directions (range mean difference, − 5.35: − 1.49, range 95% CI [− 6.46: − 2.18 to − 4.35: − 0.30]. Classification via ROC showed that composite TCI had high discriminatory potential (area under curve [95% CI], 0.90 [0.84–0.96]), driven by TCI from antero-posterior perturbations (area under curve [95% CI], 0.99 [0.97–1.00]). Consistent reductions in TCI suggests global changes in trunk mechanics that may go undetected in classic clinical examination. Evaluation of TCI in younger adults with mild pain and disability may serve as a biomarker for chronicity, leading to improved preventative measures in cLBP. Trial Registration and Funding RELIEF is registered with clinicaltrials.gov (NCT01854892) and funded by the NIH National Center for Complementary & Integrative Health (R01AT006978). Chronic low back pain (cLBP) rates among younger individuals are rising. Although pain and disability are often less severe, underlying changes in trunk behavior may be responsible for recurrence. We examine the biomarker capacity of a simple Trunk Compliance Index (TCI) to distinguish individuals with and without cLBP. A random subset (n = 49) of the RELIEF RCT were matched to healthy controls for sex, age, height and weight. We measured TCI (as displacement/ weight-normalized perturbation force) using anthropometrically-matched, suddenly-applied pulling perturbations to the trunk segment, randomized across three planes of motion (antero-posterior, medio-lateral, and rotational). Mean differences between cLBP, sex and perturbation direction were assessed with repeated-measures analysis of variance. Discriminatory accuracy of TCI was assessed using Receiver Operator Characteristic (ROC) analysis. Baseline characteristics between groups were equivalent (x̅ [range]): sex (57% female / group), age (23.0 [18–45], 22.8 [18–45]), height, cm (173.0 [156.5–205], 171.3 [121.2–197], weight, kg (71.8 [44.5–116.6], 71.7 [46.8–117.5]) with cLBP associated with significantly lower TCI for 5 of 6 directions (range mean difference, − 5.35: − 1.49, range 95% CI [− 6.46: − 2.18 to − 4.35: − 0.30]. Classification via ROC showed that composite TCI had high discriminatory potential (area under curve [95% CI], 0.90 [0.84–0.96]), driven by TCI from antero-posterior perturbations (area under curve [95% CI], 0.99 [0.97–1.00]). Consistent reductions in TCI suggests global changes in trunk mechanics that may go undetected in classic clinical examination. Evaluation of TCI in younger adults with mild pain and disability may serve as a biomarker for chronicity, leading to improved preventative measures in cLBP.Trial Registration and Funding RELIEF is registered with clinicaltrials.gov (NCT01854892) and funded by the NIH National Center for Complementary & Integrative Health (R01AT006978). |
| ArticleNumber | 7592 |
| Author | Kinser, Patricia A. Pidcoe, Peter E. Stamenkovic, Alexander Clark, Brian C. van der Veen, Susanne M. France, Christopher R. Thomas, James S. Russ, David W. |
| Author_xml | – sequence: 1 givenname: Alexander surname: Stamenkovic fullname: Stamenkovic, Alexander email: astamenkovic@vcu.edu organization: Department of Physical Therapy, College of Health Professions, Virginia Commonwealth University – sequence: 2 givenname: Brian C. surname: Clark fullname: Clark, Brian C. organization: Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Department of Biomedical Sciences, Ohio University – sequence: 3 givenname: Peter E. surname: Pidcoe fullname: Pidcoe, Peter E. organization: Department of Physical Therapy, College of Health Professions, Virginia Commonwealth University – sequence: 4 givenname: Susanne M. surname: van der Veen fullname: van der Veen, Susanne M. organization: Department of Physical Therapy, College of Health Professions, Virginia Commonwealth University, Physical and Rehabilitation Medicine, Virginia Commonwealth University – sequence: 5 givenname: Christopher R. surname: France fullname: France, Christopher R. organization: Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Department of Psychology, Ohio University – sequence: 6 givenname: David W. surname: Russ fullname: Russ, David W. organization: School of Physical Therapy & Rehabilitation Sciences, University of South Florida – sequence: 7 givenname: Patricia A. surname: Kinser fullname: Kinser, Patricia A. organization: School of Nursing, Virginia Commonwealth University – sequence: 8 givenname: James S. surname: Thomas fullname: Thomas, James S. organization: Department of Physical Therapy, College of Health Professions, Virginia Commonwealth University, Physical and Rehabilitation Medicine, Virginia Commonwealth University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33828171$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_3390_healthcare9070900 crossref_primary_10_1016_j_gaitpost_2021_10_004 crossref_primary_10_3390_healthcare9121733 crossref_primary_10_1007_s42399_024_01658_6 crossref_primary_10_2196_31685 crossref_primary_10_3390_bs12100353 |
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Biomech.20201021096071:STN:280:DC%2BB38%2FhvFehsA%3D%3D10.1016/j.jbiomech.2020.109607 R Chou (87138_CR10) 2007; 147 F Baumgart (87138_CR23) 2000; 31 S Manogharan (87138_CR31) 2017; 21 JS Thomas (87138_CR16) 2020; 3 AM Ellingson (87138_CR34) 2013; 38 SL Koppenhaver (87138_CR11) 2014; 19 AYL Wong (87138_CR14) 2017; 9 P Hodges (87138_CR20) 2009; 42 ML Ferreira (87138_CR32) 2014; 18 GBD Disease (87138_CR3) 2018; 392 AY Wong (87138_CR7) 2017; 12 M Vazirian (87138_CR18) 2016; 49 J Abboud (87138_CR42) 2016; 10 M Allegri (87138_CR25) 2016; 6 RJ Gatchel (87138_CR30) 2003; 13 D Hoy (87138_CR5) 2010; 24 T Xia (87138_CR22) 2017; 17 TS Keller (87138_CR33) 1987; 5 U Quint (87138_CR35) 2008; 17 CG Maher (87138_CR12) 1998; 78 NV Karayannis (87138_CR38) 2013; 8 DW Hosmer (87138_CR27) 2013 87138_CR26 WS Marras (87138_CR37) 2000; 25 JC Licciardone (87138_CR2) 2015; 115 D Lakens (87138_CR24) 2017; 8 JK Freburger (87138_CR4) 2009; 169 M Griffioen (87138_CR36) 2020; 102 AN Khan (87138_CR39) 2017; 1410 I Pagé (87138_CR41) 2015; 16 SZ George (87138_CR9) 2020; 5 AC Traeger (87138_CR6) 2019; 97 P Morris (87138_CR40) 2020; 21 87138_CR1 W Kaplan (87138_CR15) 2013 MA Seffinger (87138_CR13) 2004; 29 M Freddolini (87138_CR19) 2014; 36 KM Moorhouse (87138_CR29) 2007; 40 KP Granata (87138_CR28) 2007; 17 AP Goode (87138_CR21) 2019; 20 KM Dunn (87138_CR8) 2013; 27 EM Miller (87138_CR17) 2012; 15 |
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| Snippet | Chronic low back pain (cLBP) rates among younger individuals are rising. Although pain and disability are often less severe, underlying changes in trunk... Abstract Chronic low back pain (cLBP) rates among younger individuals are rising. Although pain and disability are often less severe, underlying changes in... Abstract Chronic low back pain (cLBP) rates among younger individuals are rising. Although pain and disability are often less severe, underlying changes in... |
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| Title | Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance |
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