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The biomechanical parameters studied in non-specific chronic low back pain patients in a locomotion task have so far focused on straight line walking. Although locomotion is primarily an automated action composed of repetitive patterns allowing movement from one place to another, walkers must respond to the environmental demands.These modifications show a flexible and adaptive approach to the constraints of the environment. In this study, we are particularly interested in a task of passage through a horizontal opening, similar to a doorway, which is a standardized task that has shown its interest in the study of perceptual-motor co-ordinations. In particular, it allows to consider anthropometric and functional abilities of individuals, reflecting their action capacities.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Non-Specific Low Back Pain patients | Participants must have pain located between the thoracolumbar hinge and the lower gluteal fold, with or without pain in either leg, present for more than 12 weeks, on a daily or almost daily basis (at least 4 days out of 7). |
| |
| Control group | Participant with no current or past chronic pain |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Quantified analysis of walking during a task of passage through a horizontal opening | Other | Functional test that reproduce a task of daily living, similar to a doorway |
|
| Measure | Description | Time Frame |
|---|---|---|
| Critical threshold | Defined as the width of opening making the transition between openings that it is possible or not to cross while walking without modification of the movement. We will then identify the trials, i.e. the door widths, where the participants have turned their shoulders. To do this, we will compare the shoulder angle observed during the doorway crossing with the average angle observed in the control conditions, corresponding to a straight line walk without any opening to cross. | Clinical assessment at base line |
| Measure | Description | Time Frame |
|---|---|---|
| Phase shift between shoulder and pelvic angles in the transverse plane | Analysis of the difference between the scapular and pelvic angles in the transverse plane during aperture crossing | Clinical assessment at base line |
| Stability of the trunk |
| Measure | Description | Time Frame |
|---|---|---|
| Pain intensity | Pain intensity reflects the overall magnitude of the patient's perceived pain experience. We will assess this variable using a visual analogue scale (VAS) in paper format. The VAS is represented by a 100 mm long horizontal line with descriptors at both ends: on the left "no pain" and on the right "worst pain imaginable". The patient must then draw a mark on the line corresponding to his or her pain experience. "0" corresponds to "no pain" and "10" corresponds to "worst pain imaginable". |
Inclusion Criteria NSCLBP patients:
Exclusion Criteria NSCLBP patients:
Participants must not be pregnant or nursing mothers.
Participants must not have cognitive or psychological impairments that are incompatible with compliance and/or understanding of the protocol (MMSE > 28)
Participants must not be unable to understand informed consent, or be under guardianship or conservatorship
Subjects must not already be participating in another research protocol involving the human subject or in parallel
Participants must not be persons deprived of liberty by judicial or administrative decision
Participants must not be under psychiatric care
The participants must not present neurological signs evoking a neurodegenerative disease responsible for walking disorders (parkinsonian syndrome, ...)
The participants must not present warning signs (red flags) pointing to an underlying pathology requiring specific and/or urgent care such as
Inclusion and Exclusion Criteria of control group :
Participants strictly meet the same inclusion and non-inclusion criteria as NSCLBP patients, but must not have ongoing chronic pain or a history of significant chronic pain (≥ 4/10 for at least 6 months). They are matched for age and gender. They must not have any pathologies that affect walking or posture. These individuals must be able to perform the studied movements without the appearance of discomfort or exaggerated fatigue.
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NSCLBP patients who do their medical follow-up in medical center in France
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| Name | Affiliation | Role |
|---|---|---|
| Olivier Roze, MD | clinique de la Sagesse | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Rennes 2 | Rennes | 35000 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37419055 | Derived | Bilhaut A, Menard M, Roze O, Cretual A, Olivier AH. Locomotion behavior of chronic Non-Specific Low Back Pain (cNSLBP) participants while walking through apertures. Gait Posture. 2023 Jul;104:140-146. doi: 10.1016/j.gaitpost.2023.06.015. Epub 2023 Jun 22. |
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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Analysis of the amplitude of the medio-lateral oscillation movements in the frontal plane during the task
| Clinical assessment at base line |
| Step length | Analysis of the step length before the obstacle compared to the step length in the nominal walking condition (with no obstacle in the path) | Clinical assessment at base line |
| Walking speed | Analysis of the walking speed before the obstacle compared to the walking speed in the nominal walking condition (without obstacle on the path) | Clinical assessment at base line |
| Clinical assessment at base line |
| Temporal aspects of pain | Assessment of the impact of the variability of pain over time, i.e. the duration of painful episodes (in number of months). | Clinical assessment at base line |
| Levels of anxiety and depression | Anxiety refers to fear, extreme worrying and hyperarousal symptoms. Depression refers to negative mood, loss of self-confidence, loss of motivation and pleasure. We will use these measures using the Hospital Anxiety Depression Scale (HADS). This tool consists of 14 items scored from 0 to 3. Seven questions relate to anxiety (Total A) and 7 questions to the depressive dimension (Total D), resulting in two scores with a maximum total of 21 each. The higher the score, the more anxiety or depression the person has. | Clinical assessment at base line |
| Pain Catastrophizing | Catastrophizing refers to the cognitive process in which anxious patients dwell on the most negative consequences and refers here to the interpretation of pain as extremely threatening. We will use the Pain Catastrophizing Scale (PCS) to assess three dimensions: rumination, amplification and helplessness. This scale consists of 13 items scored from 0 (not at all) to 4 (all the time) with a maximum score of 52. The higher the score, the greater the level of catastrophisation. | Clinical assessment at base line |
| Kinesiophobia | Fear of movement is characterized by pain-related fears and anxieties that often result in avoidance of movement that could cause or worsen an injury. We will use the Tampa Scale Kinesiophobia (TSK). This scale consists of 17 items rated from 1 (strongly disagree) to 4 (strongly agree) with a maximum score of 68. The higher the score, the greater the level of kinesiophobia. | Clinical assessment at base line |
| Psychological Inflexibility in Pain | Psychological flexibility measures psychological functioning in phase (in fusion) with the pain or whether the patient has certain degrees of freedom from it. We will use the Psychological Inflexibility in Pain Scale (PIPS) allowing us to assess two factors: avoidance and cognitive fusion. This scale consists of 16 items with a scale of 1 (never true) to 7 (always true). The higher the score, the greater the level of psychological inflexibility. | Clinical assessment at base line |
| Fear Avoidance Beliefs | Fear and avoidance beliefs reflect patients' pain avoidance behaviors. We will use the Fear Avoidance Beliefs Questionnaire (FABQ) to assess two subscales: beliefs about work and beliefs about physical activity. The questionnaire consists of 16 items scored from 0 (absolutely disagree with the sentence) to 6 (completely agree with the sentence). The maximum score for beliefs about work is 42 and the maximum score for beliefs about physical activity is 24. The higher the score, the greater the level of beliefs. | Clinical assessment at base line |
| Physical functioning | Physical functioning refers to the impact on the patient's ability to perform daily physical activities necessary to meet basic needs, ranging from self-care to more complex activities that require a combination of skills. We will use the Roland Morris Disability Questionnaire (RMDQ). This questionnaire has 24 items with a maximum score of 24. The higher the score, the more functional disabilities the person has. | Clinical assessment at base line |
| Quality of life (EQ-5D) | Quality of life refers to the impact on the physical, psychological, and social domains of health, considered as distinct domains that are influenced by a person's experiences, beliefs, expectations, and perceptions. We will use the EuroQol 5 Dimension questionnaire (EQ-5D) allowing for the assessment of five dimensions: mobility, ability to care for oneself, usual work, home, and leisure activities, pain/discomfort, anxiety, and depression. Five degrees of severity in ascending order are used to assess each dimension: "no problems" to "total disability" for items that assess ability, and "no problem" to "extreme" for the other items. The higher the score, the lower the level of quality of life. | Clinical assessment at base line |
| D013568 |
| Pathological Conditions, Signs and Symptoms |