Mechanical coupling between transverse plane pelvis and thorax rotations during gait is higher in people with low back pain

This study investigated whether people with low back pain (LBP) reduce variability of movement between the pelvis and thorax (trunk) in the transverse plane during gait at different speeds compared to healthy controls. Thirteen people with chronic LBP and twelve healthy controls walked on a treadmill at speeds from 0.5 to 1.72 m/s, with increments of 0.11 m/s. Step-to-step variability of the trunk, pelvis, and thorax rotations were calculated. Step-to-step deviations of pelvis and thorax rotations from the average pattern (residual rotations) were correlated to each other, and the linear regression coefficients between these deviations calculated. Spectral analysis was used to determine the frequencies of the residual rotations, to infer the relation of reduced trunk variability to trunk stiffness and/or damping. Variability of trunk motion (thorax relative to pelvis) was lower (P=0.02), covariance between the residual rotations of pelvis and thorax motions was higher (P=0.03), and the linear regression coefficients were closer to 1 (P=0.05) in the LBP group. Most power of segmental residual rotations was below stride frequency (∼1 Hz). In this frequency range, trunk residual rotations had less power than pelvis or thorax residual rotations. These data show that people with LBP had lower variability of trunk rotations, as a result of the coupling of deviations of residual rotations in one segment to deviations of a similar shape (correlation) and amplitude (regression coefficient) in the other segment. These results support the argument that people with LBP adopt a protective movement strategy, possibly by increased trunk stiffness.