Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance

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 indi...

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Autores principales:	Alexander Stamenkovic, Brian C. Clark, Peter E. Pidcoe, Susanne M. van der Veen, Christopher R. France, David W. Russ, Patricia A. Kinser, James S. Thomas
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1f5b8256c05f4e9f94ddb6e0da519ce8
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spelling	oai:doaj.org-article:1f5b8256c05f4e9f94ddb6e0da519ce82021-12-02T18:15:25ZDistinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance10.1038/s41598-021-87138-62045-2322https://doaj.org/article/1f5b8256c05f4e9f94ddb6e0da519ce82021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-87138-6https://doaj.org/toc/2045-2322Abstract 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).Alexander StamenkovicBrian C. ClarkPeter E. PidcoeSusanne M. van der VeenChristopher R. FranceDavid W. RussPatricia A. KinserJames S. ThomasNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Alexander Stamenkovic Brian C. Clark Peter E. Pidcoe Susanne M. van der Veen Christopher R. France David W. Russ Patricia A. Kinser James S. Thomas Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance
description	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).
format	article
author	Alexander Stamenkovic Brian C. Clark Peter E. Pidcoe Susanne M. van der Veen Christopher R. France David W. Russ Patricia A. Kinser James S. Thomas
author_facet	Alexander Stamenkovic Brian C. Clark Peter E. Pidcoe Susanne M. van der Veen Christopher R. France David W. Russ Patricia A. Kinser James S. Thomas
author_sort	Alexander Stamenkovic
title	Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance
title_short	Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance
title_full	Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance
title_fullStr	Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance
title_full_unstemmed	Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance
title_sort	distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/1f5b8256c05f4e9f94ddb6e0da519ce8
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Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance

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