Lumbar Stability in Healthy Individuals and Low Back Pain Patients Quantified by Wall Plank-and-Roll Test.

Background: Low back pain (LBP) has been linked to the degree of lumbar stability, but evaluating lumbar stability has remained a challenge. Previous research has shown that inertial sensors could be used to quantify motor patterns during the wall plank-and-roll (WPR) test, and that LBP may cause deviations in movement from the general motor patterns observed in healthy individuals.
Objective: To generalize the lumbar motor patterns during the WPR test in healthy individuals, and to analyze the effect of aging and LBP on the motor patterns during the WPR test.
Design: A descriptive, exploratory research with a convenience sample. This study is registered at the Clinical Research Information Service (Korea) under public trial registration numbers KCT0002481 and KCT0002533.
Setting: A biomechanics laboratory of a tertiary university hospital.
Participants: 57 healthy individuals (23 men 36.7 ± 15.4 years old and 34 women 42.4 ± 17.7 years old) and 17 patients (5 men 48.4 ± 10.9 years old and 12 women 33.7 ± 9.9 years old) with axial LBP.
Methods: Participants performed the WPR test with 2 inertial sensors placed on the thoracic spine and sacrum. Relative angles between the sensors were calculated to quantify and examine lumbar motion in 3 anatomical planes: axial twist, kyphosis-lordosis, and lateral bending.
Main Outcome Measures: General motor patterns during the WPR test in healthy participants were examined, stratified based on age, and changes based on age were analyzed. Motor patterns of LBP patients were compared with those from the healthy group.
Results: Movement in the kyphosis-lordosis and lateral bending axes showed little variation in healthy participants, whereas in the axial twist axis there were 2 dominant patterns. A χ ² test revealed that the distributions of 2 motor patterns in the axial twist axis between the younger group and the older group were significantly different (P < .05). Furthermore, the older group had decreased lordosis at the static position (P = .02) and at the maximal rotating position (P = .03). Compared with the healthy group, LBP patients showed increasing lateral bending at the maximal rotating position (P = .007) and increased lateral bending excursion angle (P = .04) during the WPR test.
Conclusions: A general lumbar motor pattern was observed during the WPR test in the healthy participants, but age contributed to variations in this general pattern. Comparison of motor patterns between healthy individuals and LBP patients revealed a different type of variation in the LBP patients. The results presented should be scrutinized with further research, characterizing specific variations in different subgroups of LBP patients.
Level of Evidence: III.
(© 2018 American Academy of Physical Medicine and Rehabilitation.)