Footwear-Generated Dynamic Biomechanical Manipulation and Perturbation Training for Chronic Nonspecific Low Back Pain

Se Won Lee, Ratnakar Veeramachaneni, Ibrahim Abou Saleh, Karen Morice, Timothy K. Tiu, Yungtai Lo, Kevin Frison, Matthew N. Bartels

Research output: Contribution to journalArticle

Abstract

Background: Home-based therapy optimizing biomechanics and neuromuscular control is increasingly recognized as a treatment option for chronic nonspecific low back pain (CNSLBP). However, its impact on pain, function, and gait is limited among patients in a metropolitan area. Objective: To evaluate the change of pain, function, and gait parameters with home-based therapy with the use of footwear-generated biomechanical manipulation and perturbation training in a population with CNSLBP in a metropolitan area. Design: Prospective observational study. Setting: Outpatient rehabilitation clinic at an academic teaching hospital. Participants: One hundred sixteen patients with CNSLBP for more than 6 months. Intervention: Six months of home-based therapy with a biomechanical device using 4 modular elements attached to a foot-worn platform. Main Outcome Measures: Instrumental gait analysis (gait velocity, step length, single limb support phase % of gait cycle), Numeric Rating Scale for pain, and Oswestry Disability Questionnaire Index for pain and function. Results: Only 43 patients (37.1%) completed the study. Among 43 patients, mean gait velocity increased from 86.6 ± 20.7 to 99.7 ± 22.1 cm/s (P <.0001) in 6 months. Mean left step length increased from 51.1 ± 8.4 to 54.8 ± 9.8 cm (P <.0001). Mean right step length increased from 51.0 ± 7.9 to 55.4 ± 9.0 cm (P <.0001). Mean single limb support increased from 36.4 ± 2.8 to 37.2 ± 2.5%, (P =.208) in the right side and from 36.6 ± 3.0 to 37.8 ± 4.4%, (P =.019) in the left side. Median Oswestry Disability Questionnaire Index score improved from 28 (18-44; interquartile range) to 17 (10-35) (P =.045). Mean Numeric Rating Scale for back pain improved from 7.7 ± 1.8 to 3.3 ± 3.1 (P <.0001). Conclusion: At 6 months, patients with CNSLBP undergoing home-based therapy with footwear-generated biomechanical manipulation and perturbation training demonstrated significant improvement of objective gait parameters, pain, and function.

Original languageEnglish (US)
JournalPM and R
DOIs
StateAccepted/In press - Jan 1 2018

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Low Back Pain
Gait
Pain
Extremities
Therapeutics
Back Pain
Ambulatory Care Facilities
Biomechanical Phenomena
Teaching Hospitals
Observational Studies
Foot
Rehabilitation
Outcome Assessment (Health Care)
Prospective Studies
Equipment and Supplies
Population

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Neurology
  • Clinical Neurology

Cite this

Footwear-Generated Dynamic Biomechanical Manipulation and Perturbation Training for Chronic Nonspecific Low Back Pain. / Lee, Se Won; Veeramachaneni, Ratnakar; Saleh, Ibrahim Abou; Morice, Karen; Tiu, Timothy K.; Lo, Yungtai; Frison, Kevin; Bartels, Matthew N.

In: PM and R, 01.01.2018.

Research output: Contribution to journalArticle

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title = "Footwear-Generated Dynamic Biomechanical Manipulation and Perturbation Training for Chronic Nonspecific Low Back Pain",
abstract = "Background: Home-based therapy optimizing biomechanics and neuromuscular control is increasingly recognized as a treatment option for chronic nonspecific low back pain (CNSLBP). However, its impact on pain, function, and gait is limited among patients in a metropolitan area. Objective: To evaluate the change of pain, function, and gait parameters with home-based therapy with the use of footwear-generated biomechanical manipulation and perturbation training in a population with CNSLBP in a metropolitan area. Design: Prospective observational study. Setting: Outpatient rehabilitation clinic at an academic teaching hospital. Participants: One hundred sixteen patients with CNSLBP for more than 6 months. Intervention: Six months of home-based therapy with a biomechanical device using 4 modular elements attached to a foot-worn platform. Main Outcome Measures: Instrumental gait analysis (gait velocity, step length, single limb support phase {\%} of gait cycle), Numeric Rating Scale for pain, and Oswestry Disability Questionnaire Index for pain and function. Results: Only 43 patients (37.1{\%}) completed the study. Among 43 patients, mean gait velocity increased from 86.6 ± 20.7 to 99.7 ± 22.1 cm/s (P <.0001) in 6 months. Mean left step length increased from 51.1 ± 8.4 to 54.8 ± 9.8 cm (P <.0001). Mean right step length increased from 51.0 ± 7.9 to 55.4 ± 9.0 cm (P <.0001). Mean single limb support increased from 36.4 ± 2.8 to 37.2 ± 2.5{\%}, (P =.208) in the right side and from 36.6 ± 3.0 to 37.8 ± 4.4{\%}, (P =.019) in the left side. Median Oswestry Disability Questionnaire Index score improved from 28 (18-44; interquartile range) to 17 (10-35) (P =.045). Mean Numeric Rating Scale for back pain improved from 7.7 ± 1.8 to 3.3 ± 3.1 (P <.0001). Conclusion: At 6 months, patients with CNSLBP undergoing home-based therapy with footwear-generated biomechanical manipulation and perturbation training demonstrated significant improvement of objective gait parameters, pain, and function.",
author = "Lee, {Se Won} and Ratnakar Veeramachaneni and Saleh, {Ibrahim Abou} and Karen Morice and Tiu, {Timothy K.} and Yungtai Lo and Kevin Frison and Bartels, {Matthew N.}",
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AU - Lee, Se Won

AU - Veeramachaneni, Ratnakar

AU - Saleh, Ibrahim Abou

AU - Morice, Karen

AU - Tiu, Timothy K.

AU - Lo, Yungtai

AU - Frison, Kevin

AU - Bartels, Matthew N.

PY - 2018/1/1

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N2 - Background: Home-based therapy optimizing biomechanics and neuromuscular control is increasingly recognized as a treatment option for chronic nonspecific low back pain (CNSLBP). However, its impact on pain, function, and gait is limited among patients in a metropolitan area. Objective: To evaluate the change of pain, function, and gait parameters with home-based therapy with the use of footwear-generated biomechanical manipulation and perturbation training in a population with CNSLBP in a metropolitan area. Design: Prospective observational study. Setting: Outpatient rehabilitation clinic at an academic teaching hospital. Participants: One hundred sixteen patients with CNSLBP for more than 6 months. Intervention: Six months of home-based therapy with a biomechanical device using 4 modular elements attached to a foot-worn platform. Main Outcome Measures: Instrumental gait analysis (gait velocity, step length, single limb support phase % of gait cycle), Numeric Rating Scale for pain, and Oswestry Disability Questionnaire Index for pain and function. Results: Only 43 patients (37.1%) completed the study. Among 43 patients, mean gait velocity increased from 86.6 ± 20.7 to 99.7 ± 22.1 cm/s (P <.0001) in 6 months. Mean left step length increased from 51.1 ± 8.4 to 54.8 ± 9.8 cm (P <.0001). Mean right step length increased from 51.0 ± 7.9 to 55.4 ± 9.0 cm (P <.0001). Mean single limb support increased from 36.4 ± 2.8 to 37.2 ± 2.5%, (P =.208) in the right side and from 36.6 ± 3.0 to 37.8 ± 4.4%, (P =.019) in the left side. Median Oswestry Disability Questionnaire Index score improved from 28 (18-44; interquartile range) to 17 (10-35) (P =.045). Mean Numeric Rating Scale for back pain improved from 7.7 ± 1.8 to 3.3 ± 3.1 (P <.0001). Conclusion: At 6 months, patients with CNSLBP undergoing home-based therapy with footwear-generated biomechanical manipulation and perturbation training demonstrated significant improvement of objective gait parameters, pain, and function.

AB - Background: Home-based therapy optimizing biomechanics and neuromuscular control is increasingly recognized as a treatment option for chronic nonspecific low back pain (CNSLBP). However, its impact on pain, function, and gait is limited among patients in a metropolitan area. Objective: To evaluate the change of pain, function, and gait parameters with home-based therapy with the use of footwear-generated biomechanical manipulation and perturbation training in a population with CNSLBP in a metropolitan area. Design: Prospective observational study. Setting: Outpatient rehabilitation clinic at an academic teaching hospital. Participants: One hundred sixteen patients with CNSLBP for more than 6 months. Intervention: Six months of home-based therapy with a biomechanical device using 4 modular elements attached to a foot-worn platform. Main Outcome Measures: Instrumental gait analysis (gait velocity, step length, single limb support phase % of gait cycle), Numeric Rating Scale for pain, and Oswestry Disability Questionnaire Index for pain and function. Results: Only 43 patients (37.1%) completed the study. Among 43 patients, mean gait velocity increased from 86.6 ± 20.7 to 99.7 ± 22.1 cm/s (P <.0001) in 6 months. Mean left step length increased from 51.1 ± 8.4 to 54.8 ± 9.8 cm (P <.0001). Mean right step length increased from 51.0 ± 7.9 to 55.4 ± 9.0 cm (P <.0001). Mean single limb support increased from 36.4 ± 2.8 to 37.2 ± 2.5%, (P =.208) in the right side and from 36.6 ± 3.0 to 37.8 ± 4.4%, (P =.019) in the left side. Median Oswestry Disability Questionnaire Index score improved from 28 (18-44; interquartile range) to 17 (10-35) (P =.045). Mean Numeric Rating Scale for back pain improved from 7.7 ± 1.8 to 3.3 ± 3.1 (P <.0001). Conclusion: At 6 months, patients with CNSLBP undergoing home-based therapy with footwear-generated biomechanical manipulation and perturbation training demonstrated significant improvement of objective gait parameters, pain, and function.

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