LOW BACK FUNCTION EVALUATION
Title.
The value of objective assessment of low
back mobility for diagnosis and follow-up of the evolution
of low back disorders.
Background.
Preliminary studies suggest that the detailed
analysis of movement characteristics is able to detect individuals
with low back pain (the parameters analyzed include, for example,
the speed with which the movements are executed, the phases
of each gesture and the degree of bending or flexion of the
trunk during the motion, the degree of hip bending and the
analysis of the reaction forces that these activities generate
and their symmetry or asymmetry). These preliminary studies
have been developed with small groups of healthy subjects
(who have acted as the control group) and patients with pain
(without specifying its cause), suggesting that objective
differences exist in the detailed characteristics of their
movement.
That suggests that this system could be useful in detecting
simulation behaviors. However, it is still necessary to determine
whether different back problems (for example, non-specific
pain versus disc hernia) objectively cause disorders different
from the characteristics of mobility (which would refine and
complete the validity of that analysis to detect simulators
and would provide it a possible diagnostic value), whether
the magnitude or other characteristics of these anomalies
of mobility can predict the patient's clinical evolution (which
would provide a possible prognosis), or whether once the patient
is reestablished, these anomalies become normal (which would
suggest their value for the patient's follow-up).
Objective.
To determine whether the detailed analysis
of the characteristics of low back mobility allow one to define:
-
Deteriorations in mobility that are specific to the different
disorders and to discriminate pathological behaviors of
simulation.
-
Parameters with prognostic value.
-
- Useful parameters for the follow-up of patients' evolution.
Methodology.
The study is currently in the design phase,
so that the general proposition this section presents is only
an approximation. In principle, it is a matter of establishing
four groups:
-
One with an objective organic disorder that can be shown
to be responsible for the symptoms in a specific patient
(at first, symptomatic disc hernias).
-
One with non-specific pain.
-
One of the healthy subjects who have suffered pain in
the past and who could be asked to imitate in his/her
movements the characteristics of his/her mobility when
he /she had pain (who would act as a "control group
similar to the simulators").
-
One of the healthy subjects (who would be the real control
group).
An analysis of mobility would be made of the subjects of
the four groups and the evolution of the first two would be
followed over time, until their recovery. Finally, the characteristics
of mobility in the four groups and their evolution over time
would be analyzed.
Participants, along with the Foundation's
Science Department.
Participating groups and centers in the Spanish
Network of Researchers in Back Disorders. Within the Network,
groups form the Kovacs Foundation, the Biomechanics Institute
of Valencia, the Department of Neurosurgery of the Hospital
de Son Dureta, the Spine Unit at the Hospital Vall d'Hebrón
and Primary Care teams from Mallorca, Menorca and Ibiza are
responsible for the work group designing the study.
Status.
In the design phase, at the same time, the
possibility of making the instruments for the analysis of
the characteristics of mobility available in each one of the
clinical centers which may participate in the study is being
studied, since this is an essential aspect to ensure its viability.
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