A Novel Approach to Understanding Functional Gait and Variable Walking Strategies in an Asymptomatic Low Back Pain Population

Meaningful gait assessment in individuals with low back pain (LBP) should involve prolonged, dynamic walking conditions with directional changes that resemble functional gait. However, previous studies have investigated less ecologically valid, short, steady-state walking paradigms. The purpose of this study was to compare spatiotemporal variables during figure eight walking between asymptomatic young adults with a history of LBP and back-healthy (BH) individuals. Fifty-nine young adults participated (age 22.4 ± 0.5 years, 36 with a history of LBP, asymptomatic at the time of data collection but reporting at least a one-year history of functionally limiting episodes of pain). Participants were instrumented with inertial sensors on the sternum, wrists, lumbar spine, and feet. Participants walked at self-selected speed for five minutes in a ten-meter figure eight pattern. Spatiotemporal gait characteristics across stride cycles were calculated using Mobility Lab software (APDM Inc). Group comparisons were conducted with independent samples t-tests/Mann-Whitney U tests. Effect sizes were calculated using Cohen’s d. Groups did not differ based on age, height, weight, body mass index (BMI), and typical physical activity (p \u3e 0.05 for all comparisons). Walking speed for the LBP group was less than the BH group (LBP = 1.13 m/s, BH = 1.24 m/s, p \u3c 0.001, d = 1.01). LBP individuals exhibited reduced cadence (LBP = 110.15, BH = 113.94, p = 0.026, d = 0.61) and longer duration of gait cycle (LBP = 1.10 s, BH = 1.06 s, p = 0.027, d = 0.62) than BH individuals. Additionally, LBP participants spent a greater percentage of their gait cycle in stance phase (LBP = 59.93%, BH = 58.72%, p = 0.003, d = 0.84) and in double support (LBP = 19.90%, BH = 17.50%, p = 0.002, d = 0.86). Despite being asymptomatic at the time of data collection, young adults with a history of LBP displayed conservative spatiotemporal gait characteristics during prolonged figure-eight walking in comparison to BH individuals. Ongoing research will determine if this gait strategy is more favorable for limiting the progression of LBP over time