Table_2_Chronic Non-specific Low Back Pain and Motor Control During Gait.DOCX

Background: Chronic non-specific low back pain (LBP) poses a major socioeconomic problem, although the mechanisms are not yet clear. Impaired motor control is one of the mechanisms being discussed.
Objectives: The purpose of this review is to provide an overview of motor control parameter differences between individuals with and without non-specific LBP during gait.
Methods: A literature search on Medline, SportDiscus, PsychInfo, PsychArticels, EMBASE, and Scopus was performed. Twenty-nine articles comparing healthy adults and adults with chronic non-specific LBP in neuromuscular and/or biomechanical parameters during walking or running were examined. Data extraction and quality assessment were independently performed by two persons. Among others, we extracted population, conditions, outcome measures, and results.
Results: The results showed that persons with and without non-specific LBP differed in several parameters of motor control, which was indicated by a lower movement amplitude of the pelvis, more in-phase coordination, lower ground reaction forces, higher stride-to-stride variability and a higher activity in ES in the LBP group.
Conclusion: Despite no strong evidence for any of the parameters, a combination of biomechanical and neuromuscular parameters provides a conclusive explanation. Impaired motor control during walking is reflected in higher activity of the erector spinae, which leads to a stiffened lumbar-pelvic region. Different acquisition and processing of data renders making comparisons difficult, whereby standards for future research are necessary.

背景：慢性非特异性下腰痛（chronic non-specific low back pain, LBP）是一项重大的社会经济负担，尽管其发病机制尚未明确，而运动控制受损是目前被探讨的发病机制之一。
研究目的：本综述旨在系统梳理伴与不伴非特异性下腰痛人群在步态过程中的运动控制参数差异。
方法：本研究检索了Medline、SportDiscus、PsychInfo、PsychArticles、EMBASE及Scopus数据库，最终纳入29项对比健康成年人与慢性非特异性下腰痛成年人在步行或跑步过程中神经肌肉及/或生物力学参数的研究。由两名研究者独立完成数据提取与质量评价工作，提取内容包括研究人群、实验条件、结局指标及研究结果等。
结果：研究结果显示，伴与不伴非特异性下腰痛人群的多项运动控制参数存在显著差异，具体表现为下腰痛组患者的骨盆活动幅度更低、协调性更趋于同相位、地面反作用力更小、步间变异性更高，且竖脊肌（erector spinae, ES）活动度更高。
结论：尽管现有研究未针对任一参数提供充分确凿的证据，但将生物力学与神经肌肉参数相结合可得出较为明确的解释。步行过程中的运动控制受损表现为竖脊肌活动度升高，进而导致腰骶-骨盆区域僵硬。不同研究间的数据采集与处理方式存在差异，这使得跨研究比较难度增加，因此未来研究亟需建立统一的标准化规范。