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Pain Research and Treatment
Volume 2012 (2012), Article ID 214980, 10 pages
http://dx.doi.org/10.1155/2012/214980
Clinical Study

The Influence of Pain Distribution on Walking Velocity and Horizontal Ground Reaction Forces in Patients with Low Back Pain

1University of Texas, Health Sciences Center, San Antonio, TX 78229, USA
2A. T. Still Research Institute, A. T. Still University, Missouri Campus, 800 W Jefferson Street, Kirksville, MO 63501, USA
3Department of Physical Therapy, University of Manitoba, Winnipeg, MB, Canada R3T 2N2
4Department of Kinesiology, Rice University, Houston, TX 77251-1892, USA
5Department of Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN 38105, USA

Received 13 April 2011; Revised 19 October 2011; Accepted 16 November 2011

Academic Editor: Laura S. Stone

Copyright © 2012 Maureen J. Simmonds et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. The primary purpose of this paper was to evaluate the influence of pain distribution on gait characteristics in subjects with low back problems (LBP) during walking at preferred and fastest speeds. Design. Cross-sectional, observational study. Setting. Gait analysis laboratory in a health professions university. Participants. A convenience age- and gender-matched sample of 20 subjects with back pain only (BPO), 20 with referred leg pain due to back problems (LGP), and 20 pain-free individuals (CON). Methods and Measures. Subjects completed standardized self-reports on pain and disability and were videotaped as they walked at their preferred and fastest speeds along a walkway embedded with a force plate. Temporal and spatial gait characteristics were measured at the midsection of the walkway, and peak medial, lateral, anterior, and posterior components of horizontal ground reaction forces (hGRFs) were measured during the stance phase. Results. Patients with leg pain had higher levels of pain intensity and affect compared to those with back pain only ( , and , , resp.) and walking had an analgesic effect in the BPO group. Gait velocity was highest in the control group followed by the BPO and LGP group and differed between groups at both walking speeds ( , and , , for preferred and fastest speed condition, resp.). When normalized against gait velocity, the LGP group generated significantly less lateral force at the fastest walking speed ( ) and significantly less posterior force at both walking speeds ( ) compared to the control group. Conclusions. Pain intensity and distribution differentially influence gait velocity and hGRFs during gait. Those with referred leg pain tend to utilize significantly altered gait strategies that are more apparent at faster walking speeds.