Associations of low-back pain and pain-related cognitions with lumbar movement patterns during repetitive seated reaching

Meta H. Wildenbeest*, Henri Kiers, Matthijs Tuijt, Jaap H. van Dieën

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Background: Development of more effective interventions for nonspecific chronic low back pain (LBP), requires a robust theoretical framework regarding mechanisms underlying the persistence of LBP. Altered movement patterns, possibly driven by pain-related cognitions, are assumed to drive pain persistence, but cogent evidence is missing. Aim: To assess variability and stability of lumbar movement patterns, during repetitive seated reaching, in people with and without LBP, and to investigate whether these movement characteristics are associated with pain-related cognitions. Methods: 60 participants were recruited, matched by age and sex (30 back-healthy and 30 with LBP). Mean age was 32.1 years (SD13.4). Mean Oswestry Disability Index-score in LBP-group was 15.7 (SD12.7). Pain-related cognitions were assessed by the ‘Pain Catastrophizing Scale’ (PCS), ‘Pain Anxiety Symptoms Scale’ (PASS) and the task-specific ‘Expected Back Strain’ scale(EBS). Participants performed a seated repetitive reaching movement (45 times), at self-selected speed. Lumbar movement patterns were assessed by an optical motion capture system recording positions of cluster markers, located on the spinous processes of S1 and T8. Movement patterns were characterized by the spatial variability (meanSD) of the lumbar Euler angles: flexion-extension, lateral-bending, axial-rotation, temporal variability (CyclSD) and local dynamic stability (LDE). Differences in movement patterns, between people with and without LBP and with high and low levels of pain-related cognitions, were assessed with factorial MANOVA. Results: We found no main effect of LBP on variability and stability, but there was a significant interaction effect of group and EBS. In the LBP-group, participants with high levels of EBS, showed increased MeanSDlateral-bending (p = 0.004, η2 = 0.14), indicating a large effect. MeanSDaxial-rotation approached significance (p = 0.06). Significance: In people with LBP, spatial variability was predicted by the task-specific EBS, but not by the general measures of pain-related cognitions. These results suggest that a high level of EBS is a driver of increased spatial variability, in participants with LBP.

Original languageEnglish
Pages (from-to)216-222
Number of pages7
JournalGait and Posture
Early online date26 Oct 2021
Publication statusPublished - Jan 2022

Bibliographical note

Funding Information:
This work was supported by the Dutch Organization for Scientific Research: NWO , The Hague, The Netherlands [Grant number 0.23 0.12 0.25 ].

Publisher Copyright:
© 2021 The Authors


  • Dynamic movement
  • Linear
  • Local dynamic stability
  • Non-linear
  • Task-specific outcome measure
  • Variability


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