Range of motion and perceived pain and disability in individuals with low back pain
Introduction: Chronic low back pain (CLBP) is a major contributor to the cost of health care in the United States (Johnson, & Thomas, 2010; Dagenais, Caro & Haldeman, 2008). CLBP has many causes. CLBP effects a majority of the population (Kim et al., 2014; Johnson, & Thomas, 2010; Wong & Lee, 2004). Physical and psychological factors influence CLBP and it is beneficial to understand which factor has more of an influence. Physical factors can involve range of motion (ROM) of the hips and low back. The psychological factors can involve fear of motion, perceived pain and/or perceived disability. Purpose: The purpose of this study is to identify the most influential aspect of CLBP by finding a simple method of assessing functional impairment through the evaluation of range of motion and psychological involvement. Understanding the influential aspects of CLBP will aid clinicians in providing an all-around approach during the rehabilitation process and potentially help reduce the health care cost of low back pain. Methods: Twenty volunteers participated in this study, three were excluded from the study because of reports of surgery or injury to the low back. The range of motion of the hips and low back were assessed using a goniometer. The psychological involvement related to CLBP was assessed using three questionnaires: the Tampa Scale for Kinesiophobia (TSK), Visual Analog Scale (VAS), and Oswestry Disability Index (ODI). The TSK measured fear of movement, the VAS measured pain level, and the ODI measured perceived disability due to back pain. Participants were asked to either sit, stand, or lie down according to the goniometer measurement protocol. Goniometer measurements were done in random order following the completion of the questionnaires. Results: Pearson Correlation Coefficient results showed a significant correlation between ROM of the low back and two of the three questionnaires. There was a significant (p=0.016) negative correlation between the Visual Analog Scale (VAS) and low back ROM. There was a significant (p=0.003) negative correlation between the Oswestry Disability Index (ODI) and the ROM of the low back. No significant interaction was seen with hip ROM and any of the questionnaires. There was also no correlation between the TSK and the ROM of the hips or low back. A regression analysis revealed the correlation between ROM of the low back and the VAS and ODI were not meaningful. Conclusion: The results of this study suggest the relationship between low back ROM and the values of disability (ODI) and pain (VAS) need to be evaluated and further investigated in individuals with CLBP.