Does motion sensor biofeedback augment change in movement? A longitudinal study of lifting spinal kinematics in people with chronic low back pain undergoing Cognitive Functional Therapy with and without biofeedback

Abstract

Background

Lifting is a functional movement commonly assessed and targeted in the treatment of people with low back pain (LBP).

Objective

To investigate changes in spinal range of motion (ROM) and velocity during lifting in people with lifting-related LBP over the course of Cognitive Functional Therapy (CFT), and to compare these changes between CFT-only and CFT-with-biofeedback.

Design

Longitudinal observational study.

Method

One hundred and forty-one people with lifting-related LBP received CFT and performed a lifting task prior to each treatment session. Measures included ROM and velocity from trunk and pelvis sensors independently and the intersensor angle. Multilevel models estimated the average amount of change and inter-individual variability. Time-group interaction was used to test the differences in the mean change between CFT-only and CFT-with-biofeedback.

Results

During the 13-week intervention period, the average trunk and pelvis ROM increased significantly between week 1 and week 8 (10.6°, 95% CI: 5.9, 15.4; 10.4°, 95% CI: 6.9, 14.0), while the average intersensor ROM did not change over 13 weeks (−0.79°, 95% CI: −3.74, 2.16). The average trunk, pelvis and intersensor velocity increased significantly up to weeks 9 or 10 (17.8°/sec, 95% CI: 14.0, 21.6; 10.8°/sec, 95% CI: 8.3, 13.4; 6.0°/sec, 95% CI: 3.7, 8.3). There was no evidence for differences in change in ROM or velocity measures between CFT-only and CFT-with-biofeedback (P = 0.14–0.64).

Conclusions

People with lifting-related LBP demonstrated increases in trunk and pelvis ROM and all velocity measures but not intersensor ROM during lifting over the course of CFT. Biofeedback did not augment changes in lifting kinematics.