Pain-related threat and coordination in adults with chronic low back pain during a lifting task: A cross-sectional study

Objectives

People with low back pain (LBP) exhibit altered coordination, possibly indicating guarded movement. The connection between these changes and pain-related threat remains unclear. We aimed to determine if pain-related threat was related to spinal coordination and variability, during a lifting task, in people with chronic LBP.

Methods

Participants were adults with chronic LBP (n = 47). Upper lumbar, lower lumbar, and hip kinematics were measured during 10 crate lifting/lowering repetitions. Coordination and variability of the Hip-Lower Lumbar, and Lower Lumbar-Upper Lumbar joint pairs were calculated. Pain-related threat was measured using the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, and task-specific fear. Linear regression analyses tested the relationship between pain-related threat and coordination.

Results

Adding catastrophizing to our base model (sex) explained variance in Hip-Lower lumbar coordination (r² change = 0.125, p = 0.013). General and task specific measures of fear were unrelated to coordination and variability at both joint pairs (r² change < 0.064, p > 0.05). Exploratory t-tests revealed subgroups aligned with phenotypes of “tight” and “loose” control, where “tight” control was characterized by greater catastrophizing and disability.

Conclusion

Pain catastrophizing, but not measures of fear, was related to more in-phase (“tight”) Hip-Lower Lumbar coordination during lifting/lowering. Considering this relationship based on subgroups may add clarity.