Comparação de variáveis biomecânicas durante a marcha em pessoas com e sem lombalgia e implicações para intervenção: uma revisão de literatura

Abstract

The dynamic movement of the spine while walking is committed in the presence of low back pain, but these cinematic changes are inconsistent and poorly evaluated. In traditional evaluation, posture and movement are examined in people with the belief that the correction of dysfunctional movement can reduce pain. If the dysfunctional movement must be precisely identified, professionals must know what constitutes normal movement and how it differs in people with low back pain. In healthy people, the coordination between rotations of the trunk and pelvis, as well as the activity of paraspinal systematically vary with the speed of motion while adapting these two parameters is often reduced or absent in patients with low back pain. This systematic review looked at studies that compared the biomechanical aspects of trunk and pelvis movement in people with and without non-specific low back pain during walking at different speeds in order to identify possible factors associated with observed changes and guide interventions that seek to improve performance in functional activities of these individuals. Cochrane Central Register of Controlled Trials, PubMED, LILACS, Scielo, Google Scholar were surveyed from December 2014 to January 2015, using keywords like pelvis and low back pain, or pelvic and low back pain disorders, or thorax-pelvis and low back pain in march to selection of studies comparing adult gait with and without low back pain using priority treadmill and technical measures with markers to measure the lumbarpelvic movement. One reviewer applied criteria such as age, language and measures applied to analysis of studies that seek the relationship between trunk and pelvis in the march of individuals with and without low back pain, after data were identified, then excluded those whose back pain had as main factors cause neurological, surgical, oncology or related to pregnancy, and 10 studies were selected for review. The results revealed that compared with healthy people, on average, gait of subjects with low back pain is characterized by a less flexible coordination and stiffer with lower amplitude pelvic rotation and more in coordination standard phase even at higher speeds, and higher peak activity of the spine erector group, suggesting an increased stiffness of the trunk. Knowledge of these changes may favor the development of specific therapeutic strategies in the rehabilitation of individuals with low back pain.