A Comparison of the Spatio-Temporal Parameters during Gait in Subjects with and without Chronic Low Back Pain: A Systematic Review

Background: In chronic low back pain (CLBP) due to the phenomenon of central sensitization there might be persistent pain and flare-ups. Further due to its lasting periodicity in nature, it also results in significant economic burden. However, the mechanisms for chronicity in low back pain have not been established. Objectives: The purpose of this study is to investigate whether there are differences in spatio-temporal parameters in subjects with chronic low back pain compared with the healthy controls subjects during the gait cycle. Methods: The methodology used for the systematic review follows the PRISMA guidelines. A literature search was performed in PubMed, EMBASE, Scopus and Medline. Twelve articles comparing spatio-temporal parameters (speed, stride length and step length) in people with CLBP and healthy controls during walking or running were selected. Two persons independently performed the data extraction and quality assessment. Results: The results showed that among ten studies which measured the walking speed, only four studies reported significant differences (p less than 0.05) in the population of CLBP compared to Healthy Control (HC). In respect to stride length, among six studies, only two studies reported a significant difference (p less than 0.05) between the population of CLBP compared to HC. Eight studies which reported on step length, only three studies found a significant difference (p less than 0.05) and remaining concluded that there was no significant difference present (p greater than 0.05) between the population of CLBP compared to HC. To summaries, most of the studies found that there were no differences in the spatio-temporal parameters of subjects with and without CLBP during gait. However, the overall results remain inconclusive. Furthermore, due to the limitations to the number of studies on spatio-temporal parameters, future study results are needed to confirm the result. Conclusion: The current evidence states that the difference in spatio-temporal parameters during gait of subjects with or without CLBP remains unclear. Furthermore, the differences in acquisition and processing of the data made the comparison difficult to synthesize. Thereby, standardization in future research implication is needed. Future studies should aim at considering the spatio-temporal parameters of gait in order to improve the strength of the evidence.