Effect Of Acupuncture On Trunk-pelvis Movement Pattern In Gait Of Patients With Chronic Non-specific Low Back Pain

ObjectiveIn this study,a randomized controlled trial was designed to observe the effects of trigger point acupuncture and traditional acupuncture on pain,function and gait trunk-pelvis movement patterns in patients with chronic non-specific low back pain(CNLBP).Methods54 qualified CNLBP patients were randomly divided into trigger point acupuncture group(TPG),traditional acupuncture group(TAG),and waiting list group(WLG).Both the TPG and the TAG received different acupuncture intervention for 4 weeks.The Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)were used to evaluate the pain and function,and gait analysis before and after intervention.Gait analysis included gait cycle distribution,ground reaction force(GRF),the range of motion(ROM)and coordination pattern of trunk-pelvis.The SPSS 22.0 was used for analysis,P<0.05 considered the difference to be statistically significant.Results1.General data: there were not statistically significant differences in age,sex,height,weight,BMI,pain side,and disease course among the three groups(P>0.05).2.ODI score: after intervention,there was statistically significant difference among the three groups in ODI score(P<0.05),and the TPG was smaller than the WLG(P<0.05).3.VAS score: after the intervention,there was statistically significant difference among the three groups in VAS score(P<0.05),and the TPG and the TAG were smaller than the WLG(P<0.05).4.Gait cycle parameters: after the intervention,there were not significant differences in the proportion of gait staging time,the symmetry of the double-limb support period and the single-limb support period among the three groups(P>0.05).5.Kinetic parameters:(1)After the intervention,the difference of the left GRF characteristic F1 among the three groups was statistically significant(P<0.05),the TAG was greater than the TPG(P<0.05).(2)After the intervention,there were not statistically significant differences in the GRF time characteristics and symmetry among the three groups(P>0.05).6.Kinematic parameters(1)ROM of trunk-pelvis: after the intervention,there was significant difference in the sagittal ROM of the lower thoracic segment among the three groups during period of right single-limb support(RSLS)(P<0.05),and the TAG was larger than the TPG and WLG(P<0.05).There was significant difference in the sagittal ROM of the lower lumbar segment,during the left double-limb support(LDLS)(P<0.05),and the TPG was smaller than the WLG(P<0.05).There was statistically significant difference in sagittal ROM of pelvis during the LDLS(P<0.05),the TPG was smaller than the TAG(P<0.05).(2)Coordination pattern of trunk-pelvis: after the intervention,the difference of sagittal plane in-phase coordination pattern of the upper thoracic-pelvis among the three groups was statistically significant(P<0.05),the TAG was larger than the WLG(P<0.05).The difference of coronal plane anti-phase coordination pattern of the lower lumbar-pelvis was statistically significant(P<0.05),the TAG was larger than the WLG(P<0.05).Conclusions1.Both trigger point acupuncture therapy and traditional acupuncture therapy can effectively reduce the degree of pain and dysfunction in patients with CNLBP.2.Trigger point acupuncture therapy can reduce the sagittal ROM of the lower lumbar segment and pelvis during the period of left double-limb support.Traditional acupuncture therapy can increase the sagittal ROM of the lower thoracic segment during the period of right single-limb support.They showed that both acupuncture therapies have an improving effect on the trunk-pelvis range of motion in CNLBP patients.3.In terms of trunk-pelvis coordination pattern,traditional acupuncture therapy can adjust the coordination pattern of the lower lumbar-pelvis in coronal plane when CNLBP patients walk,which may increase GRF.While trigger acupuncture therapy may not have a significant effect on regulating the trunk-pelvis coordination pattern.