Using continuous relative phase and modified vector coding analyses to quantify spinal coordination and coordinative variability for healthy and chronic low back pain patients: An exploratory comparative analysis.

ABSTRACT

Differences in coordination and coordinative variability are common in people with low back pain. While differences may relate to the different analyses used to quantify these metrics, the preferred approach remains unclear. We aimed to compare coordination and coordinative variability, in people with and without low back pain performing a lifting/lowering task, using continuous relative phase and vector coding procedures, and to identify which technique better detects group differences. Upper lumbar (T12-L3), lower lumbar (L3-S1), and hip angular kinematics were measured using electromagnetic motion capture during 10 crate lifting/lowering repetitions from adults with (n = 47) and without (n = 17) low back pain. Coordination and coordinative variability for the Hip-Lower Lumbar and Lower Lumbar-Upper Lumbar joint pairs were quantified using mean absolute relative phase and deviation phase (continuous relative phase), and coupling angle and coupling angle variability (vector coding), respectively. T-tests examined group differences in coordination and variability. Cohen's d bootstrapping analyses identified the more sensitive technique for detecting group differences. Less in-phase and more variable behavior was observed in the low back pain group, mostly independent of joint pair and analytical technique (P < 0.05, Cohen's d range = 0.61 to 1.33). Qualitatively, the low back group limited motion at the lower lumbar spine during lifting/lowering. Continuous relative phase was more sensitive in detecting group differences in coordinative variability, while vector coding was more sensitive towards differences in coordination. These procedures convey distinct information and have their respective merits. Researchers should consider the choice of analytical techniques based on their study objectives.