How non-specific low back pain affects gait kinematics: a systematic review and meta-analysis

Background Non-specific low back pain (NS-LBP) is a is a highly prevalent musculoskeletal condition, with an estimated 619 million prevalent cases worldwide in 2020. Alterations in spinal and lower limb dynamics are considered as potential factors directly involved in this condition, thus we carried out a systematic review to summarize the evidence regarding walking kinematics in NS-LBP. Methods The reporting of this review followed the “2020 Preferred Reporting Items for Systematic Reviews and Meta-Analysis” (PRISMA 2020 checklist) and the protocol was preliminary registered in PROSPERO (ID: CRD42023431380). A search strategy was implemented in Medline, Embase, Scopus, Web of Science, and IEEE Xplore databases, up to March 2024. Inclusion criteria were: any analytical observational research instrumentally assessing the trunk and lower limbs kinematics of spontaneous walking in NS-LBP, in a comparison with healthy people. Study selection and data extraction were performed by two blinded reviewers, the methodological quality was evaluated by the Joanna Briggs Institute (JBI) Critical Appraisal Checklist and the quality of the evidence was rated through GRADE criteria. Results Overall, a total of 19 cross-sectional studies were included in this review and none of those was found without methodological issues. The meta-analysis showed a lower gait velocity [−15.42 (−22.78, −8.06) cm/s; p ≤ 0.0001], a lower cadence [−9.85 (−18.72, −0.99) steps/min; p = 0.03] and a lower step length [−6.30 (−11.83; −0.77) cm; p = 0.03] in NS-LBP. Regarding motion analysis, a few authors observed a less and asymmetrical motion of the lower spine in the frontal and in the transverse plane. Conclusion There is very-low quality evidence that gait speed, cadence and step length are reduced in patients with NS-LBP. There is proof of a movement reduction in the lower lumbar spine and in the pelvis, both in the transverse and in the frontal plane. No differences in the lower limb kinematics was consistent over the studies. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023431380.

• Publication year

  2025

• Venue

  Frontiers in Pain Research

• Publication date

  2025-11-20

• Fields of study

  Medicine

• Identifiers
  DOI 10.3389/fpain.2025.1693068PMID 41356462PMCID 12675370
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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  2023cited by this paper
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  2021cited by this paper
• Low back pain.

  2021cited by this paper
• Changes in Trunk Variability and Stability of Gait in Patients with Chronic Low Back Pain: Impact of Laboratory versus Daily-Living Environments

  2020cited by this paper
• Lower limb kinematics in individuals with chronic low back pain during walking.

  2020cited by this paper
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  2020cited by this paper
• Non-specific chronic low back pain elicits kinematic and neuromuscular changes in walking and gait termination.

  2020influential reference
• Adaptations in pelvis, hip and knee kinematics during gait and muscle extensibility in low back pain patients: A cross-sectional study

  2020cited by this paper
• Assessment of Spatiotemporal Gait Parameters in Patients with Lumbar Disc Herniation and Patients with Chronic Mechanical Low Back Pain.

  2019cited by this paper
• Gait Kinematics of Bharatanatyam Dancers with and without Low Back Pain

  2019cited by this paper
• Muscle activity and kinetics of lower limbs during walking in pronated feet individuals with and without low back pain.

  2018cited by this paper
• Comparison of standing postural control and gait parameters in people with and without chronic low back pain: a cross-sectional case–control study

  2018cited by this paper
• Identifying the PECO: A framework for formulating good questions to explore the association of environmental and other exposures with health outcomes.

  2018cited by this paper
• Comparison of the trunk-pelvis and lower extremities sagittal plane inter-segmental coordination and variability during walking in persons with and without chronic low back pain.

  2017cited by this paper
• Effect of investigator observation on gait parameters in individuals with and without chronic low back pain.

  2017cited by this paper
• Chronic low back pain patients walk with locally altered spinal kinematics.

  2017cited by this paper
• Balance recovery reactions in individuals with recurrent nonspecific low back pain: Effect of attention.

  2016cited by this paper
• Structural Changes of Lumbar Muscles in Non-specific Low Back Pain: A Systematic Review.

  2016cited by this paper
• Rayyan—a web and mobile app for systematic reviews

  2016cited by this paper
• Multi-segment analysis of spinal kinematics during sit-to-stand in patients with chronic low back pain.

  2016cited by this paper
• Low back pain.

  2015cited by this paper
• Lumbar spine kinematics during walking in people with and people without low back pain.

  2015cited by this paper
• Conducting systematic reviews of association (etiology): The Joanna Briggs Institute's approach

  2015cited by this paper
• Low back pain affects trunk as well as lower limb movements during walking and running.

  2015influential reference
• Epidemiology of Low Back Pain in Adults

  2014cited by this paper
• Lumbar kinematic variability during gait in chronic low back pain and associations with pain, disability and isolated lumbar extension strength.

  2014cited by this paper
• A cognitive dual task affects gait variability in patients suffering from chronic low back pain

  2014cited by this paper
• Coordination of Spinal Motion in the Transverse and Frontal Planes During Walking in People With and Without Recurrent Low Back Pain

  2013cited by this paper
• Physiotherapy movement based classification approaches to low back pain: comparison of subgroups through review and developer/expert survey

  2012cited by this paper
• Mechanical coupling between transverse plane pelvis and thorax rotations during gait is higher in people with low back pain.

  2012cited by this paper
• The Influence of Pain Distribution on Walking Velocity and Horizontal Ground Reaction Forces in Patients with Low Back Pain

  2012cited by this paper
• Motor Control and Low Back Pain in Dancers

  2012cited by this paper
• GRADE guidelines: 5. Rating the quality of evidence--publication bias.

  2011cited by this paper
• Effects of obesity and chronic low back pain on gait

  2011influential reference
• Influence of Low Back Pain Status on Pelvis-Trunk Coordination During Walking and Running

  2011cited by this paper
• Spine Injuries in Dancers

  2011cited by this paper
• Sagittal spino-pelvic alignment in chronic low back pain

  2011cited by this paper
• Cochrane Handbook for Systematic Reviews of Interventions

  2010cited by this paper
• Back Muscle Activation Patterns in Chronic Low Back Pain During Walking: A “Guarding” Hypothesis

  2010cited by this paper
• Discriminating Healthy Controls and Two Clinical Subgroups of Nonspecific Chronic Low Back Pain Patients Using Trunk Muscle Activation and Lumbosacral Kinematics of Postures and Movements: A Statistical Classification Model

  2009cited by this paper
• The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration

  2009cited by this paper
• The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration

  2009cited by this paper
• Regional differences in lumbar spinal posture and the influence of low back pain

  2008cited by this paper
• GRADE: an emerging consensus on rating quality of evidence and strength of recommendations

  2008cited by this paper
• Patterns of Lumbar Region Movement During Trunk Lateral Bending in 2 Subgroups of People With Low Back Pain

  2007cited by this paper
• Symmetry of timing of hip and lumbopelvic rotation motion in 2 different subgroups of people with low back pain.

  2007cited by this paper
• The influence of pain and pain-related fear and disability beliefs on walking velocity in chronic low back pain

  2003cited by this paper
• Relationship Between Hip Muscle Imbalance and Occurrence of Low Back Pain in Collegiate Athletes: A Prospective Study

  2001cited by this paper
• Reliability and responsiveness of the shuttle walking test in patients with chronic low back pain.

  2001cited by this paper
• The role of anticipation and fear of pain in the persistence of avoidance behavior in patients with chronic low back pain.

  2000cited by this paper
• Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability.

  1999cited by this paper
• Measures of pain and physical function in patients with low back pain

  1997cited by this paper
• Do pain expectancies cause pain in chronic low back patients? A clinical investigation.

  1996cited by this paper
• Physician Office Visits for Low Back Pain: Frequency, Clinical Evaluation, and Treatment Patterns From a U.S. National Survey

  1995cited by this paper
• A Fear‐Avoidance Beliefs Questionnaire (FABQ) and the role of fear‐avoidance beliefs in chronic low back pain and disability

  1993cited by this paper
• Gait analysis of patients with low back pain before and after surgery.

  1993cited by this paper

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