Mechanical energy analysis identifies compensatory strategies in individuals with and without Non-specific chronic low back pain

Abstract

This quasi-experimental study aimed to identify biomechanical compensatory strategies 19 during gait in individuals with non-specific chronic low back pain (NSCLBP) by analyzing 20 mechanical energy expenditure (MEE) at the lower limb joints. Twenty-eight male 21 participants (14 with NSCLBP and 14 healthy, mean age 27.9 ± 2.1 years) were assessed. 22 Biomechanical data were collected using a three-dimensional motion analysis system and 23 inverse dynamics method to calculate MEE in concentric, eccentric, and no-transfer (no 24 energy transfer between segments) conditions for the ankle, knee, hip, and low back joints. 25 The results revealed significantly higher eccentric MEE at the ankle, hip, and low back joints 26 in healthy controls compared to NSCLBP patients (P≤0.05). No significant differences were 27 found in concentric or no-transfer MEE at any joint, or eccentric MEE at the knee joint 28 (P>0.05). These findings indicate disruptions in the eccentric energy flow at the low back, hip 29 and ankle joints in individuals with NSCLBP, suggesting a reduction in mechanical 30 efficiency. This highlights the importance of targeted rehabilitation interventions to improve 31 gait efficiency in this population.