Lumbar surgery is the most common treatment for chronic disabling low back pain with degenerative disc disease. There are few elements to objectively evaluate the improvement of the motor control after surgery and the motor adaptation capacities of the patients.
The impact of lumbar surgery on complexity in this painful context has never been studied. Theoretically, the restriction of mobility imposed by lumbar surgery should limit the subject's adaptive capacities (of one or more lumbar segments) and thus reduce complexity. Nevertheless, improvement in pain intensity levels could allow the patient to find better motor adaptation capacities, necessary for a positive evolution in the long-term.
The aim of this study was to investigate the evolution of gait complexity in chronic low back pain patients pre- and post-surgery. If surgery improves the adaptability of walking through an antalgic benefit exceeding the induced stiffness, the complexity of walking should be superior after surgery.
This is a proof-of-concept study in which the study investigators hypothesize that measuring complexity by fractal analysis during a walking task will show the increase in gait complexity induced by lumbar surgery at 3 and 6 months after surgery.
Patients with chronic low back pain requiring prosthesis or arthrodesis surgery on one or two levels
Subject affiliated or beneficiary of a health insurance plan.
The patient must have given their free and informed consent
Patients with organic low back pain (infection, tumor, inflammatory rheumatism)
Patient with a neurological deficit (cauda equina syndrome or motor testing MRC < 3 on a muscle group of the lower limbs)
Patient who has already undergone lumbar surgery (except single discectomy)
Patient with serious concomitant pathologies
Patients with chronic low back pain requiring prosthesis or arthrodesis surgery for their lumbar pathology (surgery on one or two levels) followed at the Nîmes University Hospital or at the Grand Sud Polyclinic.
Case-only
Prospective
Walking task
Other interventionTreadmill walking task with study of fractal variability (complexity) for 10 minutes.
Gait complexity
fractal analysis of gait variability: value normally between 0.5 (degraded structure) to 1 (optimal structure)
Gait complexity
fractal analysis of gait variability: value normally between 0.5 (degraded structure) to 1 (optimal structure)
Gait complexity
fractal analysis of gait variability: value normally between 0.5 (degraded structure) to 1 (optimal structure)
Patient reported pain
Visual analog scale (0-100)
Patient reported pain
Visual analog scale (0-100)
Patient reported pain
Visual analog scale (0-100)
Apprehension of pain of movement
Tampa Scale of Kinesiophobia. Score ranging from 17-68. Higher scores denote greater level of kinesiophobia (a score \>40 is considered significant kinesiophobia)
Click on the lead sponsor to view all of their trials.
