TY - JOUR
T1 - Association between central sensitization and gait in chronic low back pain
T2 - Insights from a machine learning approach
AU - Zheng, Xiaoping
AU - Reneman, Michiel
AU - Ansuategui Echeita, Jone
AU - Schiphorst Preuper, Rita
AU - Kruitbosch, Herbert
AU - Otten, Bert
AU - Lamoth, Claudine
N1 - Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - BACKGROUND: Central sensitization (CS) is often present in patients with chronic low back pain (CLBP). Gait impairments due to CLBP have been extensively reported; however, the association between CS and gait is unknown. The present study examined the association between CS and CLBP on gait during activities of daily living.METHOD: Forty-two patients with CLBP were included. CS was assessed through the Central Sensitization Inventory (CSI), and patients were divided in a low and high CS group (23 CLBP- and 19 CLBP+, respectively). Patients wore a tri-axial accelerometer device for one week. From the acceleration signals, gait cycles were extracted and 36 gait outcomes representing quantitative and qualitative characteristics of gait were calculated. A Random Forest was trained to classify CLBP- and CLBP + based on the gait outcomes. The maximum Youden index was computed to measure the diagnostic test's ability and SHapley Additive exPlanations (SHAP) indexed the gait outcomes' importance to the classification model.RESULTS: The Random Forest accurately (84.4%) classified the CLBP- and CLBP+. Youden index was 0.65, and SHAP revealed that the gait outcomes' important to the classification model were related to gait smoothness, stride frequency variability, stride length variability, stride regularity, predictability, and stability.CONCLUSIONS: CLBP- and CLBP + patients had different motor control strategies. Patients in the CLBP- group presented with a more "loose control", with higher gait smoothness and stability, while CLBP + patients presented with a "tight control", with a more regular, less variable, and more predictable gait pattern.
AB - BACKGROUND: Central sensitization (CS) is often present in patients with chronic low back pain (CLBP). Gait impairments due to CLBP have been extensively reported; however, the association between CS and gait is unknown. The present study examined the association between CS and CLBP on gait during activities of daily living.METHOD: Forty-two patients with CLBP were included. CS was assessed through the Central Sensitization Inventory (CSI), and patients were divided in a low and high CS group (23 CLBP- and 19 CLBP+, respectively). Patients wore a tri-axial accelerometer device for one week. From the acceleration signals, gait cycles were extracted and 36 gait outcomes representing quantitative and qualitative characteristics of gait were calculated. A Random Forest was trained to classify CLBP- and CLBP + based on the gait outcomes. The maximum Youden index was computed to measure the diagnostic test's ability and SHapley Additive exPlanations (SHAP) indexed the gait outcomes' importance to the classification model.RESULTS: The Random Forest accurately (84.4%) classified the CLBP- and CLBP+. Youden index was 0.65, and SHAP revealed that the gait outcomes' important to the classification model were related to gait smoothness, stride frequency variability, stride length variability, stride regularity, predictability, and stability.CONCLUSIONS: CLBP- and CLBP + patients had different motor control strategies. Patients in the CLBP- group presented with a more "loose control", with higher gait smoothness and stability, while CLBP + patients presented with a "tight control", with a more regular, less variable, and more predictable gait pattern.
U2 - 10.1016/j.compbiomed.2022.105329
DO - 10.1016/j.compbiomed.2022.105329
M3 - Article
C2 - 35231802
SN - 0010-4825
VL - 144
JO - Computers in biology and medicine
JF - Computers in biology and medicine
M1 - 105329
ER -