Distinguishing between typical and atypical motion patterns amongst healthy individuals during a constrained spine flexion task

Abstract Despite ‘abnormal’ motion being considered a risk factor for low back injury, the current understanding of ‘normal’ spine motion is limited. Identifying normal motion within an individual is complicated by the considerable variation in movement patterns amongst healthy individuals. Therefore, the purpose of this study was to characterize sources of variation in spine motion among a sample of healthy participants. The second objective of this study was to develop a multivariate model capable of predicting an expected movement pattern for an individual. The kinematic shape of the lower thoracic and lumbar spine was recorded during a constrained dynamic trunk flexion movement; as this is not a normal everyday movement task, movements are considered ‘typical’ and ‘atypical’ for this task rather than ‘normal’ and ‘abnormal’. Variations in neutral standing posture accounted for 85% of the variation in spine motion throughout the task. Differences in total spine range of flexion and a regional re-weighting of range of motion between lower thoracic and lumbar regions explained a further 9% of the variance among individuals. The analysis also highlighted a difference in temporal sequencing of motion between lower thoracic and lumbar regions which explained 2% of the total movement variation. These identified sources of variation were used to select independent variables for a multivariate linear model capable of predicting an individuals’ expected movement pattern. This was done as a proof-of-concept to demonstrate how the error between predicted and observed motion patterns could be used to differentiate between ‘typical’ and ‘atypical’ movement strategies.