ViMove for low back pain - putting the bio back into biopsychosocial rehabilitation

Low back pain is the leading cause of years lived with disability both in Australia and the world (1). This is due to the fact that most people will experience back pain in their lifetime and many people who develop an acute episode of back pain will develop persistent (chronic) back pain. In an Australian survey, 10% of respondents reported severe back pain causing severe disability in the preceding 6 months (2).

Research has shown that chronic low back pain is often associated with biomechanical changes in posture (3), movement patterns (4, 5) and muscle activation (6, 7). These biomechanical changes can occur as a direct consequence of having persistent back pain and they are not reliably related to changes in spinal structures seen on CT or MRI scans. These biomechanical changes often go unrecognised as they are difficult to visualise and identify. These changes, whilst initially caused by the inciting injury, can lead to persisting back pain and frequent exacerbations of pain long after the injury has healed.

ViMove by dorsaVi.com is a new and exciting technology that allows non-invasive measurement of your posture, movements and muscle activation patterns using electronic sensors placed directly on the skin.

In a randomised trial using ViMove, the group of patients using the ViMove showed improvements in pain and function at 10 weeks compared with the usual care group (8). These benefits were even greater over a 12 month period. Other researchers have demonstrated that improving functional movement patterns in people with chronic pain reduces pain and improves function (9).

At The Rehabilitation Medicine Group, our physiotherapist Darren Lau performs the ViMove Live Low Back Assessment. This involves applying sensors to the skin over the lumbar spine, lower thoracic spine and pelvis. You then perform back movements including bending forwards, backwards and sideways. Posture is assessed as you stand and sit. Pelvic movements are assessed during standing, sitting and moving. Muscle activation of the erector spine muscles (spinal extensor muscles) is analyzed during these movements (this is known as surface electromyography or EMG). Your pain experience during the assessment is also recorded to determine if there are specific movements or postures exacerbating your pain. The ViMove sensors send information wirelessly to a computer to be analyzed by specialized software during the assessment. This information is then used to help improve your spinal movements and posture by directing a more specific exercise intervention program designed specifically for you.

This biomechanical assessment forms part of our comprehensive physiotherapy and pain management assessment for multidisciplinary rehabilitation treatment for chronic low back pain.

References

1. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163-96.

2. Walker BF, Muller R, Grant WD. Low back pain in Australian adults: prevalence and associated disability. J Manipulative Physiol Ther. 2004;27(4):238-44.

3. O'Sullivan PB, R; Holte, J. The relationship beween posture and back muscle endurance in industrial workers with flexion-related low back pain. Manual therapy. 2006;11(4):264-71.

4. Geisser ME, Haig AJ, Wallbom AS, Wiggert EA. Pain-related fear, lumbar flexion, and dynamic EMG among persons with chronic musculoskeletal low back pain. Clin J Pain. 2004;20(2):61-9.

5. Laird RAG, Jayce, Kent, Peter; Keating, Jennifer L. Comparing lumbo-pelvic kinematics in people with and without back pain: a systematic review and meta-analysis. BMC musculoskeletal disorders. 2014;15:229.

6. Geisser MER, Mohammed; Haig, Andrew J;Roth, Randy S; Zucker, Robert, Ambroz, Clara and Caruso, Marianne. A Meta-Analytic review of Surface Electromyography Among Persons With Low Back Pain and Normal, Healthy Controls. The Journal of Pain. 2005;6(11):711-26.

7. Dankaerts W, O'Sullivan P, Burnett A, Straker L, Davey P, Gupta R. 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. Spine (Phila Pa 1976). 2009;34(15):1610-8.

8. Kent PL, Robert; Haines, Terry. The effect of changing movement and posture using motion-sensor biofeedback, versus guidelines-based care, on the clinical outcomes of people with sub-acute or chronic low back pain-a multicentre, cluster-randomised, placebo-controlled, pilot trial. BMC musculoskeletal disorders. 2015;16(131).

9. Vibe Fersum K, O'Sullivan P, Skouen JS, Smith A, Kvale A. Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: a randomized controlled trial. European journal of pain. 2013;17(6):916-28.


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