Is Lifting Technique Related to Pain and Functional Limitation? A Replicated Single-Case Design Study of Five People With Lifting-Related Chronic Low Back Pain

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-07-01 DOI:10.1002/ejp.70071

Ivan Pui Hung Au, Nic Saraceni, Anne Smith, Peter O'Sullivan, Leo Ng, Amity Campbell

{"title":"Is Lifting Technique Related to Pain and Functional Limitation? A Replicated Single-Case Design Study of Five People With Lifting-Related Chronic Low Back Pain","authors":"Ivan Pui Hung Au, Nic Saraceni, Anne Smith, Peter O'Sullivan, Leo Ng, Amity Campbell","doi":"10.1002/ejp.70071","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Chronic low back pain (CLBP) is often provoked by lifting activities, but the relationship between changes in lifting technique and clinical outcomes while undergoing intervention remains unclear. This study examined the within-person relationships between changes in lifting technique and changes in pain and functional limitation in people with lifting-related CLBP.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Five participants with lifting-related CLBP completed repeated measures of their lifting techniques, pain and functional limitation across baseline (4–6 weeks), intervention (12 weeks) and follow-up periods (3 months). Participants received up to 10 sessions of Cognitive Functional Therapy (CFT) during the intervention period. Wearable sensors measured the spinal and lower extremities' range of motion (ROM) and velocity during a repeated lift task. Pain and functional limitation were assessed via online questionnaires. Within-person relationships were estimated using cross-correlation analyses.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>All participants demonstrated changes in lifting technique throughout the study, though with varied timing and direction. Changes in lifting technique were frequently related to changes in functional limitation (18/25 relationships, 72%) and sometimes to changes in pain (13/25 relationships, 52%). When relationships were observed, reductions in pain and functional limitation were predominantly (27/31 relationships, 87%) associated with a transition along a continuum from squat-like towards semi-squat-like and stoop-like lifting techniques with faster lifting movements.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Within-person changes in lifting technique varied among individuals. Greater trunk ROM and velocity, lower knee ROM and velocity, and faster lifting movements often co-occurred with lower levels of pain and functional limitation. This reflects a transition along a continuum from squat-like towards semi-squat-like and stoop-like lifting techniques.</p>\n </section>\n \n <section>\n \n <h3> Significance Statement</h3>\n \n <p>Our study reveals that changes in lifting technique may relate to clinical improvements in people with lifting-related CLBP on an individual basis. Contrary to conventional clinical and ergonomic advice promoting ‘safe’ squat lifting techniques, our findings suggest that transition from squat-like towards semi-squat-like and stoop-like lifting techniques with faster lifting movements often corresponds with reductions in pain and functional limitation. These findings challenge pervasive recommendations for squat lifting and support an individualised multi-dimensional approach to managing people with lifting-related CLBP.</p>\n </section>\n </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 6","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.70071","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Pain","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ejp.70071","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Chronic low back pain (CLBP) is often provoked by lifting activities, but the relationship between changes in lifting technique and clinical outcomes while undergoing intervention remains unclear. This study examined the within-person relationships between changes in lifting technique and changes in pain and functional limitation in people with lifting-related CLBP.

Methods

Five participants with lifting-related CLBP completed repeated measures of their lifting techniques, pain and functional limitation across baseline (4–6 weeks), intervention (12 weeks) and follow-up periods (3 months). Participants received up to 10 sessions of Cognitive Functional Therapy (CFT) during the intervention period. Wearable sensors measured the spinal and lower extremities' range of motion (ROM) and velocity during a repeated lift task. Pain and functional limitation were assessed via online questionnaires. Within-person relationships were estimated using cross-correlation analyses.

Results

All participants demonstrated changes in lifting technique throughout the study, though with varied timing and direction. Changes in lifting technique were frequently related to changes in functional limitation (18/25 relationships, 72%) and sometimes to changes in pain (13/25 relationships, 52%). When relationships were observed, reductions in pain and functional limitation were predominantly (27/31 relationships, 87%) associated with a transition along a continuum from squat-like towards semi-squat-like and stoop-like lifting techniques with faster lifting movements.

Conclusions

Within-person changes in lifting technique varied among individuals. Greater trunk ROM and velocity, lower knee ROM and velocity, and faster lifting movements often co-occurred with lower levels of pain and functional limitation. This reflects a transition along a continuum from squat-like towards semi-squat-like and stoop-like lifting techniques.

Significance Statement

Our study reveals that changes in lifting technique may relate to clinical improvements in people with lifting-related CLBP on an individual basis. Contrary to conventional clinical and ergonomic advice promoting ‘safe’ squat lifting techniques, our findings suggest that transition from squat-like towards semi-squat-like and stoop-like lifting techniques with faster lifting movements often corresponds with reductions in pain and functional limitation. These findings challenge pervasive recommendations for squat lifting and support an individualised multi-dimensional approach to managing people with lifting-related CLBP.

Abstract Image

查看原文本刊更多论文

举重技术是否与疼痛和功能限制有关？一项针对5名举重相关慢性腰痛患者的重复单例设计研究

背景：慢性腰痛（CLBP）通常由举重活动引起，但在进行干预时，举重技术的变化与临床结果之间的关系尚不清楚。本研究考察了与举重相关的CLBP患者的举重技术变化与疼痛和功能限制变化之间的个人关系。方法5名与举重相关的CLBP患者在基线期（4-6周）、干预期（12周）和随访期（3个月）完成了他们的举重技术、疼痛和功能限制的重复测量。在干预期间，参与者接受了多达10次的认知功能治疗（CFT）。可穿戴传感器测量脊柱和下肢的运动范围（ROM）和速度在重复的举起任务。通过在线问卷评估疼痛和功能限制。人与人之间的关系用相互关系分析来估计。结果所有参与者在整个研究过程中都表现出举重技术的变化，尽管时间和方向有所不同。举重技术的改变通常与功能限制的改变有关（18/25,72%），有时与疼痛的改变有关（13/25,52%）。当观察到相关关系时，疼痛和功能限制的减少主要（27/31关系，87%）与从深蹲式到半深蹲式和弯腰式举重技术的连续过渡以及更快的举重动作有关。结论：个体间举重技术的变化是不同的。更大的躯干活动度和速度，更低的膝关节活动度和速度，更快的举重运动通常伴随着更低程度的疼痛和功能限制。这反映了从蹲式到半蹲式和弯腰式举重技术的连续过渡。我们的研究表明，在个体基础上，举重技术的改变可能与举重相关CLBP患者的临床改善有关。与提倡“安全”深蹲举重技术的传统临床和人体工程学建议相反，我们的研究结果表明，从深蹲式举重技术向半深蹲式和弯腰式举重技术的过渡，以及更快的举重动作，通常与疼痛和功能限制的减少相对应。这些发现挑战了深蹲举的普遍建议，并支持个性化的多维方法来管理与举重相关的CLBP患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.