{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:12:12Z","timestamp":1790737932134,"version":"4.1.0"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Non-specific low back pain (NS-LBP) is a is a highly prevalent musculoskeletal condition, with an estimated 619 million prevalent cases worldwide in 2020. Alterations in spinal and lower limb dynamics are considered as potential factors directly involved in this condition, thus we carried out a systematic review to summarize the evidence regarding walking kinematics in NS-LBP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The reporting of this review followed the \u201c2020 Preferred Reporting Items for Systematic Reviews and Meta-Analysis\u201d (PRISMA 2020 checklist) and the protocol was preliminary registered in PROSPERO (ID: CRD42023431380). A search strategy was implemented in Medline, Embase, Scopus, Web of Science, and IEEE Xplore databases, up to March 2024. Inclusion criteria were: any analytical observational research instrumentally assessing the trunk and lower limbs kinematics of spontaneous walking in NS-LBP, in a comparison with healthy people. Study selection and data extraction were performed by two blinded reviewers, the methodological quality was evaluated by the Joanna Briggs Institute (JBI) Critical Appraisal Checklist and the quality of the evidence was rated through GRADE criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, a total of 19 cross-sectional studies were included in this review and none of those was found without methodological issues. The meta-analysis showed a lower gait velocity [\u221215.42 (\u221222.78, \u22128.06)\u2005cm\/s;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.0001], a lower cadence [\u22129.85 (\u221218.72, \u22120.99)\u2005steps\/min;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03] and a lower step length [\u22126.30 (\u221211.83; \u22120.77)\u2005cm;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03] in NS-LBP. Regarding motion analysis, a few authors observed a less and asymmetrical motion of the lower spine in the frontal and in the transverse plane.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is very-low quality evidence that gait speed, cadence and step length are reduced in patients with NS-LBP. There is proof of a movement reduction in the lower lumbar spine and in the pelvis, both in the transverse and in the frontal plane. No differences in the lower limb kinematics was consistent over the studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n                      , identifier CRD42023431380.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpain.2025.1693068","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T06:20:11Z","timestamp":1763619611000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["How non-specific low back pain affects gait kinematics: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"6","author":[{"given":"Fulvio","family":"Dal Farra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola Francesco","family":"Lopomo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Fascia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Scalona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Cerfoglio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Cimolin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e316","DOI":"10.1016\/S2665-9913(23)00098-X","article-title":"Global, regional, and national burden of low back pain, 1990\u20132020, its attributable risk factors, and projections to 2050: a systematic analysis of the global burden of disease study 2021","volume":"5","author":"Ferreira","year":"2023","journal-title":"Lancet Rheumatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1098100","DOI":"10.3389\/fpubh.2023.1098100","article-title":"Global and regional estimates of clinical and economic burden of low back pain in high-income countries: a systematic review and meta-analysis","volume":"11","author":"Fatoye","year":"2023","journal-title":"Front Public Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1097\/00007632-199501000-00003","article-title":"Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey","volume":"20","author":"Hart","year":"1995","journal-title":"Spine"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/ner.12018","article-title":"Epidemiology of low back pain in adults","volume":"17","author":"Manchikanti","year":"2014","journal-title":"Neuromodulation"},{"key":"B5","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/1471-2474-13-24","article-title":"Physiotherapy movement based classification approaches to low back pain: comparison of subgroups through review and developer\/expert survey","volume":"13","author":"Karayannis","year":"2012","journal-title":"BMC Musculoskeletal Disord"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2060","DOI":"10.1016\/j.jbiomech.2016.05.015","article-title":"Multi-segment analysis of spinal kinematics during sit-to-stand in patients with chronic low back pain","volume":"49","author":"Christe","year":"2016","journal-title":"J Biomechan"},{"key":"B7","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1007\/s00586-011-1931-2","article-title":"Sagittal spino-pelvic alignment in chronic low back pain","volume":"20","author":"Chal\u00e9at-Valayer","year":"2011","journal-title":"Eur Spine J"},{"key":"B8","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1016\/j.apmr.2006.12.021","article-title":"Symmetry of timing of hip and lumbopelvic rotation motion in 2 different subgroups of people with low back pain","volume":"88","author":"Van Dillen","year":"2007","journal-title":"Arch Phys Med Rehabil"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1016\/j.jbiomech.2015.01.042","article-title":"Low back pain affects trunk as well as lower limb movements during walking and running","volume":"48","author":"M\u00fcller","year":"2015","journal-title":"J Biomech"},{"key":"B10","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/1743-0003-5-13","article-title":"Effects of attention on the control of locomotion in individuals with chronic low back pain","volume":"5","author":"Lamoth","year":"2008","journal-title":"J Neuroeng Rehabil"},{"key":"B11","doi-asserted-by":"publisher","first-page":"E286","DOI":"10.1097\/BRS.0b013e318281de28","article-title":"Coordination of spinal motion in the transverse and frontal planes during walking in people with and without recurrent low back pain","volume":"38","author":"Crosbie","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"key":"B12","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.jbiomech.2011.10.024","article-title":"Mechanical coupling between transverse plane pelvis and thorax rotations during gait is higher in people with low back pain","volume":"45","author":"van den Hoorn","year":"2012","journal-title":"J Biomech"},{"key":"B13","doi-asserted-by":"publisher","first-page":"E1070","DOI":"10.1097\/BRS.0b013e3182015f7c","article-title":"Influence of low back pain status on pelvis-trunk coordination during walking and running","volume":"36","author":"Seay","year":"2011","journal-title":"Spine (Phila Pa 1976)"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1610","DOI":"10.1097\/BRS.0b013e3181aa6175","article-title":"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","volume":"34","author":"Dankaerts","year":"2009","journal-title":"Spine (Phila Pa 1976)"},{"key":"B15","doi-asserted-by":"publisher","first-page":"b2700","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration","volume":"339","author":"Liberati","year":"2009","journal-title":"Br Med J (Clin Res Ed)"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/j.envint.2018.07.015","article-title":"Identifying the PECO: a framework for formulating good questions to explore the association of environmental and other exposures with health outcomes","volume":"121","author":"Morgan","year":"2018","journal-title":"Environ Int"},{"key":"B17","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan-a web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst Rev"},{"key":"B18","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1097\/XEB.0000000000000064","article-title":"Conducting systematic reviews of association (etiology): the joanna briggs institute\u2019s approach","volume":"13","author":"Moola","year":"2015","journal-title":"Int J Evid Based Healthcare"},{"key":"B19","doi-asserted-by":"crossref","DOI":"10.1002\/9781119536604","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins","year":"2019"},{"key":"B20","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"B21","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1097\/00004356-200306000-00004","article-title":"The influence of pain and pain-related fear and disability beliefs on walking velocity in chronic low back pain","volume":"26","author":"Al-Obaidi","year":"2003","journal-title":"Int J Rehabil Res"},{"key":"B22","doi-asserted-by":"publisher","first-page":"277","DOI":"10.5137\/1019-5149.JTN.27499-19.2","article-title":"Assessment of spatiotemporal gait parameters in patients with lumbar disc herniation and patients with chronic mechanical low back pain","volume":"30","author":"Amir Rashedi Bonab","year":"2020","journal-title":"Turk Neurosurg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1016\/j.gaitpost.2015.08.010","article-title":"Lumbar spine kinematics during walking in people with and people without low back pain","volume":"42","author":"Gombatto","year":"2015","journal-title":"Gait Posture"},{"key":"B24","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.3390\/sym13112129","article-title":"Gait asymmetry comparison between subjects with and without nonspecific chronic low back pain","volume":"13","author":"Lee","year":"2021","journal-title":"Symmetry (Basel)"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e000286","DOI":"10.1136\/bmjsem-2017-000286","article-title":"Comparison of standing postural control and gait parameters in people with and without chronic low back pain: a cross-sectional case-control study","volume":"4","author":"MacRae","year":"2018","journal-title":"BMJ Open Sport Exerc Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"102404","DOI":"10.1016\/j.jelekin.2020.102404","article-title":"Lower limb kinematics in individuals with chronic low back pain during walking","volume":"51","author":"Rahimi","year":"2020","journal-title":"J Electromyogr Kinesiol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1016\/j.gaitpost.2020.12.005","article-title":"Non-specific chronic low back pain elicits kinematic and neuromuscular changes in walking and gait termination","volume":"84","author":"Rum","year":"2021","journal-title":"Gait Posture"},{"key":"B28","doi-asserted-by":"publisher","first-page":"214980","DOI":"10.1155\/2012\/214980","article-title":"The influence of pain distribution on walking velocity and horizontal ground reaction forces in patients with low back pain","volume":"2012","author":"Simmonds","year":"2012","journal-title":"Pain Res Treat"},{"key":"B29","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.gaitpost.2017.01.002","article-title":"Effect of investigator observation on gait parameters in individuals with and without chronic low back pain","volume":"53","author":"Vickers","year":"2017","journal-title":"Gait Posture"},{"key":"B30","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.jbiomech.2017.06.042","article-title":"Chronic low back pain patients walk with locally altered spinal kinematics","volume":"60","author":"Christe","year":"2017","journal-title":"J Biomech"},{"key":"B31","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/1743-0003-8-55","article-title":"Effects of obesity and chronic low back pain on gait","volume":"8","author":"Cimolin","year":"2011","journal-title":"J Neuroeng Rehabil"},{"key":"B32","doi-asserted-by":"publisher","first-page":"49","DOI":"10.3233\/BMR-191528","article-title":"Adaptations in pelvis, hip and knee kinematics during gait and muscle extensibility in low back pain patients: a cross-sectional study","volume":"33","author":"Jim\u00e9nez-Del-Barrio","year":"2020","journal-title":"J Back Musculoskelet Rehabil"},{"key":"B33","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.humov.2017.01.004","article-title":"Comparison of the trunk-pelvis and lower extremities sagittal plane inter-segmental coordination and variability during walking in persons with and without chronic low back pain","volume":"52","author":"Ebrahimi","year":"2017","journal-title":"Hum Mov Sci"},{"key":"B34","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.jelekin.2018.01.006","article-title":"Muscle activity and kinetics of lower limbs during walking in pronated feet individuals with and without low back pain","volume":"39","author":"Farahpour","year":"2018","journal-title":"J Electromyogr Kinesiol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1615\/CritRevPhysRehabilMed.2019030243","article-title":"Gait kinematics of bharatanatyam dancers with and without low back pain","volume":"31","author":"Mullerpatan","year":"2019","journal-title":"Crit Rev Phys Rehabil Med"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.2147\/JPR.S310775","article-title":"Changes in trunk variability and stability of gait in patients with chronic low back pain: impact of laboratory versus daily-living environments","volume":"14","author":"Nishi","year":"2021","journal-title":"J Pain Res"},{"key":"B37","doi-asserted-by":"publisher","first-page":"109883","DOI":"10.1016\/j.jbiomech.2020.109883","article-title":"Walking and running with non-specific chronic low back pain: what about the lumbar lordosis angle?","volume":"108","author":"Simonet","year":"2020","journal-title":"J Biomech"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1097\/00007632-199318110-00008","article-title":"Gait analysis of patients with low back pain before and after surgery","volume":"18","author":"Khodadadeh","year":"1993","journal-title":"Spine (Phila Pa 1976)"},{"key":"B39","doi-asserted-by":"publisher","first-page":"53","DOI":"10.3109\/09593989709036448","article-title":"Measures of pain and physical function in patients with low back pain","volume":"13","author":"Simmonds Maureen","year":"1997","journal-title":"Physiother Theory Pract"},{"key":"B40","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1002\/pri.225","article-title":"Reliability and responsiveness of the shuttle walking test in patients with chronic low back pain","volume":"6","author":"Taylor","year":"2001","journal-title":"Physiother Res Int"},{"key":"B41","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.1097\/00007632-200005010-00014","article-title":"The role of anticipation and fear of pain in the persistence of avoidance behavior in patients with chronic low back pain","volume":"25","author":"Al-Obaidi","year":"2000","journal-title":"Spine"},{"key":"B42","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1016\/s0005-7967(96)00049-6","article-title":"Do pain expectancies cause pain in chronic low back patients? A clinical investigation","volume":"34","author":"Crombez","year":"1996","journal-title":"Behav Res Ther"},{"key":"B43","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/s0304-3959(98)00229-2","article-title":"Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability","volume":"80","author":"Crombez","year":"1999","journal-title":"Pain"},{"key":"B44","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.gaitpost.2015.11.017","article-title":"Balance recovery reactions in individuals with recurrent nonspecific low back pain: effect of attention","volume":"44","author":"Etemadi","year":"2016","journal-title":"Gait Posture"},{"key":"B45","doi-asserted-by":"publisher","first-page":"3509","DOI":"10.1007\/s00221-014-4039-1","article-title":"A cognitive dual task affects gait variability in patients suffering from chronic low back pain","volume":"232","author":"Hamacher","year":"2014","journal-title":"Exp Brain Res"},{"key":"B46","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1186\/1471-2474-9-152","article-title":"Regional differences in lumbar spinal posture and the influence of low back pain","volume":"9","author":"Mitchell","year":"2008","journal-title":"BMC Musculoskeletal Disord"},{"key":"B47","doi-asserted-by":"publisher","first-page":"441","DOI":"10.2522\/ptj.20050370","article-title":"Patterns of lumbar region movement during trunk lateral bending in 2 subgroups of people with low back pain","volume":"87","author":"Gombatto","year":"2007","journal-title":"Phys Ther"},{"key":"B48","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1097\/AJP.0b013e3181b40eca","article-title":"Back muscle activation patterns in chronic low back pain during walking: a \u201cguarding\u201d hypothesis","volume":"26","author":"van der Hulst","year":"2010","journal-title":"Clin J Pain"},{"key":"B49","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1016\/j.clinbiomech.2014.09.013","article-title":"Lumbar kinematic variability during gait in chronic low back pain and associations with pain, disability and isolated lumbar extension strength","volume":"29","author":"Steele","year":"2014","journal-title":"Clin Biomech"},{"key":"B50","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1249\/JSR.0b013e318205e08b","article-title":"Spine injuries in dancers","volume":"10","author":"Gottschlich","year":"2011","journal-title":"Curr Sports Med Rep"},{"key":"B51","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1055\/s-0032-1321722","article-title":"Motor control and low back pain in dancers","volume":"34","author":"Roussel","year":"2013","journal-title":"Int J Sports Med"},{"key":"B52","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1097\/00002060-200108000-00005","article-title":"Relationship between hip muscle imbalance and occurrence of low back pain in collegiate athletes: a prospective study","volume":"80","author":"Nadler","year":"2001","journal-title":"Am J Phys Med Rehabil"},{"key":"B53","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1186\/s12891-023-06920-x","article-title":"Is there hip muscle weakness in adults with chronic non-specific low back pain? A cross-sectional study","volume":"24","author":"Pizol","year":"2023","journal-title":"BMC Musculoskeletal Disord"},{"key":"B54","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1186\/s12891-024-07241-3","article-title":"Changes of trunk muscle stiffness in individuals with low back pain: a systematic review with meta-analysis","volume":"25","author":"Vatovec","year":"2024","journal-title":"BMC Musculoskeletal Disord"},{"key":"B55","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/0304-3959(93)90127-B","article-title":"A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability","volume":"52","author":"Waddell","year":"1993","journal-title":"Pain"},{"key":"B56","first-page":"E985","article-title":"Structural changes of lumbar muscles in non-specific low back pain: a systematic review","volume":"19","author":"Goubert","year":"2016","journal-title":"Pain Physician"},{"key":"B57","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/S0140-6736(21)00733-9","article-title":"Low back pain","volume":"398","author":"Knezevic","year":"2021","journal-title":"Lancet"},{"key":"B58","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1002\/ejp.2190","article-title":"Personalized assessment and management of non-specific low back pain","volume":"28","author":"Wirth","year":"2024","journal-title":"Eur J Pain"},{"key":"B59","doi-asserted-by":"publisher","first-page":"106070","DOI":"10.1016\/j.clinbiomech.2023.106070","article-title":"The effect of low back pain on spine kinematics: a systematic review and meta-analysis","volume":"108","author":"Errabity","year":"2023","journal-title":"Clinical Biomech"},{"key":"B60","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1016\/j.jclinepi.2011.01.011","article-title":"GRADE Guidelines: 5. Rating the quality of evidence\u2013publication bias","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"}],"container-title":["Frontiers in Pain Research"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpain.2025.1693068\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T06:20:12Z","timestamp":1763619612000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpain.2025.1693068\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,20]]},"references-count":60,"alternative-id":["10.3389\/fpain.2025.1693068"],"URL":"https:\/\/doi.org\/10.3389\/fpain.2025.1693068","relation":{},"ISSN":["2673-561X"],"issn-type":[{"value":"2673-561X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,20]]},"article-number":"1693068"}}