{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T20:05:43Z","timestamp":1776801943956,"version":"3.51.2"},"reference-count":55,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Current routine diagnostic procedures for back pain mainly focus on static spinal analyses. Dynamic Surface Topography (DST) is an easy-to-use, radiation-free addition, allowing spine analyses under dynamic conditions. Until now, it is unclear if this method is applicable to back pain patients, and data reports are missing. Within a prospective observational study, 32 patients suffering from thoracic and lumbar back pain were examined while walking, randomized at four speeds (2, 3, 4, 5 km\/h), using a DST measuring device (DIERS 4Dmotion\u00ae Lab). The measurement results were compared with those of a healthy reference group. We calculated the intrasegmental rotation for every subject and summed up the spinal motion in a standardized gait cycle. The Mann\u2013Whitney U Test was used to compare the painful and healthy reference groups at the four different speeds. In a subgroup analysis, the painful group was divided into two groups: one with less pain (\u22643 points on the Visual Analogue Scale) and one with more pain (&gt;3 points on the Visual Analogue Scale). The Kruskal\u2013Wallis Test was used to compare these subgroups with the healthy reference group. Of the 32 included patients, not all could walk at the intended speeds (5 km\/h: 28\/32). At speeds of 2\u20134 km\/h, our results point to greater total segmental rotation of back pain patients compared to the healthy reference group. At a speed of 3 km\/h, we observed more movement in the patients with more pain. Overall, we monitored small differences on average between the groups but large standard deviations. We conclude that the DST measuring approach is eligible for back pain patients when they feel confident enough to walk on a treadmill. Initial results suggest that DST can be used to obtain interesting therapeutic information for an individual patient.<\/jats:p>","DOI":"10.3390\/bioengineering12030289","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T04:29:18Z","timestamp":1741926558000},"page":"289","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Dynamic Surface Topography for Thoracic and Lumbar Pain Patients\u2014Applicability and First Results"],"prefix":"10.3390","volume":"12","author":[{"given":"Johanna","family":"Kniepert","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6630-2772","authenticated-orcid":false,"given":"Henriette","family":"R\u00f6nsch","sequence":"additional","affiliation":[{"name":"Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2157-4287","authenticated-orcid":false,"given":"Ulrich","family":"Betz","sequence":"additional","affiliation":[{"name":"Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2297-3482","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Konradi","sequence":"additional","affiliation":[{"name":"Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janine","family":"Huthwelker","sequence":"additional","affiliation":[{"name":"Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8134-2664","authenticated-orcid":false,"given":"Claudia","family":"Wolf","sequence":"additional","affiliation":[{"name":"Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruben","family":"Westphal","sequence":"additional","affiliation":[{"name":"Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Stra\u00dfe 69, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Drees","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"ref_1","unstructured":"GBD 2021 Low Back Pain Collaborators (2023). 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. Lancet Rheumatol., 5, e316\u2013e329."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0140-6736(16)30970-9","article-title":"Non-specific low back pain","volume":"389","author":"Maher","year":"2017","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.diii.2014.02.019","article-title":"A review of the value of MRI signs in low back pain","volume":"96","author":"Ract","year":"2015","journal-title":"Diagn. Interv. Imaging"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/0304-3959(91)90145-N","article-title":"Situational and psychophysiological factors in psychologically induced pain","volume":"44","author":"Bayer","year":"1991","journal-title":"Pain"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1056\/NEJM199407143310201","article-title":"Magnetic resonance imaging of the lumbar spine in people without back pain","volume":"331","author":"Jensen","year":"1994","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.math.2005.07.001","article-title":"Diagnosis and classification of chronic low back pain disorders: Maladaptive movement and motor control impairments as underlying mechanism","volume":"10","year":"2005","journal-title":"Man. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s00586-004-0825-y","article-title":"Effects of chronic low back pain on trunk coordination and back muscle activity during walking: Changes in motor control","volume":"15","author":"Lamoth","year":"2006","journal-title":"Eur. Spine J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/j.jshs.2022.02.001","article-title":"Do people with low back pain walk differently? A systematic review and meta-analysis","volume":"11","author":"Smith","year":"2022","journal-title":"J. Sport Health Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1007\/s11517-006-0132-3","article-title":"Development of a real-time three-dimensional spinal motion measurement system for clinical practice","volume":"44","author":"Goodvin","year":"2006","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.gaitpost.2016.05.009","article-title":"Corrigendum to \u201cTest-retest reliability and minimal detectable change of three-dimensional gait analysis in chronic low back pain patients\u201d [Gait Posture 42 (2015) 491-497]","volume":"48","author":"Fernandes","year":"2016","journal-title":"Gait Posture"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Betsch, M., Wild, M., Johnstone, B., Jungbluth, P., Hakimi, M., Kuhlmann, B., and Rapp, W. (2013). Evaluation of a novel spine and surface topography system for dynamic spinal curvature analysis during gait. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0070581"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1007\/s00132-015-3175-z","article-title":"Radiation-free diagnosis of scoliosis: An overview of the surface and spine topography","volume":"44","author":"Betsch","year":"2015","journal-title":"Orthopade"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1007\/s001320050603","article-title":"Functional rasterstereographic images. A new method for biomechanical analysis of skeletal geometry","volume":"30","author":"Drerup","year":"2001","journal-title":"Orthopade"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1016\/0021-9290(92)90057-8","article-title":"Evaluation of frontal radiographs of scoliotic spines\u2014Part II. Relations between lateral deviation, lateral tilt and axial rotation of vertebrae","volume":"25","author":"Drerup","year":"1992","journal-title":"J. Biomech."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1016\/0021-9290(92)90291-8","article-title":"Evaluation of frontal radiographs of scoliotic spines\u2014Part I. Measurement of position and orientation of vertebrae and assessment of clinical shape parameters","volume":"25","author":"Drerup","year":"1992","journal-title":"J. Biomech."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/0268-0033(94)90055-8","article-title":"Back shape measurement using video rasterstereography and three-dimensional reconstruction of spinal shape","volume":"9","author":"Drerup","year":"1994","journal-title":"Clin. Biomech."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/0021-9290(88)90244-8","article-title":"A television\/computer three-dimensional surface shape measurement system","volume":"21","year":"1988","journal-title":"J. Biomech."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/0268-0033(96)00025-3","article-title":"Assessment of scoliotic deformity from back shape asymmetry using an improved mathematical model","volume":"11","author":"Drerup","year":"1996","journal-title":"Clin. Biomech."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1097\/BRS.0b013e3181cbc157","article-title":"Reproducibility of rasterstereography for kyphotic and lordotic angles, trunk length, and trunk inclination: A reliability study","volume":"35","author":"Mohokum","year":"2010","journal-title":"Spine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"721829","DOI":"10.1155\/2014\/721829","article-title":"Evaluating the Reproducibility of Motion Analysis Scanning of the Spine during Walking","volume":"2014","author":"Gipsman","year":"2014","journal-title":"Adv. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1080\/10255842.2020.1828375","article-title":"General method for automated feature extraction and selection and its application for gender classification and biomechanical knowledge discovery of sex differences in spinal posture during stance and gait","volume":"24","author":"Dindorf","year":"2020","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Dindorf, C., Konradi, J., Wolf, C., Taetz, B., Bleser, G., Huthwelker, J., Werthmann, F., Bartaguiz, E., Kniepert, J., and Drees, P. (2021). Classification and Automated Interpretation of Spinal Posture Data Using a Pathology-Independent Classifier and Explainable Artificial Intelligence (XAI). Sensors, 21.","DOI":"10.3390\/s21186323"},{"key":"ref_23","first-page":"377","article-title":"Automatic measurement of body surfaces using rasterstereography. Part I: Image scan and control point measurement","volume":"49","author":"Frobin","year":"1983","journal-title":"Photogramm. Eng. Rem. S"},{"key":"ref_24","first-page":"1443","article-title":"Automatic measurement of body surfaces using rasterstereography. Part II: Analysis of the rasterstereographic line pattern and three-dimensional surface reconstruction","volume":"49","author":"Frobin","year":"1983","journal-title":"Photogramm. Eng. Rem. S"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"103054","DOI":"10.1016\/j.humov.2022.103054","article-title":"Reference values and functional descriptions of transverse plane spinal dynamics during gait based on surface topography","volume":"88","author":"Huthwelker","year":"2023","journal-title":"Hum. Mov. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.apmr.2014.10.006","article-title":"Two-minute walk test performance by adults 18 to 85 years: Normative values, reliability, and responsiveness","volume":"96","author":"Bohannon","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1007\/s001320050486","article-title":"Oberfl\u00e4chenvermessung des R\u00fcckens","volume":"29","author":"Asamoah","year":"2000","journal-title":"Der Orthop\u00e4de"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Huthwelker, J., Konradi, J., Wolf, C., Westphal, R., Schmidtmann, I., Drees, P., and Betz, U. (2022). Reference Values for 3D Spinal Posture Based on Videorasterstereographic Analyses of Healthy Adults. Bioengineering, 9.","DOI":"10.3390\/bioengineering9120809"},{"key":"ref_29","unstructured":"Kniepert, J. (2019). 4D-Bewegungsanalyse der Wirbels\u00e4ule im Gang nach mono-und Multisegmentaler Versteifung der Wirbels\u00e4ule Sowie bei Patienten mit R\u00fcckenschmerzen. [Ph.D. Thesis, Johannes Gutenberg-Universit\u00e4t Mainz]."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"102919","DOI":"10.1016\/j.humov.2021.102919","article-title":"Comprehensive visualization of spinal motion in gait sequences based on surface topography","volume":"81","author":"Haimerl","year":"2022","journal-title":"Hum. Mov. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1080\/10255842.2021.1981884","article-title":"Machine learning techniques demonstrating individual movement patterns of the vertebral column: The fingerprint of spinal motion","volume":"25","author":"Dindorf","year":"2021","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_32","unstructured":"Konradi, J. (2022). SPSS syntax script to create graphs of spinal motion relative to phases of gait. Mendeley Data, V1."},{"key":"ref_33","unstructured":"Konradi, J. (2022). SPSS syntax script to create graphs of spinal motion for a Standardized Gait Cycle. Mendeley Data, V1."},{"key":"ref_34","unstructured":"Konradi, J., and Betz, U. (2022). Validation of automatic detection of gait phases. Mendeley Data, V1."},{"key":"ref_35","unstructured":"Schmidtmann, I., and Konradi, J. (2022). SAS syntax script for merging export files. Mendeley Data, V1."},{"key":"ref_36","unstructured":"Westphal, R., and Konradi, J. (2022). SAS syntax script for creation of a Standardized Gait Cycle. Mendeley Data, V1."},{"key":"ref_37","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioural Sciences, Lawrence Erlbaum. [2nd ed.]."},{"key":"ref_38","unstructured":"Hedges, L.V., and Olkin, I. (1985). Statistical Methods for Meta-Analysis, Academic Press. [1st ed.]."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/S0268-0033(02)00032-3","article-title":"Relationship between pain and vertebral motion in chronic low-back pain subjects","volume":"17","author":"Dickey","year":"2002","journal-title":"Clin. Biomech."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"795","DOI":"10.2214\/AJR.04.1629","article-title":"Axial rotation of the lumbar spinal motion segments correlated with concordant pain on discography: A preliminary study","volume":"186","author":"Blankenbaker","year":"2006","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"29","DOI":"10.2106\/JBJS.I.01348","article-title":"Segmental lumbar rotation in patients with discogenic low back pain during functional weight-bearing activities","volume":"93","author":"Passias","year":"2011","journal-title":"J. Bone Jt. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1007\/s005860000199","article-title":"Three-dimensional kinematics of the lumbar spine during treadmill walking at different speeds","volume":"10","author":"Feipel","year":"2001","journal-title":"Eur. Spine J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/BF00298413","article-title":"Normal motion of the lumbar spine as related to age and gender","volume":"4","author":"Dvorak","year":"1995","journal-title":"Eur. Spine J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1097\/BRS.0b013e318060122b","article-title":"In vivo measurements of lumbar segmental motion during axial rotation in asymptomatic and chronic low back pain male subjects","volume":"32","author":"Ochia","year":"2007","journal-title":"Spine"},{"key":"ref_45","doi-asserted-by":"crossref","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":"ref_46","doi-asserted-by":"crossref","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"},{"key":"ref_47","unstructured":"B\u00f6rm, W., Meyer, F., Bullmann, V., and Knop, C. (2017). 2.1 Biomechanik der Wirbels\u00e4ule. Wirbels\u00e4ule Interdisziplin\u00e4r: Operative und Konservative Therapie, Schatthauer."},{"key":"ref_48","doi-asserted-by":"crossref","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":"Rietman","year":"2010","journal-title":"Clin. J. Pain"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/1743-0003-6-32","article-title":"Walking speed-related changes in stride time variability: Effects of decreased speed","volume":"6","author":"Beauchet","year":"2009","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Akl, A.R., Gon\u00e7alves, P., Fonseca, P., Hassan, A., Vilas-Boas, J.P., and Concei\u00e7\u00e3o, F. (2021). Muscle Co-Activation around the Knee during Different Walking Speeds in Healthy Females. Sensors, 21.","DOI":"10.3390\/s21030677"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1007\/s00221-003-1457-x","article-title":"Experimental muscle pain changes feedforward postural responses of the trunk muscles","volume":"151","author":"Hodges","year":"2003","journal-title":"Exp. Brain Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1016\/j.pain.2011.12.009","article-title":"Fear-avoidance model of chronic musculoskeletal pain: 12 years on","volume":"153","author":"Vlaeyen","year":"2012","journal-title":"Pain"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/0304-3959(95)00115-8","article-title":"The influence of low back pain on muscle activity and coordination during gait: A clinical and experimental study","volume":"64","author":"Svarrer","year":"1996","journal-title":"Pain"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1007\/s00586-005-0960-0","article-title":"Three-dimensional relation of skin markers to lumbar vertebrae of healthy subjects in different postures measured by open MRI","volume":"15","author":"Blickhan","year":"2006","journal-title":"Eur. Spine J."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s40798-018-0139-y","article-title":"A Review of the Evolution of Vision-Based Motion Analysis and the Integration of Advanced Computer Vision Methods Towards Developing a Markerless System","volume":"4","author":"Colyer","year":"2018","journal-title":"Sports Med. Open"}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/3\/289\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:53:21Z","timestamp":1760028801000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/12\/3\/289"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,13]]},"references-count":55,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["bioengineering12030289"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering12030289","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,13]]}}}