Can We Identify Subgroups of Patients with Chronic Low Back Pain Based on Motor Variability? A Systematic Scoping Review

Abstract

The identification of homogeneous subgroups of patients with chronic low back pain (CLBP), based on distinct patterns of motor control, could support the tailoring of therapy and improve the effectiveness of rehabilitation. The purpose of this review was (1) to assess if there are differences in motor variability between patients with CLBP and pain-free controls, as well as inter-individually among patients with CLBP, during the performance of functional tasks; and (2) to examine the relationship between motor variability and CLBP across time. A literature search was conducted on the electronic databases Pubmed, EMBASE, and Web of Science, including papers published any time up to September 2021. Two reviewers independently screened the search results, assessed the risk of bias, and extracted the data. Twenty-two cross-sectional and three longitudinal studies investigating motor variability during functional tasks were examined. There are differences in motor variability between patients with CLBP and pain-free controls during the performance of functional tasks, albeit with discrepant results between tasks and among studies. The longitudinal studies revealed the persistence of motor control changes following interventions, but the relationship between changes in motor variability and reduction in pain intensity was inconclusive. Based on the reviewed literature, no stratification of homogeneous subgroups into distinct patterns of motor variability in the CLBP population could be made. Studies diverged in methodologies and theoretical frameworks and in metrics used to assess and interpret motor variability. In the future, more large-sample studies, including longitudinal designs, are needed, with standardized metrics that quantify motor variability to fill the identified evidence gaps.