Unveiling the Future of Low Back Pain Assessment: The Power of Movement Biomarkers

The short version: 

• A 2023 study of 60 participants demonstrated a clear set of physiologic biomarkers to indicate whether or not an individual could be classified as suffering from low back pain. 
• This study, and many like it, are the foundation of a set of reliable indicators of musculoskeletal (MSK) health based on objective measure.
• 30 healthy and 30 pain participants were included in the study and among the 72 biomarkers evaluated, four were identified as key due to their high reliability and validity.
• Technologies that are available at any point-of-care, like the FIGUR8 solution, are now available to providers across the globe to ensure biomarker assessment is part of any physical health exam.

The Power of Movement Biomarkers in low back pain patients

Hundreds of millions of lives are affected daily by non-specific chronic low back pain, often leading to significant impairment and reduced quality of life. Receiving the right care at the right time for pain management can be complex, as the pathway to recovery often requires the support of multiple stakeholders in the healthcare ecosystem.

So how do they all ensure the best possible outcome for each pain patient's recovery? By understanding the health of the individual under care.

Identifying reliable musculoskeletal (MSK) biomarkers, or more specifically objective measures of health, allows providers and case management teams to differentiate between patients with pain and those that are healthy quickly and efficiently. This ability to objectively understand MSK health based on physiologic measures can revolutionize diagnosis, treatment, and patient management. 

While it is possible to use clinical information from a visual assessment to inform you that someone suffers from chronic low back pain, as well as what their treatment should be, this type of knowledge is often subjective and not valuable as a reliable indicator of pain and function for the individual whose health is being assessed.

This overview of a 2023 study by Moissenet, Armand, and Genevay offers significant insights into this quest to understand MSK health by providing a robust evaluation of 72 movement biomarkers to determine their efficacy in distinguishing between pain and healthy populations.

Key Findings: Reliable and Valid Movement Biomarkers

After consolidating existing knowledge on movement biomarkers by assessing their reliability, validity and interpretability, the team at Geneva University Hospitals and the University of Geneva was able to identify four key biomarkers that demonstrated scientifically significant reliability and validity as clear indicators of pain versus health.

Below are details on the four biomarkers that were highly reliable and showed significant differences between the healthy and pain groups. All of these biomarkers were collected in the sagittal plane.

1. Maximum Lumbar Angle: This measures the maximum angle achieved highlighting the extent of lumbar flexion or extension.
2. Lumbar Angle Range of Motion (ROM): This captures the total movement range reflecting flexibility and mobility.
3. Mean Lumbar Angular Velocity: This measures the average speed of lumbar movement, providing insights into the dynamics of spinal motion.
4. Maximal Upper Lumbar Angle during Trunk Bending: This focuses on the upper lumbar region's movement during bending, indicating specific segmental mobility.

These four biomarkers showed higher values in healthy participants compared to pain patients in general, suggesting that decreased lumbar movement could be a characteristic of chronic low back pain.

Interestingly, these biomarkers exhibited weak correlations with patient-reported outcome measures (PROMs). Since PROMs are currently used to assess the health and wellness of an individual, this finding emphasizes the need for access to truly objective MSK assessments to better understand an individual's health in clinical settings and where the source of pain lies.

Technological Advancements: FIGUR8's bioMotion Assessment Platform

Traditionally, capturing movement biomarkers that quantify MSK health has relied on optical motion capture systems, like VICON. Despite their accuracy and detail, these systems pose several challenges. They are often expensive, require extensive setup, and necessitate technical expertise for data analysis. These barriers limit widespread adoption in the majority of clinical practice settings even as these tools are known as the gold standard of evaluation.

As technology continuously improves across healthcare, motion capture is no exception to the rapid expansion of meaningful clinical tools that can drive access to the best possible assessment and care of an individual during recovery. The bioMotion Assessment Platform (bMAP), by FIGUR8, is a solution designed to democratize access to precise movement analysis. The groundbreaking  solution leverages advanced sensor technology and artificial intelligence to provide detailed biomechanical data at any point-of-care without the high costs and complexities associated with traditional systems.

With technology partners like FIGUR8, providers are able to benefit from:

1. Affordability and Accessibility: The bMAP is cost-effective and small with all the necessary pieces fitting into a box the size of a laptop. This form factor change to the traditional biomechanics lab makes biomarker data collection accessible to a broader range of healthcare providers, including physical therapists and primary care physicians.
2. Ease of Use: The solution is user-friendly and requires minimal setup time. Clinicians are able to integrate bMAP seamlessly into their practice and on the other side of the table, stakeholders in case management can access objective data about the MSK health of an individual via easy to understand bioMotion reporting.
3. Immediate Access to Advanced Data Analysis: With near real-time data processing and visualization, immediate feedback and timely decision-making for patient care is possible.
4. Comprehensive Assessment: The platform captures a wide array of movement biomarkers, providing a holistic view of a patient’s musculoskeletal health.

"Every single patient that walks into our clinic would benefit from using FIGUR8’s assessment and data to help drive the clinicians plan of care.” FIGUR8 Enabled Clinician

Overcoming Limitations: A Comparative Edge

While optical motion capture systems remain the gold standard in research settings due to their precision, the practical limitations cannot be overlooked. Technology-forward solutions like FIGUR8 address these issues by offering a reliable alternative that maintains high accuracy levels comparable to traditional systems. 

By removing barriers such as cost, complexity, and the need for specialized expertise, FIGUR8 empowers more healthcare providers to leverage movement biomarkers in their clinical practice which in turn creates a common language in MSK care management.

The future of healthcare, a data-driven approach

The study by Moissenet, Armand, and Genevay underscores the importance of identifying reliable movement biomarkers to differentiate unhealthy from healthy individuals. The integration of advanced technologies like FIGUR8's bioMotion Assessment Platform heralds a new era in MSK health, where precise, accessible, and user-friendly tools enhance patient care.

As the world continues to shift and embrace technologies that were once only thought up in dreams, the future of low back pain care looks promising, with the potential to significantly improve the health and wellbeing of millions of sufferers worldwide.

Interested in learning more about FIGUR8? 
Reach out to info@figur8tech.com to discover what a new standard of care looks like.