Proprioceptive change impairs balance control in older patients with low back pain

Abstract

Abstract. [Purpose] This study aims to determine the specific proprioceptive control strategy used during postural balance in older patients with low back pain (LBP) and non-LBP (NLBP) and to assess whether this strategy is related to proprioceptive decline and LBP. [Subjects and Methods] Pressure displacement center was determined in 47 older persons with LBP and 64 older persons with NLBP during upright stance on a balance board without vision. Gastrocnemius (GS) and lumbar multifidus muscle (LM) vibratory stimulations of 60 and 240-Hz, respectively, were applied to evaluate the relative contributions of different proprioceptive signals (relative proprioceptive weighting ratio, RPW) used in postural control. Age, height, weight, back muscle strength, L1/2 and L4/5 lumbar multifidus cross section area ratio, skeletal muscle mass index, sagittal vertical axis, and Roland-Morris disability questionnaire (RDQ) were evaluated.[Results] Compared with older patients with NLBP, those with LBP showed a lower RPW 240-Hz, lower L4/5 lumbar multifidus cross-sectional area ratio, and a significantly higher age and RDQ. Logistic regression analysis showed that RPW 240-Hz and age were independently associated with LBP, after controlling for confounding factors.[Conclusion] Older patients with LBP decreased their reliance on GS (RPW 240-Hz) proprioceptive signals during balance control.

Association Between Back Muscle Strength and Proprioception or Mechanoreceptor Control Strategy in Postural Balance in Elderly Adults with Lumbar Spondylosis

“…Furthermore, they reported that poor proprioception could lead to impaired sensory control of the limbs during periods of movement and when there is increased dynamic joint load. Previous studies have shown that elderly patients with LBP depend on proprioceptive inputs of the Vater-Pacini corpuscles [5,17], which may imply that the postural strategy adopted by elderly adults with lumbar spondylosis depends on the mechanoreceptors of the Vater-Pacini corpuscles in the LM and GS muscles. Other studies reported that proprioception and muscle spindles in the trunk decrease in both young and elderly adults with LBP [6][7][8][9][10]15,16,[19][20][21].…”

“…COP excursion was recorded using a balance board (Wii; Nintendo Co., Ltd., Kyoto, Japan) [5,[16][17][18][23][24][25]. Balance board data were acquired using a sampling frequency of 100 Hz and calculated using MATLAB (MathWorks, Inc., Natick, MA, USA).…”

“…Each subject's COP excursion was measured under six conditions, that is, two muscles × three frequencies of vibratory stimulation: 1 LM. The measurement time was 30 s, which was divided into two intervals of 15 s each [5,[16][17][18]. Vibratory stimulation was applied to the participants during the last 15 s. We labeled the first 15 s as "Pre" and the last 15 s as "During."…”

“…The relationship between back muscle strength and the adaptive proprioception and mechanoreceptor responses to changing vibratory stimulations has not yet been clearly established. Local vibration, which is known to be a strong stimulus for Meissner corpuscles, muscle spindles, and Vater-Pacini corpuscles, has been used to assess the role of proprioception or mechanoreceptors in postural control [5][6][7][8][9][10][15][16][17][18][19][20][21][22]. Investigating the specific role of proprioception and mechanoreceptors during stimulation is essential to gain insight into the variability of postural control strategies and the possible relationship between impaired proprioception or mechanoreceptors and back muscle strength.…”

Effects of Low Back Pain on Balance Performance in Older People: A Systematic Review and Meta-analysis

“…Following the title andabstract screening, 35 fulltext articles were retrieved. The full-text review was completed to determine nal inclusion; 17 articles (13 case-control studies [20][21][22][23][24][25][26][27][28][29][30][31][32] , four RCTs [33][34][35][36] ) met the inclusion criteria. Only the 13 case-control studies were included in the meta-analysis.…”