Comparison of standing postural control and gait parameters in people with and without chronic low back pain: a cross-sectional case–control study

Abstract

ObjectiveDifferences in postural control and gait have been identified between people with and without chronic low back pain (CLBP); however, many previous studies present data from small samples, or have used methodologies with questionable reliability. This study, employing robust methodology, hypothesised that there would be a difference in postural control, and spatiotemporal parameters of gait in people with CLBP compared with asymptomatic individuals.MethodsThis cross-sectional case–control study age-matched and gender-matched 16 CLBP and 16 asymptomatic participants. Participants were assessed barefoot (1) standing, over three 40 s trials, under four posture challenging conditions (2) during gait. Primary outcome was postural stability (assessed by root mean squared error of centre of pressure (CoP) displacement (CoPRMSEAP) and mean CoP velocity (CoPVELAP), both in the anteroposterior direction); gait outcomes were hip range of movement and peak moments, walking speed, cadence and stride length, assessed using force plates and a motion analysis system.ResultsThere were no differences between groups in CoPRMSEAP (P=0.26), or CoPVELAP (P=0.60) for any standing condition. During gait, no differences were observed between groups for spatiotemporal parameters, maximum, minimum and total ranges of hip movement, or peak hip flexor or extensor moments in the sagittal plane.ConclusionsIn contrast to previous research, this study suggests that people with mild to moderate CLBP present with similar standing postural control, and parameters of gait to asymptomatic individuals. Treatments directed at influencing postural stability (eg, standing on a wobble board) or specific parameters of gait may be an unnecessary addition to a treatment programme.

Postural Stability in Individuals with and without Sacroiliac Joint Dysfunction Before and After Pelvic Belt Application

“…Our results showed longer RT at the affected side of SIJD individuals that is in line with LBP studies (12,20,44,45) in which a longer RT was shown in LBP individuals. However, the present study was contrary to Macrae et al (46). The reason for this difference was due to methodological variations in other studies (12).…”

Do people with low back pain walk differently? A systematic review and meta-analysis

“…Five studies reported kinetic measures in the lower extremities during walking[83,85,86,93,94]. In three studies examining sagittal plane total net joint moments at the hip, there were no differences between individuals with and without LBP[83,86,93]. During running, sagittal plane hip moments did not differ between groups[30,35].…”

Sacroiliac Joint Hypermobility Biomechanics and What it Means for Health Care Providers and Patients

“…Various options are available for assessment, such as the Sorenson test, 31 Prone Plank test, 32 Functional Movement Screen, 33 other movement control tests, 34 and laboratory-based gait analyses. 35 The Lumbar Spine Instability Questionnaire is a 15-item questionnaire that may be useful in assessing instability and guiding treatment approaches. 36,37 A thorough kinematic evaluation of bilateral lumbopelvic movement symmetry can provide important information for the management of patients with LBP.…”

“…Successful management of lumbopelvic pain syndromes should include both anatomical and functional assessments of strength, endurance, flexibility, motor control, gait, and lumbopelvic kinematics. Various options are available for assessment, such as the Sorenson test, Prone Plank test, Functional Movement Screen, other movement control tests, and laboratory‐based gait analyses . The Lumbar Spine Instability Questionnaire is a 15‐item questionnaire that may be useful in assessing instability and guiding treatment approaches .…”