Non-specific Low Back Pain and Postural Control During Quiet Standing—A Systematic Review

Abstract

Background: There is a great number of people who require treatment for non-specific low back pain (LBP) yet the causes are still unclear. One proposed cause for LBP is impaired motor control and more specific an impaired postural control. Objective: The purpose of this review is to provide an overview of postural control parameter differences in persons with and without non-specific LBP during quite standing. Methods: A literature search in five databases from January 2000 until January 2018 was performed and was followed by a hand search. Twenty-one articles comparing healthy adults and adults with non-specific LBP in neuromuscular and/or biomechanical parameters during bipedal stance without external perturbation in lab studies were examined. Data extraction and quality assessment were independently performed by two persons. Factors such as study population, outcome measures, and results were extracted from the articles and included in this analysis. Results: The results show that persons with and without non-specific LBP differed in several parameters of postural control such as the center of pressure displacement, postural control strategy, and muscle activation patterns. Conclusion: While the results show that none of the parameters alone lead to significant effects, the combination of neuromuscular and biomechanical parameters was associated with the impairment of postural control in individuals with LBP during standing. Since the studies included in this analysis used different methodological procedures a replication of these studies with standardized procedures is imperative for the acquisition of more conclusive evidence on the differences in postural control during standing.

Motor and postural control in patients with chronic non-specific low back pain: a blinded, prospective, and controlled cross-sectional study

“…Consistent with previous findings, MPCD was more common in the cLBP group (1,2). To determine whether cLBP is related to MPCD generally or to specific features of MPCD, we included tests relevant to MPCD but not cLBP.…”

“…Motor and postural control deficiencies (MPCD) contribute to chronic, non-specific low back pain (cLBP) [1,2]. However, studies examining training programs to specifically improve MPCD have not shown superiority to general exercise [3], and clinical outcomes are not predictable based on findings of the deep stabilization system [4,5].…”

A case control study to investigate differences in motor control between individuals with and without non-specific low back pain during standing

“…In the case of standing, recent reviews have confirmed altered motor control in NSLBP [ 9 – 11 ] based on different parameters. Two of these reviews [ 9 , 10 ] investigate changes in CoP data during different quiet standing conditions.…”

<p>Balance Control in Patients with Subacute Non-Specific Low Back Pain, with and without Lumbar Instability: A Cross-Sectional Study</p>

“…40,41 A recent systematic review by Koch and Hȁnsel (2019) also concluded that there were differences in certain parameters of postural control in quiet standing between patients with NSLBP and healthy subjects. 42 A previous study by Sung et al evaluated the lumbar stability index, relative standstill time, of patients with and without LBP and found that the stability index significantly decreased, particularly when visual feedback was blocked, for patients with LBP. 43 In the present study, patients with subacute NSLBP demonstrated a shorter single-leg standing time than healthy control subjects, even with their eyes open.…”