Postural Control of Patients with Low Back Pain Under Dual-Task Conditions

Abstract

Low back pain is a major global public health problem, but the current intervention effect is not ideal. A large body of previous literature suggests that patients with chronic low back pain may have abnormal postural control, which is more evident in the dual task situation. In recent years, research on postural control in patients with low back pain under dual-task conditions has gradually become a hot topic. However, the results obtained from these studies were not entirely consistent. In this review, we summarized relevant studies on the performance of postural control in patients with low back pain under dual-task conditions, analyze it from the perspective of the theoretical model of dual-task interaction, the specific research paradigm of dual task, the performance of postural control, and the related factors affecting postural control performance, etc. It was reasonable to assume that patients with low back pain might have a certain degree of abnormal postural control, and this abnormality was affected by comprehensive factors such as age, cognitive resource capacity, attention needs, complex sensorimotor integration, external environment, etc. Furthermore, postural control performance in low back pain patients under dual-task conditions was further influenced by the nature and complexity of the different tasks. In general, the more attention resources were needed, the external environmental conditions were worse, and the age-related functions were degenerate, etc., the weaker posture control ability was. In short, a deeper understanding of postural control in patients with low back pain under dual-task conditions may shed light on more references for the rehabilitation and management of low back pain, as well as some new ideas for scientific research on cognition and postural control.

The effect of dual-task conditions on postural control in adults with low back pain: a systematic review and meta-analysis

“…Previous studies using a dual-task interference paradigm to investigate postural control in individuals with LBP have reported inconclusive results. Xiao et al [ 17 ] proposed multiple factors that could affect postural control among patients with LBP when performing dual-task activities. However, there are two crucial factors that need to be considered in maintaining postural stability.…”

“…However, there are two crucial factors that need to be considered in maintaining postural stability. The first factor is sensory strategies which have a significant role in maintaining postural stability [ 17 ]. When proprioceptive information from the ankle is reliable, individuals tend to rely on ankle strategy for postural control.…”

“…The final search strategy was subjected to review by a library scientist following the PRESS (Peer Review of Electronic Search Strategies) guidelines [ 23 ]. Additional studies were identified by manual searching [ 17 ] and cross-references and contacting expert authors from the field.…”

“…Furthermore, some studies have indicated that dual-task conditions requiring cognitive or motor processing can lead to decreased postural control and stability in individuals with LBP [ 14 , 15 ]. However, the findings in the available literature are not entirely consistent [ 17 ]. For instance, a study suggested that when performing a dual task, the introduction of low attention loads impeded the conscious processing of postural memory associated with pain, resulting in improved trunk coupling compared to a single-task condition [ 5 ].…”

Home-Based Rehabilitation Training with Human Key-Point Detection for Chronic Low Back Pain Patients: A Randomized Controlled Trial Protocol

“…Tele-rehabilitation technology based on mobile health (m-health) has experienced rapid development, especially during the COVID-19 outbreak [13] . This technology enables patients to receive exercise instructions through mobile devices and engage in rehabilitation treatment anytime and anywhere [14] .Our preliminary exploratory study has indicated that core stability training instruction provided remotely has the potential to improve lower back function and reduce pain intensity in patients with chronic low back pain [15] .Research has demonstrated that remote education and exercise guidance via videoconferencing hold promise in achieving therapeutic effects [16] .However, these interventions have not provided patients with objective and accurate supervision and exercise guidance in their homes.Research has shown that unsupervised app-based treatments have not demonstrated signi cant treatment e cacy and costeffectiveness [17] .…”