Postural sway and integration of proprioceptive signals in subjects with LBP

Abstract

Patients with non-specific low back pain (LBP) may use postural control strategies that differ from healthy subjects. To study these possible differences, we measured the amount and structure of postural sway, and the response to muscle vibration in a working cohort of 215 subjects. Subjects were standing on a force plate in bipedal stance. In the first trial the eyes were open, no perturbation applied. In the following 6 trials, vision was occluded and subjects stood under various conditions of vibration/no vibration of the lumbar spine or m. Triceps Surae (TSM) on firm surface and on foam surface. We performed a factor analysis to reduce the large amount of variables that are available to quantify all effects. Subjects with LBP showed the same amount of sway as subjects without LBP, but the structure of their sway pattern was less regular with higher frequency content. Subjects with LBP also showed a smaller response to TSM vibration, and a slower balance recovery after cessation of vibration when standing on a solid surface. There was a weak but significant association between smaller responses to TSM vibration and an irregular, high frequency sway pattern, independent from LBP. A model for control of postural sway is proposed. This model suggests that subjects with LBP use more co-contraction and less cognitive control, to maintain a standing balance when compared to subjects without LBP. In addition, a reduced weighting of proprioceptive signals in subjects with LBP is suggested as an explanation for the findings in this study.

Reliability and validity of a novel Kinect-based software program for measuring posture, balance and side-bending

“…On the other hand, we found that the point estimates did not differ between the groups indicating no clinical difference between the groups. As previous studies have found differences in posture and balance between patients with chronic LBP and healthy controls [ 23 , 24 ], our results showed that that Qinematic™ is not sensitive enough for measuring differences in posture and balance for patients with LBP.…”

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

“…The associated effects on the disability and physical scale were also low, which means that our sample was not strongly affected by NSLBP during the investigation. Though, other studies have reported differences between individuals with low pain ratings and healthy controls [ 29 , 30 ].…”

Age-related differences on low back pain and postural control during one-leg stance: a case–control study

“…However, when using a similar balance task (but in erect posture without manipulating the sensorial systems), Kiers et al [28] showed no significant differences in COP oscillation between those with low back pain (n = 33) as compared to those without pain (n = 182). This demonstrates further that the one-legged stance can be a more sensitive test than other balance conditions, as for example bipedal posture (with or without eyes closed) for assessing postural control responses when musculoskeletal pathology is of concern [15].…”

“…A limitation of the present study was that there was no comparison with neuromuscular activation and/or with the influence of vibration [28] to help explain the possible proprioceptive mechanisms for maintaining balance during a one-leg stance with CLBP. However, from the clinical perspective, the new findings reported here contribute to the literature towards improving the process of evaluating balance and intervening in subjects with and without CLBP during rehabilitation programs.…”