Stability threshold during seated balancing is sensitive to low back pain and safe to assess

Reeves, N. Peter; Celi, Victor Giancarlo Sal y Rosas; Ramadan, Ahmed; Popovich, John M.; Prokop, Lawrence L.; Zatkin, Mathew A.; DeStefano, Lisa; Francisco, Timothy; Rowan, Jacob J.; Radcliffe, Clark J.; Choi, Jongeun; Cowdin, Nathan D.; Cholewicki, Jacek

doi:10.1016/j.jbiomech.2021.110541

Cited by 5 publications

(2 citation statements)

References 27 publications

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“…This is likely explained by differences in seat dynamics imposed by hemisphere-based seats (more challenging) versus springs-based seats (less challenging) when balancing. A lesser task difficulty might limit the potential to identify differences between groups [ 22 , 72 , 96 ]. The research group using the unstable springs-based sitting paradigm chose to use a not too difficult task (60% R spring ) to help participants maintain balance long enough (60 s) to obtain reliable summary measures of trunk postural control [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Trunk postural control during unstable sitting among individuals with and without low back pain: A systematic review with an individual participant data meta-analysis

Alshehri,

Alzahrani,

van den Hoorn

et al. 2024

PLoS ONE

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Introduction Sitting on an unstable surface is a common paradigm to investigate trunk postural control among individuals with low back pain (LBP), by minimizing the influence lower extremities on balance control. Outcomes of many small studies are inconsistent (e.g., some find differences between groups while others do not), potentially due to confounding factors such as age, sex, body mass index [BMI], or clinical presentations. We conducted a systematic review with an individual participant data (IPD) meta-analysis to investigate whether trunk postural control differs between those with and without LBP, and whether the difference between groups is impacted by vision and potential confounding factors. Methods We completed this review according to PRISMA-IPD guidelines. The literature was screened (up to 7th September 2023) from five electronic databases: MEDLINE, CINAHL, Embase, Scopus, and Web of Science Core Collection. Outcome measures were extracted that describe unstable seat movements, specifically centre of pressure or seat angle. Our main analyses included: 1) a two-stage IPD meta-analysis to assess the difference between groups and their interaction with age, sex, BMI, and vision on trunk postural control; 2) and a two-stage IPD meta-regression to determine the effects of LBP clinical features (pain intensity, disability, pain catastrophizing, and fear-avoidance beliefs) on trunk postural control. Results Forty studies (1,821 participants) were included for the descriptive analysis and 24 studies (1,050 participants) were included for the IPD analysis. IPD meta-analyses revealed three main findings: (a) trunk postural control was worse (higher root mean square displacement [RMSdispl], range, and long-term diffusion; lower mean power frequency) among individuals with than without LBP; (b) trunk postural control deteriorated more (higher RMSdispl, short- and long-term diffusion) among individuals with than without LBP when vision was removed; and (c) older age and higher BMI had greater adverse impacts on trunk postural control (higher short-term diffusion; longer time and distance coordinates of the critical point) among individuals with than without LBP. IPD meta-regressions indicated no associations between the limited LBP clinical features that could be considered and trunk postural control. Conclusion Trunk postural control appears to be inferior among individuals with LBP, which was indicated by increased seat movements and some evidence of trunk stiffening. These findings are likely explained by delayed or less accurate corrective responses. Systematic review registration This review has been registered in PROSPERO (registration number: CRD42021124658).

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Section: Discussionmentioning

confidence: 99%

Trunk postural control during unstable sitting among individuals with and without low back pain: A systematic review with an individual participant data meta-analysis

Alshehri,

Alzahrani,

van den Hoorn

et al. 2024

PLoS ONE

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“…However, postural control changes in sitting are much less explored. Limited studies have compared the postural control between patients with LBP and pain-free subjects in seated postures with specifically designed sitting surface and force platforms, motion capture systems or inertial sensors [12], [16], [17], [18], [19], [20], [21]. Previous studies have shown inconclusive results.…”

Section: Introductionmentioning

confidence: 99%

Discriminative Changes in Sitting and Standing Postural Steadiness in Patients With Chronic Low Back Pain

Lee,

Liang

2023

IEEE Trans. Neural Syst. Rehabil. Eng.

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Postural control is reduced in patients with low back pain (LBP), which is considered an important factor attributing to the chronicity of LBP and a target for treatment. It is proposed that the changes in postural steadiness in sitting reflect the trunk control better than those in standing, but the previous study results are inconsistent. Thus, this study aimed to compare trunk sway parameters during standing and sitting between patients with chronic LPB (CLBP) and controls using a tracker-based posturography to record the trunk displacement trajectories at the lumbar level (TD L ). A total of 64 participants (32 patients with CLBP and 32 pain-free controls) were included in this study. The postural sway was measured under four conditions, sitting or standing on unstable surface, with eyes open or closed. The TD L parameters were compared between the two groups to explore their discriminative ability. The CLBP group had more body sway than the control group, characterized by several TD L parameters in sitting with eyes closed and standing with eyes open. The TD L parameters with the highest area under the curve according to the receiver operating characteristic curve analysis were the root mean square distance and mean frequency in the medial-lateral direction obtained in the sitting with eyes closed. In conclusion, we confirmed the advantage of using sitting posturographic parameters as a sensitive measure to detect impaired trunk control in patients with CLBP. The results would help choose sensitive outcome measures to reflect the postural control of patients with LBP.

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Validation of proprioception measures of the lumbar spine

Larivière,

Eskandari,

Mecheri

et al. 2024

Journal of Electromyography and Kinesiology

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Stability threshold during seated balancing is sensitive to low back pain and safe to assess

Cited by 5 publications

References 27 publications

Trunk postural control during unstable sitting among individuals with and without low back pain: A systematic review with an individual participant data meta-analysis

Trunk postural control during unstable sitting among individuals with and without low back pain: A systematic review with an individual participant data meta-analysis

Discriminative Changes in Sitting and Standing Postural Steadiness in Patients With Chronic Low Back Pain

Validation of proprioception measures of the lumbar spine

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