Young individuals with a more ankle-steered proprioceptive control strategy may develop mild non-specific low back pain

Abstract

Altered proprioceptive postural control has been demonstrated in people with non-specific low back pain (LBP). However, the cause-effect relation remains unclear. Therefore, more prospective studies are necessary. Proprioceptive postural control of 104 subjects was evaluated at baseline using a force plate and with application of vibration stimulation on ankle and back muscles. Spinal postural angles were measured with digital photographs. Psychosocial variables and physical activity were registered using questionnaires. Ninety subjects were followed over two years concerning their LBP status, 14 were lost to follow-up. Four distinct groups were determined after two years based on pain and disability scores: never LBP, no LBP at intake with future mild LBP, mild LBP at intake with no further LBP, LBP at intake with further episodes of mild LBP. Risk factors for developing or sustaining LBP were calculated using logistic regression analysis. A more ankle-steered proprioceptive postural control strategy in upright standing increased the risk for developing or having recurrences of mild LBP within two years (Odds: 3.5; 95% CI: 1.1-10.8; p < 0.05). Increased postural sway, altered spinal postural angles, psychosocial and physical activity outcomes were not identified as risk factors for future mild LBP. These findings could contribute to improving the prevention and rehabilitation of LBP.

The development of the Dutch version of the Fremantle Back Awareness Questionnaire

“…This might be obvious because the questionnaire is especially developed for individuals 'with' LBP (for which the internal consistency was found to be sufficient) and not for those without. As item 4, 5 and 6 are specifically related to lumbar proprioceptive acuity, we recommend further studies to further reveal potential independence of this feature, for example by use of local muscle vibration (Brumagne et al, 2000;Brumagne et al, 2008;Claeys et al, 2011;Claeys et al, 2015). Also, we recommend future studies to perform a confirmatory factor analysis as there are only few language versions of the FreBAQ available at this point (English and Japanese).…”

Proprioceptive use and sit-to-stand-to-sit after lumbar microdiscectomy: The effect of surgical approach and early physiotherapy

“…1): transmuscular surgery + physiotherapy (n = 6), transmuscular surgery + usual care (n = 6), paramedian surgery + physiotherapy (n = 6), and paramedian surgery + usual care (n = 7). These groups were clustered by a mixed group design because power analysis (Brumagne et al, 2008;Claeys et al, 2011Claeys et al, , 2012Claeys et al, , 2015Janssens et al, 2015) revealed a sample size of 11 participants to provide adequate power (0.80 with a two-tailed alpha level of 0.05) to detect a clinically relevant difference in center of pressure displacement on unstable support surface (our primary outcome measure with smallest effect size). First, they were randomly allocated (blinded by computer algorithm) for surgical approach into a transmuscular group (n = 12; 7 women/5 men) and paramedian group (n = 13; 7 women/6 men).…”

“…The amount of this center of pressure displacement represents the extent to which an individual makes use of the proprioceptive signals of the vibrated muscles to maintain the upright posture. Muscle vibrators (Maxon motors, Switzerland) were applied bilaterally over the triceps surae ('ankle') muscles and lumbar paraspinal ('back') muscles, as studied previously (Brumagne et al, 2008;Claeys et al, 2011Claeys et al, , 2012Claeys et al, , 2015Janssens et al, 2015). Participants were instructed to stand barefoot on the force plate, with their arms relaxed along the body and occluded vision.…”

“…'Abs ankle' is the absolute value of the mean center of pressure displacement during ankle muscle vibration and 'Abs back' during back muscle vibration. An RPW score equal to 1 corresponds to 100% reliance on ankle muscle proprioception, whereas a score equal to 0 corresponds to 100% reliance on back muscle proprioception (Brumagne et al, 2008;Claeys et al, 2011Claeys et al, , 2012Claeys et al, , 2015Janssens et al, 2015).…”

“…A possible mechanism for this is reduced lumbosacral proprioception. When lumbosacral proprioceptive signals lose reliability due to LBP, individuals are likely to rely dominantly on ankle proprioceptive signals, irrespective of the postural demands (Brumagne et al, 2008;Claeys et al, 2011Claeys et al, , 2015. Consensus on the effect of lumbar surgery on postural control is lacking.…”