Persons with recurrent low back pain exhibit a rigid postural control strategy.
Simon Brumagne1, Lotte Janssens, Stefanie Knapen
1Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven (K.U.Leuven), Tervuursevest 101, 3001 Leuven, Belgium. simon.brumagne@faber.kuleuven.be
Summary
Individuals with recurrent low back pain (LBP) rely heavily on ankle proprioception for postural control, even on unstable surfaces. This consistent ankle strategy may contribute to spinal loading and pain recurrence.
Area of Science:
- Biomedical Engineering
- Neuroscience
- Physical Therapy
Background:
- Recurrent low back pain (LBP) is associated with altered proprioceptive postural control.
- Patients with LBP often exhibit trunk stiffening and increased reliance on ankle proprioception for balance.
Purpose of the Study:
- To investigate the effect of varying postural conditions (stable vs. unstable surfaces) on postural stability and control strategies in individuals with recurrent LBP.
Main Methods:
- Evaluated postural sway in 21 individuals with recurrent LBP and 24 healthy controls.
- Tested upright posture on stable and foam surfaces under conditions of no vibration, triceps surae vibration, paraspinal muscle vibration, and tibialis anterior vibration.
- Vision was occluded during most trials; vibration stimuli targeted muscle spindles.
Main Results:
- Individuals with recurrent LBP demonstrated a significantly greater reliance on ankle muscle proprioceptive control compared to paraspinal control on both stable (0.83 vs. 0.67) and unstable (0.87 vs. 0.46) surfaces.
- This ankle-dominant strategy was consistent across different postural conditions.
Conclusions:
- Young individuals with recurrent LBP consistently employ an ankle-dominant proprioceptive strategy, irrespective of the postural challenge.
- This strategy, while potentially effective in simple conditions, may be maladaptive on unstable surfaces, potentially contributing to spinal loading and pain recurrence.
