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Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
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Decrease in postural sway and trunk stiffness during cognitive dual-task in nonspecific chronic low back pain

Ulrike Van Daele1, Friso Hagman, Steven Truijen

  • 1Department of Health Sciences, Division of Musculoskeletal Physiotherapy, Artesis University College of Antwerp, Antwerp, Belgium. ulrike.vandaele@artesis.be.

Spine
|February 12, 2010
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Summary

Cognitive dual-tasks can reduce postural sway in chronic low back pain patients during difficult balance tasks. This effect is linked to the dual-task

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Area of Science:

  • Biomechanics
  • Neuroscience
  • Clinical Rehabilitation

Background:

  • Postural control relies on integrated cognitive and sensory systems.
  • Cognitive dual-tasking can reveal increased reliance on cognitive resources for balance.
  • Understanding cognitive load's impact on balance is crucial for low back pain management.

Purpose of the Study:

  • To assess the impact of a cognitive dual-task on pelvic and trunk postural sway in chronic low back pain (CLBP) patients during unstable sitting.
  • To compare postural control responses between CLBP patients and healthy controls under dual-task conditions.
  • To investigate the influence of task difficulty on cognitive-motor interference in CLBP.

Main Methods:

  • A 2-group experimental design comparing 21 CLBP patients and 21 healthy controls.
  • Subjects performed two sitting balance tests (easy and difficult) with and without a cognitive dual-task.
  • A 3D motion analysis system quantified trunk and pelvic angular displacement.

Main Results:

  • In the difficult balance condition, healthy controls showed increased postural sway with dual-tasking (significant for 50% of variables).
  • CLBP patients exhibited decreased postural sway with dual-tasking in the difficult condition, though not significantly.
  • Trunk and pelvic sway patterns were similar for both groups; CLBP patients showed reduced trunk-pelvis coordination during dual-tasking.

Conclusions:

  • Cognitive dual-tasking appears to reduce postural sway and trunk stiffness in CLBP patients during difficult balance tasks.
  • This sway reduction in CLBP patients under dual-task conditions may be attributed to attentional distraction.
  • The observed effect is contingent on the difficulty level of the balance task.