Low back pain development differentially influences centre of pressure regularity following prolonged standing

Occupations requiring prolonged periods of static standing are associated with the development of low back pain (LBP). Certain individuals are susceptible to LBP development during prolonged standing (pain developers, PDs) while others are not (non-pain developers, NPDs). Linear centre of pressure (COP) measures suggest that standing balance control is negatively influenced following prolonged standing, and that PDs and NPDs may be differentially affected. The objective of this study was to determine if nonlinear standing balance control, quantified on COP, using sample entropy, is altered after 2-h of standing. Thirty two participants stood for 2-h. Separate 2-min standing trials, performed with eyes open and eyes closed, were collected before and after the 2-h standing protocol. Sample entropy, median power frequency and RMS amplitude of the COP time-series, was calculated from the 2-min standing trials for all participants. For comparison, participants were classified, post hoc, as PDs or NPDs according to visual analog scale pain scores. Sample entropy decreased after 2-h of standing for both PDs and NPDs, however, the decrease for NPDs was only 21% of the decrease observed in PDs. This study demonstrated that nonlinear control of upright standing changes after 2- hours of standing, resulting in an increase in COP regularity post 2- hours of standing for both PDs and NPDs. PDs displayed a greater change in COP regularity, which is supported by the theory that increased COP regularity occurs with pain/pathology.