Targeting coordination: How focus of attention influences spinal movement control in low back pain
Cathrine H Feier1, Stephen H M Brown1
1Department of Human Health Sciences, University of Guelph, Guelph, ON, Canada.
Background:
People with low back pain often demonstrate movement pattern and motor control differences compared to asymptomatic individuals. These differences can include both high and low levels of lumbar coordination variability. The ability to modulate coordination variability could be helpful in rehabilitation settings, but specific methods need to be investigated.
Methods:
This study used marker-based motion capture and a modified vector coding procedure to assess lumbar coordination variability. 25 asymptomatic controls and 15 individuals with low back pain performed three trials (baseline, visual cue, ball) each consisting of 15 standing body-weight squats. The visual cue trial included instructions to focus on a small visual cue on the wall while performing squats. The ball trial required participants to perform squats while simultaneously focusing on throwing a small ball back and forth between the right and left hands without dropping it.
Findings:
Lumbar coordination variability was not significantly different between the control and low back pain groups, and not significantly different between the baseline (15.3° ± 0.7°) and visual cue (15.3° ± 0.7°) trials. There was a significant increase during the ball (18.9° ± 1.0°; p < .001) trial compared to baseline. While most participants displayed greater variability during the ball trial than at baseline, a few individuals with low back pain and high baseline variability levels displayed decreased variability during the ball trial.
Interpretation:
Throwing a ball while performing squats can immediately increase lumbar coordination variability, but fixing the gaze on a visual cue does not significantly change lumbar coordination variability.
