People with chronic low back pain have poorer balance than controls in challenging tasks

Abstract

Purpose: To compare the balance of individuals with and without chronic low back pain during five tasks.

Method: The participants were 20 volunteers, 10 with and 10 without nonspecific chronic low back pain, mean age 34 years, 50% females. The participants completed the following balance tasks on a force platform in random order: (1) two-legged stance with eyes open, (2) two-legged stance with eyes closed, (3) semi-tandem with eyes open, (4) semi-tandem with eyes closed and (5) one-legged stance with eyes open. The participants completed three 60-s trials of tasks 1–4, and three 30-s trials of task 5 with 30-s rests between trials. The center of pressure area, velocity and frequency in the antero-posterior and medio-lateral directions were computed during each task, and compared between groups and tasks.

Results: Participants with chronic low back pain presented significantly larger center of pressure area and higher velocity than the healthy controls (p < 0.001). There were significant differences among tasks for all center of pressure variables (p < 0.001). Semi-tandem (tasks 3 and 4) and one-leg stance (task 5) were more sensitive to identify balance impairments in the chronic low back pain group than two-legged stance tasks 1 and 2 (effect size >1.37 vs. effect size <0.64). There were no significant interactions between groups and tasks.

Conclusions: Individuals with chronic low back pain presented poorer postural control using center of pressure measurements than the healthy controls, mainly during more challenging balance tasks such as semi-tandem and one-legged stance conditions.

Implications for Rehabilitation

• People with chronic low back had poorer balance than those without it.

• Balance tasks need to be sensitive to capture impairments.

• Balance assessments during semi-tandem and one-legged stance were the most sensitive tasks to determine postural control deficit in people with chronic low back.

• Balance assessment should be included during rehabilitation programs for individuals with chronic low back pain for better clinical decision making related to balance re-training as necessary.

Keywords:

• Posture
• spine
• biomechanics
• rehabilitation
• low back pain

Acknowledgements

This study from a large research project supported by National Counsel of Technological and Scientific Development - CNPq, Brazil (Process# 477467/2013-0). Also, Dr. Rubens da Silva was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES, Brazil (Process# BEX 3084/15-9) from a senior postdoctoral fellowship in the Florida International University (Miami, FL, USA) for analysis of this study. We gratefully acknowledge the assistance of physical therapy students and research agents of the university (UNOPAR) for recruitment of subjects and data collection.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This study from a large research project supported by National Counsel of Technological and Scientific Development – CNPq, Brazil (Process# 477467/2013-0). Also, Dr. Rubens da Silva was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – CAPES, Brazil (Process# BEX 3084/15-9) from a senior postdoctoral fellowship in the Florida International University (Miami, FL, USA) for analysis of this study. We gratefully acknowledge the assistance of physical therapy students and research agents of the university (UNOPAR) for recruitment of subjects and data collection.