Title: Low back pain and postural control : effects of task difficulty on COP and spinal kinematics
Authors : Schelldorfer, Sarah
Ernst, Markus
Rast, Fabian
Bauer, Christoph
Meichtry, André
Kool, Jan
Conference details: 8. Physiocongress, Berne, 13 - 14 June 2014
Issue Date: 2014
License (according to publishing contract) : Licence according to publishing contract
Type of review: Not specified
Language : English
Subjects : Kinematics; Postural control
Subject (DDC) : 615.82: Physical therapy
617.5: Orthopaedic surgery
Abstract: Introduction Postural control strategies are described as feedback mechanism derived by the interaction of sensory input and adapted motor output. Postural control strategies on firm ground with open eyes predominantly use peripheral or ankle strategies for the sagittal plane. In contrast the frontal plane control-mechanisms are described as proximal or hip loading/unloading strategies. Aim The aim of this study was to examine the sway of the thoracic and lumbar spine, the hip and Centre of pressure (COP) during three standing tasks conditions with increasing PC requirements in patients with Non Specific Low Back Pain (NSLBP) and asymptomatic controls Methods Included were patients with NSLBP for longer than 4 weeks with at least moderate disability, defined as an Oswestry-disability-index (ODI) >8% and a low level of having biopsychosocial risk factors defined with less than 4 points in the STarT Back Screening tool and asymptomatic healthy controls. Subjects were asked to stand stable, arms crossed in front of the chest, in three different conditions in a fixed order of increasing requirements on PC adaptation: feet together, hard surface, eyes open = (Open-hard) feet together, hard surface, blindfolded = (Blind-hard) feet together on foam, blindfolded = (Blind-Foam) Standing tasks lasted one minute and were repeated three times, for each condition. Results Fifty-seven patients with NSLBP and 22 asymptomatic controls from Winterthur area (Switzerland) were included. Mean absolute deviation of position (MADpos) showed larger between-group differences than Mean absolute deviation of velocity (MADvel). Patients with NSLBP had generally greater MADpos and higher MADvel than asymptomatic controls.These differences reached statistical significance for MADpos in the lumbar spine in the frontal plane (Relative change -0.19). There were three interaction effects (condition x group), all for the frontal plane (Figure). Asymptomatic controls and NSLBP patients showed significantly different strategies, when they changed from condition 1(Open-Hard) to condition 2 (Blind-Hard) for the MADpos of the thoracic (Relative change: -0.23) and lumbar spine (Relative change: -0.23) (Figure). MADvel of the thoracic spine was significantly lower in asymptomatic controls then in subjects with NSLBP (Relative change: -0.12). There were no significant interaction effects in MADpos and MADvel in the sagittal plane for the spinal, hip and COP parameters. Gender, Pain intensity and age affected the results significantly. Discussion: These results indicate that NSLBP patients need adaptive PC strategies using trunk movements, while in control subjects hip loading/unloading strategies, with a more stable trunk, suffices.
Departement: Gesundheit
Organisational Unit: Institute of Physiotherapy (IPT)
Publication type: Conference Poster
URI: https://digitalcollection.zhaw.ch/handle/11475/8955
Appears in Collections:Publikationen Gesundheit

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