Affiliations: [a] Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey | [b] Department of Audiology, Voice and Speech Disorders, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
Correspondence:
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Corresponding author: Cigdem Ayhan, Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, 06100, Samanpazari, Ankara, Turkey. Tel.: +90 3123051576; E-mail:cayhan@hacettepe.edu.tr
Abstract: BACKGROUND: Automatic and voluntary body position control is
essential for postural stability; however, little is known about individual
factors that impair the sensorimotor system associated with low back pain
(LBP). OBJECTIVE: To evaluate automatic and voluntary motor control
impairments causing postural instability in patients with LBP. METHODS: Motor control impairments associated with poor movement
and balance control were analyzed prospectively in 32 patients with LBP.
Numeric Rating Scale (NRS) for pain assessment, Oswestry Disability Index
(ODI) for disability measurement, and computerized dynamic posturography
(CDP) for analysis of postural responses were used to measure outcomes of
all patients. Computerized dynamic posturography tests including Sensory
organization test (SOT), limits of stability test (movement velocity,
directional control, endpoint, and maximum excursion), rhythmic weight shift
(rhythmic movement speed and directional control), and adaptation test
(toes-up and toes-down tests) were performed and the results compared with
NeuroCom normative data. RESULTS: The mean age of the patients was 40.50 ± 12.28 years. Lower equilibrium scores were observed in SOT (p <
0.05). There was a significant increase in reaction time and
decrease in movement velocity, directional control, and endpoint excursion
(p < 0.05). Speed of rhythmic movement along the anteroposterior direction
decreased, while speed increased along the lateral direction (p < 0.05).
Poor directional control was recorded in the anteroposterior direction (p < 0.05). Toes-down test showed an increased COG sway in patients compared with
that in the controls (p < 0.05). CONCLUSIONS: LBP causes poor voluntary control of body positioning,
a reduction in movement control, delays in movement initiation, and a
difficulty to adapt to sudden surface changes.
Keywords: Low back pain, postural stability, balance control, posturography
