Comparison of the reliance of the postural control system on the visual,vestibular and proprioceptive inputs in chronic low back pain patients and asymptomatic participants |
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| Affiliation: | 1. School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC;2. Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC;3. Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran;4. Department of Physical Therapy, College of Medicine, National Cheng Kung University, Taiwan, ROC;5. Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung, Taiwan, ROC;6. School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC;7. Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan, ROC;8. Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC |
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| Abstract: | BackgroundAlthough proprioception deficits have been documented in chronic low back pain (CLBP) patients, little is known about adaptive strategies to provide postural control in these patients. Substitution of unreliable proprioceptive information with other afferents might be considered plausible.Research questionIs the response of the postural control system dependent on the source of sensory afferents being manipulated in persons with and without CLBP?MethodsSixty persons with and without CLBP participated in this cross-sectional study. Center of pressure (COP) displacement range, velocity, path length and area were calculated under four sensory conditions: 1) normal upright standing; 2) upright standing on a foam with eyes open and head in neutral position; 3) upright standing with eyes open and 60° cervical extension and 4) upright standing with eyes closed and 60° cervical extension. A two-way repeated measures analysis of variance was used to compare COP masseurs under different conditions and between the groups.ResultsCLBP patients demonstrated fewer alterations to manipulation of both visual and vestibular afferents in terms of number of COP variables significantly altered. ML range and velocity in both groups and path length in the CLBP group were significantly different between conditions 2 and 4. In both groups, all COP variables except AP range increased significantly in condition 2 compared to conditions 1and 3 (p < 0.001). AP velocity was the only variable to be different between conditions 1 and 3 in both CLBP (p = 0.025) and control (p < 0.001) groups. Between group differences were significant on AP velocity (p = 0.019).SignificanceNo overweighting was observed in the vestibular or visual afferents in CLBP patients. Compensatory strategies seem to lie within proprioceptive system by reweighting afferents from different body segments. The postural control system behaved more robustly in CLBP patients while AP COP velocity was found as the most sensitive and discriminating parameter. |
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| Keywords: | Chronic low back pain Postural control Proprioception Center of pressure Sensory manipulation |
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