Ann Rehabil Med.  2013 Feb;37(1):17-25. 10.5535/arm.2013.37.1.17.

Effects of Acute Low Back Pain on Postural Control

• Sohn MK
• Lee SS
• Song HT

• KMID: 2266646
• DOI: http://doi.org/10.5535/arm.2013.37.1.17

Abstract

OBJECTIVE
To evaluate the changes in static and dynamic postural control after the development of acute low back pain.
METHODS
Thirty healthy right-handed volunteers were divided into three groups; the right back pain group, the left back pain group, and the control group. 0.5 mL of 5% hypertonic saline was injected into L4-5 paraspinal muscle for 5 seconds to cause muscle pain. The movement of the center of gravity (COG) during their static and dynamic postural control was measured with their eyes open and with their eyes closed before and 2 minutes after the injection.
RESULTS
The COGs for the healthy adults shifted to the right quadrant and the posterior quadrant during their static and dynamic postural control test (p<0.05). The static and dynamic instability index while they had their eyes closed was significantly increased than when they had their eyes open with and without acute back pain. After pain induction, their overall and anterior/posterior instability was increased in both the right back pain group and the left back pain group during the static postural control test (p<0.05). A right deviation and a posterior deviation of the COG still remained, and the posterior deviation was greater in the right back pain group (p<0.05).
CONCLUSION
The static instability, particularly the anterior/posterior instability was increased in the presence of acute low back pain, regardless of the visual information and the location of pain.

Keyword

Low back pain; Postural control; Balance

MeSH Terms

Adult
Back Pain
Eye
Gravitation
Humans
Low Back Pain
Muscles

Figure

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  Fig. 1 Dynamic postural stability test. When subject's center of gravity was deviated to one side, the foot plate began to tilt to the same side.

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  Fig. 2 The result sheet of the postural stability test. Movement from the center of gravity can be seen in the green trace line. Overall, anterior/posterior, medial/lateral instability indexes, and percentage of time in the quadrant were measured.

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  Fig. 3 The static and dynamic postural stability test showed that the proportion of the center of gravity was significantly deviated to the right side compared to the left side (A), and to the posterior side compared to the anterior side (B). p<0.05 by independent t-test.

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  Fig. 4 The overall, anterior/posterior (AP), and medial/lateral (ML) instability indexes increased significantly with eyes closed than with eyes open during the static (A) and the dynamic postural stability test (B). *p<0.05 by paired t-test.

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  Fig. 5 Instability index after induction of the experimental low back pain increased significantly in the static postural stability test and in the overall instability (A), anterior/posterior instability test (B), and medial/lateral instability (C) compared to those of preinjection. *p<0.05.

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  Fig. 6 The postural deviation toward the right side still existed even after induction of the experimental low back pain in the static postural control test (A). Interestingly, the right low back pain group (B) showed greater posterior side deviation after induction of the pain during the static postural stability test. *p<0.05.

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