Abstract
The literature shows that low back pain causes a reduced lumbar range of movement, affecting patients’ proprioception and motor control. Nevertheless, studies have found that proprioception and motor control of the spine and posture are vague and individually expressed even in healthy young adults. This study aimed to investigate the standing posture and its modifications induced by an instinctive self-correction manoeuvre in subacute and chronic nonspecific low back pain (NSLBP) patients to clarify how NSLBP relates to body upright posture, proprioception, and motor control and how these are modified in patients compared to healthy young adults (121 healthy young adults: 57 females and 64 males). A cohort of 83 NSLBP patients (43 females, 40 males) were recruited in a cross-sectional observational study. Patients’ entire body posture, including 3D spine shape reconstruction, was measured using a non-ionising 3D optoelectronic stereophotogrammetric approach. Thirteen quantitative biomechanical parameters describing the nature of body posture were computed. The statistical analysis was performed using multivariate methods. NSLBP patients did not present an altered proprioception and motor control ability compared to healthy young adults. Furthermore, as for healthy subjects, NSLBP patients could not focus and control their posture globally. Proprioception and motor control in natural erect standing are vague for most people regardless of gender and concurrent nonspecific low back pain. Self-correction manoeuvres improving body posture and spine shape must be learned with specific postural training focusing on the lumbar spine.
Highlights
Introduction published maps and institutional affilThe problem of “low back pain” (LBP) involves an ever-increasing percentage of the population, with the potential for further high growth due to the progressive increase in the average age [1,2,3,4]
Except for the above-summarised essential anatomical–structural difference found in the nonspecific low back pain (NSLBP) sample, patients did not present an altered proprioception and motor control ability compared to healthy young adults
The following behaviours previously recognised in healthy young adults were found in the NSLBP group: self-correction manoeuvre leading to a global improvement of standing natural erect posture was not instinctive, but had to be learned with specific postural training; subjects could not focus and control their posture in a global way, but only in a few aspects at a time; participants showed better “attention” to the sagittal plane but with substantial neglect of the spine’s lumbar tract; the postural changes of the instinctive self-correction manoeuvre (ISCO) manoeuvre rarely induced a better posture than indifferent orthostasis (IO)
Summary
Introduction published maps and institutional affilThe problem of “low back pain” (LBP) involves an ever-increasing percentage of the population, with the potential for further high growth due to the progressive increase in the average age [1,2,3,4]. The World Health Organisation (WHO) report indicates that, throughout life, NSLBP patients have a high prevalence worldwide, reaching 60–70%. In developed countries [6], with a strong economic and social effect being the leading cause of activity limitation and absence from work worldwide [2,4,5,7,8,9]. Recent guidelines have put minor emphasis on pharmacological and surgical treatments [3,4,5], while they promote postural self-awareness through exercises to provide the patients with the proper physical and proprioceptive tools for an early return to activity as the first-line treatment [3,10]. Recent guidelines have put minor emphasis on pharmacological and surgical treatments [3,4,5], while they promote postural self-awareness through exercises to provide the patients with the proper physical and proprioceptive tools for an early return to activity as the first-line treatment [3,10]. iations.
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