A kinematic analysis of relative stability of the lower extremities between subjects with and without chronic low back pain

Abstract

Even though a number of studies have evaluated postural adjustments based on kinematic changes in subjects with low back pain (LBP), kinematic stability has not been examined for abnormal postural responses during the one leg standing test. The purpose of this study was to evaluate the relative kinematic stability of the lower extremities and standing duration in subjects with and without chronic LBP. In total, 54 subjects enrolled in the study, including 28 subjects without LBP and 26 subjects with LBP. The average age of the subjects was 37.8±12.6years and ranged from 19 to 63years. The outcome measures included normalized holding duration and relative kinematic stability. All participants were asked to maintain the test position without visual input (standing on one leg with his/her eyes closed and with the contra lateral hip flexed 90°) for 25s. The age variable was used as a covariate to control confounding effects for the data analyses. The control group demonstrated significantly longer holding duration times (T=-2.78, p=0.007) than the LBP group (24.6±4.2s vs. 20.5±6.7s). For the relative kinematic stability, there was a difference in dominance side (F=9.91, p=0.003). There was a group interaction between side and lower extremities (F=11.79, p=0.001) as well as an interaction between age and dominance side (F=7.91, p=0.007). The relative kinematic stability had a moderate negative relationship with age (r=-0.60, p=0.007) in subjects without LBP. Clinicians need to understand the effects of age and relative stability, which decreased significantly in the single leg holding test, in subjects with LBP in order to develop effective rehabilitation strategies.