Abstract
Objectives To explore the relationship between postural control and pain-related clinical outcomes in patients with chronic nonspecific low back pain (cNLBP). Methods Participants with cNLBP and healthy individuals were recruited. Muscle activities were recorded during internal and external perturbation tasks. Postural control capacity was assessed by muscle onset time and integrals of electromyography (iEMGs) of postural muscles during the phases of anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs). Correlation analysis was employed to investigate the relationship between postural control capacity, pain, and disability. Results Twenty-seven patients with cNLBP and 27 healthy participants were recruited. Gastrocnemius (GA) muscle onset time was earlier in the cNLBP group than in the control group in the internal perturbation task. The onset time of GA and erector spinae (ES) of the cNLBP group was later than that of the controls in the external perturbation task. Disability level moderately correlated with the iEMGs of rectus abdominis (RA), GA, and external oblique (EO) during APAs. Pain score moderately correlated with the iEMGs of RA, EO, and ES during CPAs of perturbation tasks. Conclusion cNLBP participants had altered muscle activation strategy to maintain postural stability in response to perturbation. This study further discovered that pain-related disabilities of cNLBP participants were likely related to the APAs capacity, whereas the pain intensity may relate to the CPAs capacity. Pain and disability may therefore be related to the control process of the posture-related muscles.
Highlights
Chronic low back pain is a common health problem that causes heavy social and economic burden [1]
Among 76% of people with Chronic low back pain (cLBP) were diagnosed with chronic nonspecific low back pain. cNLBP is characterized by pain sensation that appears between the 12th rib and the hip with or without leg pain [1]. e exact mechanism that contributes to cNLBP remains unknown, and there continues to be a debate surrounding which biological marker may contribute to the reoccurrence of pain
Pain Research and Management resulted in suboptimal load placed on the passive tissues of the spine during movement and impaired balance function, which contribute to symptoms occurrence [3, 4]. e ability to maintain balance is related to postural control adjustments, which could be broadly classified as anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) [5, 6]
Summary
Chronic low back pain (cLBP) is a common health problem that causes heavy social and economic burden [1]. Among 76% of people with cLBP were diagnosed with chronic nonspecific low back pain (cNLBP). Among numerous proposed theories, altered motor control is commonly reported as a contributing factor to the persistence of pain [2]. Altered motor control often refers to the activation timing of the core muscles, e.g., transverse abdominus, in response to a postural perturbation task. E ability to maintain balance is related to postural control adjustments, which could be broadly classified as anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) [5, 6]. CPA is comparable to the feedback control, which is a bottom-up control in response to imperative perturbation [7]
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