Abstract
Purpose Pain catastrophizing may contribute to the altered trunk muscle activity in patients with nonspecific chronic low back pain (NSCLBP). It is unclear if pain catastrophizing influences static postural control in patients with NSCLBP. This study aimed to investigate the relationship between pain catastrophizing and static postural control in NSCLBP patients. Methods Sixty-eight participants with NSCLBP and 40 healthy participants were recruited. Postural control was assessed by the sway area and the sway length of the center of pressure (COP) during balance tests. Pain catastrophizing in participants with NSCLBP was assessed by the Pain Catastrophizing Scale (PCS). Bilateral transversus abdominis (TrA) activation was evaluated by ultrasound imaging-measured percent change in muscle thickness. Associations between COP parameter and PCS/subscales of PCS were examined by multiple linear regression (MLR). Results Our results observed a larger COP sway area in NSCLBP group under eyes-closed condition (p < 0.001) and a lower level of voluntary activation of the bilateral TrA (p < 0.001), compared with the healthy control group. The MLR analyses revealed that the COP area sway under eyes-closed condition was significantly associated with the PCS score/helplessness score of PCS, voluntary activation of the left TrA, and age in participants with NSCLBP (β = 0.222/0.236, 0.341/0.344, and 0.328/0.325; p=0.045/0.033, 0.002, and 0.004, resp.). Conclusions Static postural control was associated with pain catastrophizing, voluntary activation of TrA, and age in participants with NSCLBP. This indicated that pain catastrophizing may affect postural control and should be considered when interpreting balance test results and managing NSCLBP.
Highlights
Chronic low back pain (LBP) is considered as the leading cause of disability
nonspecific LBP (NSCLBP) is multidimensional in nature, with various factors contributing to its onset and persistence [2]. e negative cognitive-emotional factors predispose the person into the development of LBP [3]. e strengthened corticostriatal functional connectivity may contribute to the transition of acute LBP to chronic LBP [4], and the motor control alteration may play a role in the persistence or chronification of LBP [2]
A total of 92 patients were excluded due to the following reasons: 11 patients were not diagnosed with NSCLBP; 33 patients did not meet the criteria for duration of symptoms or severity of pain; 5 patients were excluded for history of surgery; 6 patients were excluded for cardio-cerebrovascular disease; 2 patients were excluded for history of cancer; 2 patients were excluded for cognitive deficits and difficulties in communication; 1 patient was excluded for body mass index (BMI) above 30; 22 patients were unable to participate because of location and time conflicts; and 10 patients declined to participate. e study included 68 participants with NSCLBP and 40 age- and sex-matched healthy controls
Summary
Chronic low back pain (LBP) is considered as the leading cause of disability. E strengthened corticostriatal functional connectivity may contribute to the transition of acute LBP to chronic LBP [4], and the motor control alteration may play a role in the persistence or chronification of LBP [2]. Among these factors, trunk postural control impairment has been suggested to be a contributing factor to NSCLBP [2, 5]. Postural control is responsible for spine stability, posture, and movement It is fundamental for bearing loads and avoiding injury and pain [2].
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