Lumbar Proprioception Research Articles

Validation of proprioception measures of the lumbar spine

BackgroundTo better personalize treatment and monitor recovery of individuals with low back pain, objective tests of sensorimotor functions, such as lumbar proprioception, must be selected based on their reliability and validity. The primary objective of this study was to test the concurrent validity of three measures of lumbar proprioception. MethodsThirty-one participants performed three lumbar proprioception tests (motion perception threshold, active and passive joint positioning sense), a whole-body mobility and balance (time up-and-go) and two trunk-specific postural control (threshold of stability and sensor-based sway measures) tests. ResultsOnly the motion perception threshold proprioception test showed some validity, correlating with the trunk-specific postural control tests [r range (positive values): 0.37 to 0.60]. The three lumbar proprioception measures were not correlated to each other. The threshold of stability measure was correlated with the time up-and-go (r = 0.37) and trunk-specific (sensor-based sway measures) postural control [r range (positive values): 0.48 to 0.77] tests. ConclusionThe present study generated three original findings. Only the motion perception threshold proprioception test demonstrated its concurrent validity. In fact, the three lumbar proprioception tests performed in the present study were not correlated to each other, thus assessing different constructs. Finally, the threshold of stability protocol was validated against other tests. These findings will help in selecting the most appropriate lumbar proprioception measures to study the effects of exercise treatments in patients with back pain.

Assessment of the Acute Effects of Wearable Sensor Derived Auditory Biofeedback on Gross Lumbar Proprioception

Lower back disorders (LBDs) affect a large proportion of the population, and treatment for LBDs have been shifting toward individualized, patient-centered approaches. LBDs are typically associated with poor proprioception. Therefore, there has been a recent uptake in the utilization of wearable sensors that can administer biofeedback in various industrial, clinical, and performance-based settings to improve lumbar proprioception. The aim of this study was to investigate whether wearable sensor-derived acute auditory biofeedback can be used to improve measures of gross lumbar proprioception. To assess this, healthy participants completed an active target repositioning protocol, followed by a training period where lumbar-spine posture referenced auditory feedback was provided for select targets. Target re-matching abilities were captured before and after acute auditory biofeedback training to extract measures related to accuracy and precision across spine flexion targets (i.e., 20%, 40%, 60%, 80% maximum). Results suggest a heterogenous response to proprioceptive training whereby certain individuals and spine flexion targets experienced positive effects (i.e., improved accuracy and precision). Specifically, results suggest that mid-range flexion targets (i.e., 40-60% maximum flexion) benefited most from the acute auditory feedback training. Further, individuals with poorer repositioning abilities in the pre-training assessment showed the greatest improvements from the auditory feedback training.

The associations between lumbar proprioception and postural control during and after calf vibration in people with and without chronic low back pain.

The relationships of lumbar proprioception with postural control have not been clarified in people with chronic low back pain. This study aimed to compare the associations between lumbar proprioception and postural control in response to calf vibration in individuals with and without chronic low back pain. In this study, we recruited twenty patients with chronic low back pain (CLBP group) and twenty healthy control subjects (HC group) aged between 18 and 50 years. This study was a cross-sectional study and completed from May 2022 to October 2022. The passive joint repositioning sense (PJRS) test for two positions (15° and 35°) were used to assess lumbar proprioception and expressed as the mean of reposition error (RE). Postural control was tested by adding and removing calf vibration while standing on a stable force plate with eyes closed. The sway velocity in the anterior-posterior (AP) direction of center of pressure (COP) data with a window of 15s epoch at baseline, during and after calf vibration was used to evaluate postural control. Mann-Whitney U-tests were used to compare the difference of lumbar proprioception between two groups, and the independent t-tests were used to compare the difference of postural control at baseline and during vibration, and a mixed design ANOVA was used to compare the difference of postural control during post-perturbation. In addition, to explore the association between postural control and lumbar proprioception and pain intensity, Spearman's correlations were used for each group. The major results are: (1) significantly higher PJRS on RE of 15° (CLBP: 95% CI [2.03, 3.70]; HC: 95% CI [1.03, 1.93]) and PJRS on RE of 35° (CLBP: 95% CI [2.59, 4.88]; HC: 95% CI [1.07, 3.00]) were found in the CLBP group; (2) AP velocity was not different between the CLBP group and the HC group at baseline and during calf vibration. However, AP velocity was significantly larger in the CLBP group compared with the HC group at epoch 2-14 after calf vibration, and AP velocity for the CLBP group took a longer time (23 epochs) to return to the baseline after calf vibration compared with the HC group (9 epochs); (3) lumbar proprioception represented by PJRS on RE of 15°correlated negatively with AP velocity during and after vibration for the HC group. Within the CLBP group, no significant relationships between PJRS on RE for two positions (15° and 35°) and AP velocity in any postural phases were found. In conclusion, the CLBP group has poorer lumbar proprioception, slower proprioceptive reweighting and impaired postural control after calf vibration compared to the HC group. Lumbar proprioception offers different information on the control strategy of standing control for individuals with and without CLBP in the situations with proprioceptive disturbance. These results highlight the significance of assessing lumbar proprioception and postural control in CLBP patients.

Comparative Effects of Dynamic Neuromuscular Stabilization Exercises on Lumbar Proprioception, Movement Control and Functional Activity Limitation in Movement Control Impairment Subgroup of Non-Specific Chronic Low Back Pain: RCT Interim Analysis

Comparative Effects of Dynamic Neuromuscular Stabilization Exercises on Lumbar Proprioception, Movement Control and Functional Activity Limitation in Movement Control Impairment Subgroup of Non-Specific Chronic Low Back Pain: RCT Interim Analysis

Investigating the lumbar proprioception and core muscles recruitment pattern while getting up from a chair with weight lifting in patients with chronic functional constipation: cross-sectional study.

Patients with chronic functional constipation have some problems such as weakness of pelvic floor muscles, and a lack of coordination of pelvic floor and abdominal muscles has been seen. The goal of this study was to investigate the lumbar proprioception and the core muscle recruitment pattern. The study type is a cross-sectional case-control study. There were 30 participants (case, n= 15, and control, n= 15). Electromyography of the core muscles was recorded while the subjects were getting up from the chair accompanied by lifting a weight, to check the pattern of muscle recruitment. Moreover, the lumbar proprioception was evaluated by an isokinetic device in both groups. The study was analyzed using independent t test and Mann-Whitney U test, and a nonparametric Friedman test was performed followed by Bonferroni pairwise comparison. The comparison of muscle activity delay between the two groups showed that there was a significant difference between the two groups regarding the abdominal muscles, anal sphincter, and erector spinae (p< 0.05). However, there was no significant difference in the rectus femoris and gluteal muscles between the two groups (p> 0.05). Moreover, the proprioception of the lumbar region showed a significant difference (p< 0.05) between the two groups. The results of this study demonstrated that the lumbar proprioception sense was reduced in the case group. This result can be justified, based on the problems in constipation (lack of coordination of muscles, weakness of pelvic floor muscles). The coordination of core muscles changed in patients with chronic functional constipation during a functional task.

A Cross-Sectional Study Investigating Lumbar Proprioception Impairments in Individuals with Type 2 Diabetes Mellitus: Correlations with Glycated Hemoglobin Levels.

Impaired proprioception is a recognized complication in individuals with type 2 diabetes mellitus (T2DM), contributing to balance deficits and increased risk of falls. However, limited research has focused on lumbar proprioception in this population. This study aimed to investigate lumbar proprioception in individuals with T2DM, as well as healthy individuals. Additionally, this study aimed to examine the correlation between lumbar proprioception and glycated hemoglobin (HbA1c) levels, which is a marker of long-term glycemic control in T2DM. A cross-sectional study was conducted, comparing lumbar joint reposition errors (JRE) between a T2DM group (n = 85) and a healthy group (n = 85). Lumbar JRE was assessed in flexion, extension, lateral bending left, and lateral bending right using a dual inclinometer device. HbA1c levels were measured as an indicator of glycemic control. Significant differences in lumbar JRE were found between the T2DM and healthy groups, with individuals with T2DM exhibiting larger JRE values, indicating impaired lumbar proprioception (p < 0.001). The correlation analysis revealed significant positive associations between HbA1c levels and lumbar JRE. Higher HbA1c levels were correlated with greater joint JRE in flexion (r = 0.49, p < 0.001), extension (r = 0.51, p < 0.001), left lateral bending (r = 0.45, p < 0.001), and right lateral bending (r = 0.48, p < 0.001) in the T2DM group. This study provides evidence of impaired lumbar proprioception in individuals with T2DM, as evidenced by larger lumbar JRE compared to the healthy group.

Reducing Lumbar Flexion in a Repetitive Lifting Task: Comparison of Leukotape and Kinesio Tape and Their Effect on Lumbar Proprioception

Rigid leukotape applied to the skin of the trunk dorsum, superficial to the lumbar paraspinals, has been shown to reduce lumbar flexion in repetitive lifting, with the potential to reduce the risk of injury in jobs requiring the handling of material. It is unclear which mechanism underpins this reduction, and whether a tape with more elastic properties (i.e., kinesio tape) can yield similar results. In this study, twelve participants were randomly allocated into two groups, and practiced a repetitive lifting task with either leukotape or kinesio tape applied to the skin of their trunk dorsum. The participants also performed a sagittal plane repositioning task to assess changes in lumbar proprioception. The results showed a small reduction in lumbar flexion in the kinesio tape group and a moderate reduction in the leukotape group, and suggested a reduction in repositioning errors in the kinesio tape group only. We suggest that leukotape may correct the movement and improve performance during a flexion-based task, while kinesio tape may improve lumbar proprioception and promote learning. These results have implications for the choice and use of wearable textiles aiming to reduce injury risks in the manual handling industry.

Acute effects of thoracolumbar fascia release techniques on range of motion, proprioception, and muscular endurance in healthy young adults

PurposeThis study investigates the acute effects of Graston and myofascial release on thoracolumbar fascia (TLF) on lumbar range of motion (ROM), lumbar and cervical proprioception, and trunk muscle endurance in healthy young adults. MethodTwenty-four healthy young individuals were included in the study. Individuals were randomly divided into two groups as Graston technique (GT) (n = 12) and myofascial release (MFR) (n = 12). GT group received a fascial treatment with a graston instrument and the MFR group (n = 12) received manual myofascial treatment. Both techniques were applied for 10 min and as a single session. Lumbar ROM (goniometer), lumbar proprioception (digital inclinometer), cervical proprioception (CROM device), and trunk muscle endurance (with McGill Endurance Test) were evaluated before and after treatment. ResultsAge, gender and body mass index of individuals in both groups were similar (p > 0.05). In both GT and MFR groups, an increase in ROM in the flexion direction (p < 0.05) and a decrease in the angle of deviation in proprioception in the flexion direction were determined (p < 0.05). Neither technique had a significant effect on cervical proprioception and trunk muscle endurance (p > 0.05). In addition, no difference was found between the effectiveness of Graston and myofascial release (p > 0.05). ConclusionThis study showed that Graston and myofascial release applied to TLF in healthy young adults effectively improve lumbar ROM and proprioception in the acute period. Considering these results, both Graston and myofascial release can be used to provide elasticity of TLF and improve proprioceptive return.

Knee joint repositioning error in different trunk positions among females with chronic nonspecific low back pain: A cross-sectional study

PurposeProprioception is a self-perceived sense of position and movement of one's body and its deficits can lead to motor control problems such as delayed muscle reflexes. Previous studies have confirmed lumbar proprioception impairments among individuals with Low Back Pain (LBP), which can afflict the normal central sensory-motor control and hence increases the risk of abnormal loading on the lumbar spine. Although the local investigation of proprioception is important, its influence on other joints in a kinetic chain particularly between extremities and spine should not be ignored. Therefore, the aim of this study was to compare the proprioception of knee joint in different trunk positions among females with chronic nonspecific low back pain (CNSLBP) and healthy females. DesignThe study included 24 healthy subjects and 25 patients with CNSLBP participated in this study. Repositioning error of knee joint in four different lumbar positions including flexion, neutral position, 50% ROM of left rotation and 50% ROM right rotation was evaluated using an inclinometer. Absolute error and constant error were obtained and analyzed. ResultsAbsolute error in flexion and neutral positions in the individuals with CNSLBP were significantly higher than in healthy individuals; whereas, there was no significant difference in absolute and constant error between the two groups in 50% rotation to either side. ConclusionThis study showed that knee joint repositioning accuracy was reduced in patients with CNSLBP compared to healthy ones.

Does Acute Fatigue Affect Lumbar Proprioception and Balance?

Purpose: To investigate the acute effects of trunk extensor, abdominal, and calf muscle fatigue on lumbar proprioception and balance. Method: Seventy healthy individuals, aged between 18-25, without pain in the low back and lower extremities, with right dominant lower extremities, were included in the study. Dynamic balance with the Y-balance Test, lumbar proprioception sense with the application of the IOS software, and fatigue level with the 6-20 Borg Scale were evaluated before and immediately after the back extensor, abdominal, and calf muscle fatigue protocols were applied to the individuals at 72-hour intervals. Results: After all fatigue protocols, proprioception sense at 30˚ lumbar flexion was found to change significantly (pConclusionsThis study determined that acute fatigue negatively affects proprioceptive sense and dynamic postural control in the anterior direction. Understanding how the trunk extensor, abdominal, and ankle plantar flexor muscles respond to a fatigue-inducing exercise, especially concerning postural control and trunk proprioception, is important for understanding and preventing injury risk.

Comparison of affected lumbar proprioception due to different injuries with healthy controls: An observational study

BackgroundThere is limited evidence about spinal proprioception deficiency due to different injuries. ObjectiveTo compare spinal proprioception in patients with Lumbal Spinal Stenosis (LSS) and healthy controls. Secondary objective is to investigate the effect of pain intensity and Thoracolumbar fascia (TLF) flexibility on spinal proprioception deficiency. DesignCross-sectional and healthy controlled study. SettingThis study was conducted in a state hospital. MethodsNinety participants (mean age: 46.98 ± 12.94 years) were grouped as: Healthy control (n = 30) (Group I), chronic low back pain due to LSS (n = 30) (Group II) and undergoing surgery due to LSS (n = 30) (Group III). Lumbar repositioning error (RE) was defined as reproducing a target position (neutral lumbo-pelvic posture) after tasks. Tasks were: 30° forward bending and 15° backward bending in sitting and standing. Primary outcome measuresRE, pain intensity and TLF flexibility were assesed with iphone tilt-meter app, VAS and goniometric platform, respectively. ParticipantsSixty patients with LSS and 30 healthy controls. ResultsRE scores of Group II and Group III were significantly higher than Group I (p < 0.001). Group III had lower VAS scores (p < 0.001) than Group II, except during standing with backward bending task. TLF flexibility was not differed between Group II and Group III (p˃0.05). There was no significant association between VAS and RE scores in Group II and Group III (p˃0.05). ConclussionIndividuals with LSS and healthy controls have different lumbar proprioception sense. TLF flexibility did not differ, due to different injury, in patients with LSS compared to healthy controls.

Sagittal trunk excursion and lumbar repositioning error between female and male patients with patellofemoral pain syndrome.

Patellofemoral pain syndrome (PFPS) is a challenging clinical problem affecting adults, adolescents, and physically active populations. PFPS impacts the patient's trunk kinematics in the frontal plane. Previous studies have found gender-based biomechanical differences in patients with PFPS; however, sagittal trunk kinematics during mini-squats and lumbar proprioception in PFPS have not been studied previously. To investigate sagittal trunk excursion (It is defined as the sagittal trunk flexion angle from the start to the end of the mini squat) during mini-squats as well as lumbar repositioning error between individuals with and without PFPS, and determine gender differences in the outcome variables. A sample of 56 participants aged 18-25 years was enrolled; 30 with PFPS (13 males, 17 females) and 26 asymptomatic controls (11 males, 15 females). The sagittal trunk excursion during mini-squats was examined by two-dimensional (2D) photographic analysis using Surgimap software. Active lumbar flexion repositioning error was assessed using an isokinetic dynamometer. For sagittal trunk excursion, no significant main effect of group was observed (). On the other hand, the main effect was significant for gender (), as was the interaction effect. Compared to the control group, the PFPS group showed significantly () lower sagittal trunk excursion in females than in males during mini-squats. For active lumbar flexion repositioning error, no evidence was found for significant main or interaction effects (). Females with PFPS exhibit a more erect sagittal trunk posture than males during mini-squats. Trunk posture should be considered during weight-bearing activities in PFPS, and gender-specific assessment protocols should be developed.

Comparisons of postural control, proprioception, muscle strength, pain and disability between individuals with acute, subacute and chronic low back pain

Purpose/Aim Postural control, proprioception and lower extremity muscle strength are affected in individuals with low back pain (LBP). However, it is yet unknown whether these variables differentiate between acute, subacute and chronic stages of LBP. The aim was to investigate if there were any differences in postural control, proprioception, lower extremity muscle strength, pain intensity and disability between individuals in the different stages of LBP. Materials and Methods In this cross-sectional study, 124 individuals with LBP were grouped as acute LBP (ALBP) (n = 38), subacute LBP (SLBP) (n = 30) and chronic LBP (CLBP) (n = 56) groups. Postural control was assessed via computerised technology. Lumbar proprioception, lower extremity muscle strength, pain intensity and disability were assessed using Joint Repositioning Error Test, hand-held dynamometer, Numeric Rating Scale and Oswestry Disability Index (ODI), respectively. Kruskal–Wallis Tests, ANCOVA and post hoc Mann–Whitney U-Test with Bonferroni correction were performed. Results While there were no significant differences in terms of postural control, proprioception and pain intensity (p > 0.05), significant differences were found in terms of lower extremity muscle strength and ODI scores between groups when adjusted for age (p < 0.05). Individuals with CLBP demonstrated poorer lower extremity muscle strength than those with ALBP and SLBP, and higher disability than those with ALBP (p < 0.017). Conclusions Although postural control, proprioception and pain intensity were similar between individuals with acute, subacute and chronic LBP, muscle strength and disability seem to worsen stepwise as the pain becomes chronic. Muscle strength and disability should be taken into account while evaluating and/or managing individuals with acute and subacute stages of LBP.

Effect of Maitland mobilization on lumbar proprioception, pain, and disability in patients with chronic nonspecific low back pain

IntroductionTo investigate the short-term effect of Maitland mobilization on lumbar proprioception, pain intensity, and functional disability in patients with chronic nonspecific low back pain (CNSLBP).MethodsFifty-four subjects aged 18–30 years old with CNSLBP were randomly assigned into two groups. The experimental group received a selected exercise program (stretching, strengthening, and lumbar stabilization exercises) and Maitland posterior-anterior vertebral mobilization three sessions /week, whereas the control group received exercises only. Lumbar repositioning error (LRE), pain intensity, and function disability were measured using an isokinetic dynamometer, visual analog scale (VAS), and the Arabic version of the Oswestry Disability Index (ODI), respectively. Measurements were taken at baseline and four weeks after intervention.ResultsWithin-group analysis showed a significant decrease in LRE, VAS, and ODI after treatment (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). Between-group analysis revealed a significant difference between groups post-intervention favoring the Maitland mobilization group (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) where the mean differences at 95% confidence interval were (–2.10, –1.36) for LRE, (–34.53, –25.61) for VAS and (–9, –7.07) for ODI.ConclusionsMaitland lumbar mobilization is effective in improving lumbar proprioception, pain intensity, and functional disability in patients with CNSLBP.

A Review of the Effectiveness of Exercise Protocols on Proprioception and Pain in People With Nonspecific Chronic Low Back Pain

Background and Objectives Chronic low back pain is one of the most common and costly musculoskeletal disorders in societies and is an important clinical and socio-economic epidemic, mostly in industry and non-industry. The aim of this study was to a systematic review of the effectiveness of exercise protocols on lumbar proprioception in patients with chronic nonspecific low back pain. Subjects and Methods From internal and external search engines, including Scopus, Semantic Scholar, Google Scholar, Pubmed, ISC, SID, Magiran, Irandoc, and Doaj with time limit 2010 to 2021 and the keywords exercises, proprioception, non-specific, and chronic low back pain, the present study was done using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes). Results Nine articles were selected based on inclusion criteria. These studies mainly focused on systematic review effectiveness of exercise protocols on sensation and low back pain in people with non-specific chronic low back pain. Conclusion According to the research reviewed in the present study, it seems that exercise rehabilitation protocols activate, strengthen, maintain, and increase the central region of the body, especially deep muscles, particularly the multifidus and transverse abdomen, by retraining the pelvic lumbar region. The diaphragm and diagonal of the abdomen and pelvic floor, which play a role in the important segmental stability of the lumbar spine, improve the sense of depth and pain in patients with chronic nonspecific low back pain.

Effects of dynamic lumbar motor control training on lumbar proprioception: A randomized controlled trial

BackgroundDynamic lumbar motor control training (MCT) is frequently used in low back pain management; however, whether it affects lumbar proprioception remains unclear. ObjectivesThe purpose of this study was to investigate the effect of dynamic lumbar MCT on lumbar proprioception and to determine the effectiveness of dynamic lumbar MCT in patients with low back pain. DesignRandomized controlled trial. MethodThe study included patients with chronic non-specific low back pain, who were randomized into two groups: general trunk-training group and dynamic lumbar MCT group. Training was conducted for 8 weeks, and measurements were recorded at the beginning and end of the intervention period. The outcomes were the Fremantle Back Awareness Questionnaire score (FreBAQ; subjective proprioception) and the active joint repositioning sense (AJRS; objective proprioception) in trunk-forward bending.Results/findings: Nine participants in the general trunk-training group and 10 in the dynamic lumbar MCT group were included in the final analysis. In the pre- and post-intervention comparisons, FreBAQ score decreased in the dynamic lumbar MCT group only. AJRS was not significantly different between pre- and post-intervention in both groups. Between-group comparisons of pre- and post-intervention differences showed no significant differences in either FreBAQ or AJRS. ConclusionsAlthough the effect of dynamic lumbar MCT on lumbar proprioception is no different from that of general trunk training without moving the lower limbs, dynamic lumbar MCT is effective in training to improve subjective proprioception in patients with low back pain.

Cross-legged sitting posture effect on lumbar proprioception in young adults: a cross-sectional study

BackgroundThe cross-legged sitting posture (CLS) is assumed by young adults’ results in a bent and unbalanced posture. The study purpose was to assess the effect of sitting in a cross-legged position (knee on knee) on lumbar proprioception. Thirty-six participants of both genders aged from 18 to 25 were selected and divided equally into group A who adapt to a cross-legged sitting posture and group B who adapt to erect sitting (not prefer cross-legged sitting). The Biodex System 3 pro isokinetic dynamometer was utilized to assess the lumbar proprioception by testing the lumbar region repositioning accuracy.ResultsThe lumbar repositioning error of group A increased statistically significantly as compared to group B (p < 0.05).ConclusionsCross-legged sitting posture negatively affects lumbar proprioception compared with participants who adapt to erect sitting, and this effect should be considered in the avoidance of sitting in a cross-legged position and in prevention and intervention programs of lumbar proprioception impairment.

Test-Retest Reliability of an iPhone® Inclinometer Application to Assess the Lumbar Joint Repositioning Error in Non-Specific Chronic Low Back Pain.

Background: The joint position sense (JPS) has been used as an indirect marker of proprioception in subjects with non-specific chronic low back pain (NSCLBP), showing impairment in previous studies. It seems necessary to devise reliable tests to measure proprioceptive deficits in subjects with NSLBP. The objective of this study was to analyse the test–retest reliability and smallest real difference (SRD) of lumbar proprioception through the JPS indicator in a sample of patients with NSCLBP. Methods: Fifty participants with NSCLBP performed three repetitions of 30° lumbar flexion while standing and sitting using the iPhone® inclinometer application to measure the lumbar joint repositioning error. For the reliability analysis, we performed an intra-session test–retest. Results: The total sample ICC values were excellent for standing (0.96) and sitting (0.93) 30° lumbar flexion. In addition, our results showed that, for the total sample, an SRD < 12% can be considered as a true change in proprioception concerning this procedure. On the other hand, men have better reliability than women in both standing and sitting positions. Additionally, the sitting position has better reliability than the standing position. The standard error of measurement (SEM) percentage was 4.2 for standing and 3.8 for sitting. The SRD percentage was 11.6 for standing and 10.4 for sitting. Conclusions: The iPhone® inclinometer seems reliable for assessing proprioceptive ability through the lumbar joint repositioning error in subjects with NSCLBP in both standing (ICC = 0.96) and sitting (ICC = 0.93) positions. This technological device showed a lower measurement error for sitting position (SRD < 12%).

Knee Spine Syndrome Mechanism in Knee Osteoarthritis: Review Article

Introduction: Osteoarthritis (OA) is the most common arthritis and one of the main causes of disability. This injury can occur in any joint, but the most common OA occurrence globally, especially in Indonesia, is Knee OA (KOA). Damage caused by KOA's degenerative process affects the knee and affects the surrounding structures, such as the lumbar vertebra, which increases symptoms of low back pain (LBP). The occurrence of symptoms of LBP is thought to be caused by knee spine syndrome, which is a condition reduced lumbar lordosis angle due to the degenerative phase of KOA. the mechanism of this syndrome has not yet been discussed in detail, so further discussion is needed in the future.&#x0D; Methods: We searched articles using a list of keywords, including "knee osteoarthritis and low back pain", "knee osteoarthritis and knee contracture", "knee contracture and muscle weakness", "knee contracture and spinal alignments", "knee osteoarthritis and spinal alignment", "knee osteoarthritis and sagittal spinal alignment", and "muscle activation and spinal imbalance" on the data sources of PubMed, ScienceDirect, and Google Scholar. The argumentative, descriptive analysis was used for the data analysis technique.&#x0D; Results: Based on the literature search, the author found four related articles. This study provides evidence of the effect of KOA on lumbar proprioception. These articles explained that an impact on knee posture could have long-term effects both in the spine and pelvis, such as lumbar lordosis.&#x0D; Conclusion: Knee spine syndrome results from a reduced angle of lumbar lordosis, increasing pressure between discs, which might increase LBP symptoms. In the future, it is hoped that there will be studies that raise the relationship between KOA and symptom of LBP.

Linear and Non-linear Dynamic Methods Toward Investigating Proprioception Impairment in Non-specific Low Back Pain Patients.

Central nervous system (CNS) uses vision, vestibular, and somatosensory information to maintain body stability. Research has shown that there is more lumbar proprioception error among low back pain (LBP) individuals as compared to healthy people. In this study, two groups of 20 healthy people and 20 non-specific low back pain (NSLBP) participants took part in this investigation. This investigation focused on somatosensory sensors and in order to alter proprioception, a vibrator (frequency of 70 Hz, amplitude of 0.5 mm) was placed on the soleus muscle area of each leg and two vibrators were placed bilaterally across the lower back muscles. Individuals, whose vision was occluded, were placed on two surfaces (foam and rigid) on force plate, and trunk angles were recorded simultaneously. Tests were performed in eight separate trials; the independent variables were vibration (four levels) and surface (two levels) for within subjects and two groups (healthy and LBP) for between subjects (4 × 2 × 2). MANOVA and multi-factor ANOVA tests were done. Linear parameters for center of pressure (COP) [deviation of amplitude, deviation of velocity, phase plane portrait (PPP), and overall mean velocity] and non-linear parameters for COP and trunk angle [recurrence quantification analysis (RQA) and Lyapunov exponents] were chosen as dependent variables. Results indicated that NSLBP individuals relied more on ankle proprioception for postural stability. Similarly, RQA parameters for the COP on both sides and for the trunk sagittal angle indicated more repeated patterns of movement among the LBP cohort. Analysis of short and long Lyapunov exponents showed that people with LBP caused no use of all joints in their bodies (non-flexible), are less stable than healthy subjects.