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European Journal of Applied Physiology

, Volume 111, Issue 1, pp 115–123 | Cite as

Decreased variability in postural control strategies in young people with non-specific low back pain is associated with altered proprioceptive reweighting

  • Kurt ClaeysEmail author
  • Simon Brumagne
  • Wim Dankaerts
  • Henri Kiers
  • Lotte Janssens
Original Article

Abstract

Optimal postural control is an essential capacity in daily life and can be highly variable. The purpose of this study was to investigate if young people have the ability to choose the optimal postural control strategy according to the postural condition and to investigate if non-specific low back pain (NSLBP) influences the variability in proprioceptive postural control strategies. Young individuals with NSLBP (n = 106) and healthy controls (n = 50) were tested on a force plate in different postural conditions (i.e., sitting, stable support standing and unstable support standing). The role of proprioception in postural control was directly examined by means of muscle vibration on triceps surae and lumbar multifidus muscles. Root mean square and mean displacements of the center of pressure were recorded during the different trials. To appraise the proprioceptive postural control strategy, the relative proprioceptive weighting (RPW, ratio of ankle muscles proprioceptive inputs vs. back muscles proprioceptive inputs) was calculated. Postural robustness was significantly less in individuals with NSLBP during the more complex postural conditions (p < 0.05). Significantly higher RPW values were observed in the NSLBP group in all postural conditions (p < 0.05), suggesting less ability to rely on back muscle proprioceptive inputs for postural control. Therefore, healthy controls seem to have the ability to choose a more optimal postural control strategy according to the postural condition. In contrast, young people with NSLBP showed a reduced capacity to switch to a more multi-segmental postural control strategy during complex postural conditions, which leads to decreased postural robustness.

Keywords

Postural control Multi-segmental strategy Ankle strategy Sensory reweighting Variability Low back pain 

References

  1. Allum JH, Bloem BR, Carpenter MG, Hulliger M, Hadders-Algra M (1998) Proprioceptive control of posture: a review of new concepts. Gait Posture 8(3):214–242CrossRefPubMedGoogle Scholar
  2. Baecke JA, Burema J, Frijters JE (1982) A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr 36(5):936–942PubMedGoogle Scholar
  3. Brumagne S, Cordo P, Lysens R, Verschueren S, Swinnen S (2000) The role of paraspinal muscle spindles in lumbosacral position sense in individuals with and without low back pain. Spine 25(8):989–994CrossRefPubMedGoogle Scholar
  4. Brumagne S, Cordo P, Verschueren S (2004) Proprioceptive weighting changes in persons with low back pain and elderly persons during upright standing. Neurosci Lett 366(1):63–66CrossRefPubMedGoogle Scholar
  5. Brumagne S, Janssens L, Janssens E, Goddyn L (2008a) Altered postural control in anticipation of postural instability in persons with recurrent low back pain. Gait Posture 4:657–662CrossRefGoogle Scholar
  6. Brumagne S, Janssens L, Knapen S, Claeys K, Suuden-Johanson E (2008b) Persons with recurrent low back pain exhibit a rigid postural control strategy. Eur Spine J 17(9):1177–1184CrossRefPubMedGoogle Scholar
  7. Carver S, Kiemel T, Jeka JJ (2006) Modeling the dynamics of sensory reweighting. Biol Cybern 95(2):123–134CrossRefPubMedGoogle Scholar
  8. Cordo PJ, Gurfinkel VS, Brumagne S, Flores-Vieira C (2005) Effect of slow, small movement on the vibration-evoked kinesthetic illusion. Exp Brain Res 167(3):324–334CrossRefPubMedGoogle Scholar
  9. Dankaerts W, O’Sullivan P, Burnett A, Straker L (2006) Altered patterns of superficial trunk muscle activation during sitting in nonspecific chronic low back pain patients: importance of subclassification. Spine 31(17):2017–2023CrossRefPubMedGoogle Scholar
  10. della Volpe R, Popa T, Ginanneschi F, Spidalieri R, Mazzocchio R, Rossi A (2006) Changes in coordination of postural control during dynamic stance in chronic low back pain patients. Gait Posture 24(3):349–355CrossRefPubMedGoogle Scholar
  11. Descarreaux M, Blouin JS, Teasdale N (2005) Repositioning accuracy and movement parameters in low back pain subjects and healthy control subjects. Eur Spine J 14(2):185–191CrossRefPubMedGoogle Scholar
  12. Dolan KJ, Green A (2006) Lumbar spine reposition sense: the effect of a ‘slouched’ posture. Man Ther 11(3):202–207CrossRefPubMedGoogle Scholar
  13. Fairbank JC, Pynsent PB (2000) The Oswestry disability index 5. Spine 25(22):2940–2952CrossRefPubMedGoogle Scholar
  14. Gurfinkel VS, Ivanenko Y, Levik Y, Babakova IA (1995) Kinesthetic reference for human orthograde posture. Neuroscience 68(1):229–243CrossRefPubMedGoogle Scholar
  15. Harbourne RT, Stergiou N (2009) Movement variability and the use of nonlinear tools: principles to guide physical therapist practice 5. Phys Ther 89(3):267–282CrossRefPubMedGoogle Scholar
  16. Henry SM, Hitt JR, Jones SL, Bunn JY (2006) Decreased limits of stability in response to postural perturbations in subjects with low back pain. Clin Biomech (Bristol, Avon) 21(9):881–892CrossRefGoogle Scholar
  17. Hodges PW, Moseley GL (2003) Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electromyogr Kinesiol 13(4):361–370CrossRefPubMedGoogle Scholar
  18. Horak FB, Nashner LM (1986) Central programming of postural movements: adaptation to altered support-surface configurations. J Neurophysiol 55(6):1369–1381PubMedGoogle Scholar
  19. Isableu B, Vuillerme N (2006) Differential integration of kinaesthetic signals to postural control 2. Exp Brain Res 174(4):763–768CrossRefPubMedGoogle Scholar
  20. Ivanenko YP, Talis VL, Kazennikov OV (1999) Support stability influences postural responses to muscle vibration in humans. Eur J Neurosci 11(2):647–654CrossRefPubMedGoogle Scholar
  21. Jacobs JV, Henry SM, Nagle KJ (2009) People with chronic low back pain exhibit decreased variability in the timing of their anticipatory postural adjustments. Behav Neurosci 123(2):455–458CrossRefPubMedGoogle Scholar
  22. Kiemel T, Elahi AJ, Jeka JJ (2008) Identification of the plant for upright stance in humans: multiple movement patterns from a single neural strategy 2. J Neurophysiol 100(6):3394–3406CrossRefPubMedGoogle Scholar
  23. Kokkorogiannis T (2004) Somatic and intramuscular distribution of muscle spindles and their relation to muscular angiotypes. J Theor Biol 229(2):263–280CrossRefPubMedGoogle Scholar
  24. Koumantakis GA, Winstanley J, Oldham JA (2002) Thoracolumbar proprioception in individuals with and without low back pain: intratester reliability, clinical applicability, and validity. J Orthop Sports Phys Ther 32(7):327–335PubMedGoogle Scholar
  25. MacDonald DA, Moseley GL, Hodges PW (2006) The lumbar multifidus: does the evidence support clinical beliefs? Man Ther 11(4):254–263Google Scholar
  26. Mannion AF, Weber BR, Dvorak J, Grob D, Muntener M (1997) Fibre type characteristics of the lumbar paraspinal muscles in normal healthy subjects and in patients with low back pain. J Orthop Res 15(6):881–887CrossRefPubMedGoogle Scholar
  27. Mientjes MI, Frank JS (1999) Balance in chronic low back pain patients compared to healthy people under various conditions in upright standing. Clin Biomech (Bristol, Avon) 14(10):710–716CrossRefGoogle Scholar
  28. Mok NW, Brauer SG, Hodges PW (2004) Hip strategy for balance control in quiet standing is reduced in people with low back pain. Spine (Philadelphia, PA, 1976) 29(6):107–112Google Scholar
  29. Morasso PG, Schieppati M (1999) Can muscle stiffness alone stabilize upright standing? J Neurophysiol 82(3):1622–1626PubMedGoogle Scholar
  30. Moseley GL, Hodges PW (2006) Reduced variability of postural strategy prevents normalization of motor changes induced by back pain: a risk factor for chronic trouble? Behav Neurosci 120(2):474–476CrossRefPubMedGoogle Scholar
  31. Newcomer KL, Laskowski ER, Yu B, Johnson JC, An KN (2000) Differences in repositioning error among patients with low back pain compared with control subjects. Spine 25(19):2488–2493Google Scholar
  32. O’Sullivan PB, Mitchell T, Bulich P, Waller R, Holte J (2006) The relationship between posture and back muscle endurance in industrial workers with flexion-related low back pain. Man Ther 11(4):264–271CrossRefPubMedGoogle Scholar
  33. Paulus I, Brumagne S (2008) Altered interpretation of neck proprioceptive signals in persons with subclinical recurrent neck pain 1. J Rehabil Med 40(6):426CrossRefPubMedGoogle Scholar
  34. Popa T, Bonifazi M, Della VR, Rossi A, Mazzocchio R (2007) Adaptive changes in postural strategy selection in chronic low back pain. Exp Brain Res 177(3):411–418CrossRefPubMedGoogle Scholar
  35. Radebold A, Cholewicki J, Polzhofer GK, Greene HS (2001) Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain. Spine (Philadelphia, PA, 1976) 26(7):724–730Google Scholar
  36. Roll JP, Vedel JP (1982) Kinaesthetic role of muscle afferents in man, studied by tendon vibration and microneurography. Exp Brain Res 47(2):177–190CrossRefPubMedGoogle Scholar
  37. Runge CF, Shupert CL, Horak FB, Zajac FE (1999) Ankle and hip postural strategies defined by joint torques. Gait Posture 10(2):161–170CrossRefPubMedGoogle Scholar
  38. Schieppati M, Giordano A, Nardone A (2002) Variability in a dynamic postural task attests ample flexibility in balance control mechanisms 73. Exp Brain Res 144(2):200–210CrossRefPubMedGoogle Scholar
  39. Silfies SP, Cholewicki J, Reeves NP, Greene HS (2007) Lumbar position sense and the risk of low back injuries in college athletes: a prospective cohort study. BMC Musculoskelet Disord 8:129Google Scholar
  40. Van Daele U, Hagman F, Truijen S, Vorlat P, Van Gheluwe B, Vaes P (2009) Differences in balance strategies between nonspecific chronic low back pain patients and healthy control subjects during unstable sitting. Spine 34(11):1233–1238Google Scholar
  41. Vlaeyen JW, Kole-Snijders AM, Boeren RG, van Eek H (1995) Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain 62(3)363–372Google Scholar
  42. Waddell G, Newton M, Henderson I, Somerville D, Main CJ (1993) A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability 58. Pain 52(2):157–168CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Kurt Claeys
    • 1
    • 2
    Email author
  • Simon Brumagne
    • 1
  • Wim Dankaerts
    • 1
    • 3
  • Henri Kiers
    • 4
  • Lotte Janssens
    • 1
  1. 1.Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation SciencesK.U.LeuvenLouvainBelgium
  2. 2.Department of Health CareCatholic University College of Bruges-OstendBruggeBelgium
  3. 3.Department of Health Care, AUHL-PHL, REVAL-Rehabilitation and Health Care Research CenterUniversity College LimburgHasseltBelgium
  4. 4.Department of Lifestyle and Health, Hogeschool UtrechtUniversity of Applied SciencesUtrechtThe Netherlands

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