Postural adaptations within normalized stability between older adults with and without chronic low back pain

Abstract

Background: Adaptations of dynamic balance performance are related to sway excursions in older adults with chronic low back pain (LBP). However, there is a lack of understanding on postural control within different thresholds of radius from the center of pressure (COP).

Purpose: This study was conducted to compare the normalized stability based on the time-in-boundary (TIB) during repeated unilateral limb standing trials between subjects with and without chronic LBP.

Methods: There were 26 older adults with LBP and 39 control subjects who completed three trials of repeated unilateral limb standing on a force plat.

Results: The TIB based on the seven thresholds was analyzed, and the groups demonstrated a significant interaction on thresholds for TIB (F = 8.76, p = 0.01). The TIB was significantly different in the 10 mm (F = 4.01, p = 0.04), 15 mm (F = 5.21, p = 0.03), and 20 mm (F = 4.48, p = 0.04) radius of thresholds only in the second trial. However, there was no group difference on TIB at the first and third trials due to potential compensatory and/or adaptive reactions to avoid fall risks.

Conclusion: The LBP group lacked postural stability within the thresholds less than a 20 mm radius at the second trial of unilateral standing. The significant group interaction with the thresholds indicates an adaptation strategy on sway thresholds. This postural reaction from repeated trials should be considered with sway excursion adjustments and fall prevention in older adults with LB.

Keywords: Low back pain; Postural stability; Thresholds; Time-in-boundary; Unilateral standing test.