The effects of proprioceptive weighting changes on posture control in patients with chronic low back pain: a cross-sectional study

Xue Cheng; Jiajia Yang; Zengming Hao; Yan Li; Ruochen Fu; Yao Zu; Jinjin Ma; Wai Leung Ambrose Lo; Qiuhua Yu; Guifang Zhang; Chuhuai Wang

doi:10.3389/fneur.2023.1144900

The effects of proprioceptive weighting changes on posture control in patients with chronic low back pain: a cross-sectional study

Front Neurol. 2023 May 19:14:1144900. doi: 10.3389/fneur.2023.1144900. eCollection 2023.

Authors

Xue Cheng^#¹, Jiajia Yang^#¹, Zengming Hao^#¹, Yan Li¹, Ruochen Fu¹, Yao Zu¹, Jinjin Ma¹, Wai Leung Ambrose Lo^{1

2}, Qiuhua Yu¹, Guifang Zhang¹, Chuhuai Wang¹

Affiliations

¹ Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
² Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

^# Contributed equally.

Abstract

Introduction: Patients with chronic low back pain (CLBP) exhibit changes in proprioceptive weighting and impaired postural control. This study aimed to investigate proprioceptive weighting changes in patients with CLBP and their influence on posture control.

Methods: Sixteen patients with CLBP and 16 healthy controls were recruited. All participants completed the joint reposition test sense (JRS) and threshold to detect passive motion test (TTDPM). The absolute errors (AE) of the reposition and perception angles were recorded. Proprioceptive postural control was tested by applying vibrations to the triceps surae or lumbar paravertebral muscles while standing on a stable or unstable force plate. Sway length and sway velocity along the anteroposterior (AP) and mediolateral (ML) directions were assessed. Relative proprioceptive weighting (RPW) was used to evaluate the proprioception reweighting ability. Higher values indicated increased reliance on calf proprioception.

Results: There was no significant difference in age, gender, and BMI between subjects with and without CLBP. The AE and motion perception angle in the CLBP group were significantly higher than those in the control group (JRS of 15°: 2.50 (2.50) vs. 1.50 (1.42), JRS of 35°: 3.83 (3.75) vs. 1.67 (2.00), p_JRS < 0.01; 1.92 (1.18) vs. 0.68 (0.52), p_TTDPM < 0.001). The CLBP group demonstrated a significantly higher RPW value than the healthy controls on an unstable surface (0.58 ± 0.21 vs. 0.41 ± 0.26, p < 0.05). Under the condition of triceps surae vibration, the sway length (p_stable < 0.05; p_unstable < 0.001), AP velocity (p_stable < 0.01; p_unstable < 0.001) and ML velocity (p_unstable < 0.05) had significant group main effects. Moreover, when the triceps surae vibrated under the unstable surface, the differences during vibration and post vibration in sway length and AP velocity between the groups were significantly higher in the CLBP group than in the healthy group (p < 0.05). However, under the condition of lumbar paravertebral muscle vibration, no significant group main effect was observed.

Conclusion: The patients with CLBP exhibited impaired dynamic postural control in response to disturbances, potentially linked to changes in proprioceptive weighting.

Keywords: center of pressure; chronic low back pain; posture control; proprioception; proprioceptive weighting.

Grants and funding

This study was supported by the National Natural Science Foundation of China (82172532), the Development Center for Medical Science and Technology, and the National Health Commission of the People's Republic of China (DCMSTNHC-2019-AHT-01), the Medical Scientific Research Foundation of Guangdong Province of China (B2023098), and Guangdong Basic and Applied Basic Research Foundation (2022A1515011229).