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Zielinski OB, Hallager DW, Jensen KY, Carreon L, Andersen MØ, Diederichsen LP, Bech RD. Multicentre investigation on the effect of decompressive surgery on Balance and physical ActiviTy Levels amongst patients with lumbar Spinal stenosis (B-ATLAS): protocol for a prospective cohort study. BMJ Open 2024; 14:e085667. [PMID: 39313282 PMCID: PMC11418479 DOI: 10.1136/bmjopen-2024-085667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 09/02/2024] [Indexed: 09/25/2024] Open
Abstract
INTRODUCTION Patients with lumbar spinal stenosis may have poor balance, decreased physical function and problems maintaining physical activity levels due to radiculopathy. Decompressive surgery is often indicated if conservative management fails to achieve a satisfactory clinical outcome. While surgical management has proven effective at treating radiculopathy, and patients report increased physical function postoperatively, objective measures of postural control and physical activity remain sparse. This study aims to investigate the effects of decompressive surgery on postural control and activity levels of elderly patients with lumbar spinal stenosis using objective measurements. METHODS AND ANALYSIS This is a 24-month, multicentre, prospective cohort study. Patients ≥65 years of age with MRI-verified symptomatic lumbar central canal stenosis will be recruited from two separate inclusion centres, and all participants will undergo decompressive surgery. Preoperative data are collected up to 3 months before surgery, with follow-up data collected at 3, 6, 12 and 24 months postoperatively. Postural control measurements are performed using the Wii Balance Board, mini Balance Evaluation Systems Test and Tandem test, and data concerning physical activity levels are collected using ActiGraph wGT3X-BT accelerometers. Patient-reported outcomes regarding quality-of-life and physical function are collected from the EuroQol-5D, 36-Item Short Form Health Survey and Zurich Claudication Questionnaire. Primary outcomes are the change in the sway area of centre of pressure and total activity counts per day from baseline to follow-up at 24 months. A sample size of 80 participants has been calculated. ETHICS AND DISSEMINATION The study has been approved by the Regional Ethics Committee of Region Zealand (ID EMN-2022-08110) and the Danish Data Protection Agency (ID REG-100-2022). Written informed consent will be required from all participants before enrolment. All results from the study, whether positive, negative or inconclusive, will be published in international peer-reviewed journals and presented at national and international scientific meetings. Study findings will be further disseminated through national patient associations. TRIAL REGISTRATION NUMBERS NCT06075862 and NCT06057428.
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Affiliation(s)
- Oliver Bremerskov Zielinski
- Department of Orthopaedic Surgery, Zealand University Hospital Koge, Køge, Denmark
- Spine Centre of Southern Denmark, Kolding, Denmark
| | - Dennis Winge Hallager
- Department of Orthopaedic Surgery, Zealand University Hospital Koge, Køge, Denmark
- University of Copenhagen Department of Clinical Medicine, Copenhagen, Denmark
| | - Kasper Yde Jensen
- Rigshospitalet Center for Rheumatology and Spine Diseases, Copenhagen, Denmark
| | - Leah Carreon
- Spine Centre of Southern Denmark, Kolding, Denmark
| | | | - Louise Pyndt Diederichsen
- Dept. of Rheumatology, Odense University Hospital, Odense, Denmark
- Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Rune Dueholm Bech
- Department of Orthopaedic Surgery, Zealand University Hospital Koge, Køge, Denmark
- University of Copenhagen Department of Clinical Medicine, Copenhagen, Denmark
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Drozda D, Thompson Z, Vincent KR, Nixon RM, Bolling J, Vincent HK. Gait signatures of endurance runners with low back pain: A case controlled cross sectional study. Gait Posture 2024; 113:184-190. [PMID: 38905854 DOI: 10.1016/j.gaitpost.2024.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 05/30/2024] [Accepted: 06/17/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Low back pain (LBP) is an understudied condition among runners, and it is unclear what biomechanical features could be targeted for gait retraining to mitigate pain. RESEARCH QUESTION How do running biomechanics differ between healthy individuals and those with running-related LBP? METHODS This was a case-controlled, comparative study design of community runners: running-related LBP (n=52) and healthy controls (n=52). All runners completed running history forms and performed a 3-dimensional gait analysis. Kinematic data were collected using a motion capture system and normalized to a gait cycle, while participants ran on a level grade at self-selected speed on an instrumented treadmill. Current running volume, temporal-spatial, kinetic and kinematic features were compared between groups. RESULTS The LBP group had 39.5 % lower weekly distance and 15.4 % fewer were currently training for a race (all p<.05). Runners with LBP demonstrated lower cadence (166±10 step/min vs. 171±9 step/min; p=.05), greater center of gravity lateral displacement (1.4±0.5 cm vs. 1.2 ±.3 cm; p=.044) and greater stride width variability (1.3±0.4 cm versus 1.0 ± 0.04 cm; p=.008). Runners with LBP had a greater Vertical Average Loading Rate ([VALR] 67.7±22.2 bodyweights [BW]/s vs. 62.2±21.5 BW/s; p=.022), and higher joint moments (N*m/(kg*m)) at the knee in the sagittal plane (2.13±0.50 vs. 1.87±0.56; p <.001), frontal plane (1.44±0.39 vs. 1.29±0.29; p=.013), and at the hip in the frontal plane (2.04±0.51 vs. 1.84±0.41; p=.024). No differences were found between groups in the pelvis, hip, knee, and ankle joint excursions in any plane of motion during a typical gait cycle. SIGNIFICANCE These collective motion signature may reflect challenges with control of motion and VALR in the presence of back pain. Cadence training to increase step rate, coupled with core/hip muscle activation, may be an important strategy to reduce motion variability, impact loading rate and pain symptoms while running.
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Affiliation(s)
- David Drozda
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Zane Thompson
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Kevin R Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Ryan M Nixon
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Jamie Bolling
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, United States.
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Zhang L, Zeng H, Sun Y, Xue H, Gao L, Zhu W. Effect of Tai Chi Compared to Running on Drug Cravings, Attention Bias, and Physical Fitness in Men with Methamphetamine Use Disorder. Healthcare (Basel) 2024; 12:1653. [PMID: 39201211 PMCID: PMC11353623 DOI: 10.3390/healthcare12161653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 08/18/2024] [Accepted: 08/19/2024] [Indexed: 09/02/2024] Open
Abstract
BACKGROUND Methamphetamine use disorder (MUD) is a global health problem. Studies have shown Tai Chi is a potential treatment for MUD. We aimed to explore the effectiveness of Tai Chi in improving drug cravings, attention bias, and physical fitness in men with MUD compared with aerobic exercise. METHODS A total of forty-eight participants (mean age 39.1 ± 8.7 years) were randomly assigned to either the Tai Chi group (TC) or the running group (RG). The TC performed 60 min of moderate-intensity (65-75% HRmax) Tai Chi exercise three times a week. The RG performed 60 min of moderate-intensity (65-75% HRmax) running on a treadmill three times a week. Before and after the intervention, drug cravings, attention bias, and physical fitness were evaluated. RESULTS After 12 weeks, we found the TC significantly improved in attention bias (F (1, 43) = 6.023, p = 0.019, d = -0.42) and reaction time (F (1, 43) = 6.181, p = 0.017, d = -0.72). No significant improvement was found in other variables in the TC, compared to the RG (p > 0.05). CONCLUSIONS The 12-week Tai Chi intervention improved attention bias and reaction time, compared to RG. Tai Chi exercise might be a potential auxiliary method for the rehabilitation for men with MUD.
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Affiliation(s)
| | | | | | | | - Liquan Gao
- School of Physical Education, Shaanxi Normal University, Xi’an 710119, China; (L.Z.); (H.Z.); (Y.S.); (H.X.)
| | - Wenfei Zhu
- School of Physical Education, Shaanxi Normal University, Xi’an 710119, China; (L.Z.); (H.Z.); (Y.S.); (H.X.)
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Merlo JK, da Silva AV, Casonatto J, Ribeiro AS, de Oliveira Junior E, do Nascimento AP, de Oliveira RG, Buzzachera CF, da Silva RA, Aguiar AF. Effects of a Mat Pilates Exercise Program Associated with Photobiomodulation Therapy in Patients with Chronic Nonspecific Low Back Pain: A Randomized, Double-Blind, Sham-Controlled Trial. Healthcare (Basel) 2024; 12:1416. [PMID: 39057559 PMCID: PMC11276592 DOI: 10.3390/healthcare12141416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/26/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVE To investigate the effects of combining a Pilates program with photobiomodulation therapy (PBMT) in patients with chronic nonspecific low back pain (CNLBP). METHODS Thirty-eight adults with CNLBP were randomly assigned to two groups: Pilates exercise + active PBMT (PIL + PBMT) or Pilates exercise + sham PBMT (PIL + SHAM). Both groups performed an 8-week mat Pilates program and received PBMT on their lumbar muscles 10 min before and after each session. The following variables were assessed before and after intervention: peak pain intensity, postural balance (i.e., center of the pressure [A-COP], velocity anteroposterior [Vel AP], and velocity mediolateral [Vel ML]), perceived disability (i.e., Oswestry Disability Index [ODI] and Roland Morris Disability Questionnaire [RMDQ]), and pain-related fear of movement (i.e., Tampa Scale of Kinesiophobia [TSK], Fear Avoidance Beliefs Questionnaire [FABQ], and Pain Catastrophizing Scale [PCS]). RESULTS Postural balance variables showed no statistically significant differences (p > 0.05) across time or between groups. The groups showed similar (p < 0.05) reductions in peak pain intensity, ODI, RMDQ, and PCS scores, but no statistically significant difference (p > 0.05) in TSK and FABQ scores. CONCLUSION The mat Pilates program reduced peak pain intensity, perceived disability, and pain catastrophizing in adults with CNLBP, but PBMT had no additional effect on these variables. Mat Pilates alone or combined with PBMT was not able to improve postural balance.
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Affiliation(s)
- Jeanne Karlette Merlo
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
| | - Adriano Valmozino da Silva
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
| | - Juliano Casonatto
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
- Postgraduate Program in Physical Exercise in Health Promotion, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil;
| | - Alex Silva Ribeiro
- Postgraduate Program in Physical Exercise in Health Promotion, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil;
| | - Eros de Oliveira Junior
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
| | - Ana Paula do Nascimento
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
- Postgraduate Program in Human Movement Sciences, State University of Northern Paraná (UENP), Jacarezinho 86400-000, PR, Brazil
| | - Raphael Gonçalves de Oliveira
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
- Postgraduate Program in Human Movement Sciences, State University of Northern Paraná (UENP), Jacarezinho 86400-000, PR, Brazil
| | - Cosme Franklim Buzzachera
- Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy;
| | - Rubens Alexandre da Silva
- Program de Physiothérapie de L’université McGill Offert en Extension à L’UNIVERSITÉ du Québec à Chicoutimi (UQAC), Québec, QC G7H 5B8, Canada
| | - Andreo Fernando Aguiar
- Postgraduate Program in Rehabilitation Sciences, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil; (J.K.M.); (A.V.d.S.); (J.C.); (E.d.O.J.) (A.P.d.N.); (R.G.d.O.)
- Postgraduate Program in Physical Exercise in Health Promotion, Northern University of Paraná (UNOPAR), Londrina 86041-120, PR, Brazil;
- Postgraduate Program in Human Movement Sciences, State University of Northern Paraná (UENP), Jacarezinho 86400-000, PR, Brazil
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Athanasakis P, Nikodelis T, Panoutsakopoulos V, Mylonas V, Loizidis T, Koutlianos NA, Kollias IA. Acute effect of dry needling on trunk kinematics and balance of patients with non-specific low back pain. J Bodyw Mov Ther 2024; 39:24-31. [PMID: 38876633 DOI: 10.1016/j.jbmt.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/18/2024] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Limited knowledge exists about the effectiveness of dry needling (DN) concerning the torso kinematics in patients with non-specific low back pain (NS-LBP). Acute effects of DN in NS-LBP patients from a functional perspective were investigated. METHODS Sixteen NS-LBP patients and 11 healthy individuals (HG) were examined. NS-LBP patients received a single session of DN at the lumbar region. Baseline and immediate post-treatment measurements during flexion-extension and lateral bending of the trunk were conducted for the NS-LBP patients. HG were measured only at baseline to be used as a reference of NS-LBP patients' initial condition. Algometry was applied in NS-LBP patients. Centre of pressure, range of motion of the trunk and its' derivatives were obtained. FINDINGS HG performed significantly faster, smoother and with greater mobility in the performed tasks compared to the pre intervention measurements of the NS-LBP patients. For the NS-LBP patients, significant greater angular velocity in frontal plane and significant lower jerk in the sagittal plane were demonstrated post intervention. DN alleviated pain tolerance significantly at the L5 level. Regarding the effectiveness of the DN upon spine kinematics, their derivatives were more sensitive. INTERPRETATION It appeared that the pathological type of torso movement was acutely affected by DN. NS-LBP patients showcased smoother movement immediately after the intervention and better control as imprinted in the higher derivative of motion although range of motion did not improve. This quantitative variable may not be subjected to acute effects of DN but rather need additional time and training to be improved.
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Affiliation(s)
- Petros Athanasakis
- Biomechanics Laboratory, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Thomas Nikodelis
- Biomechanics Laboratory, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Vassilios Panoutsakopoulos
- Biomechanics Laboratory, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Vasileios Mylonas
- Biomechanics Laboratory, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Theodoros Loizidis
- Department of Physical and Rehabilitation Medicine, Saint Loukes Hospital, 55236, Panorama, Thessaloniki, Greece.
| | - Nikolaos A Koutlianos
- Sports Medicine Laboratory, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Iraklis A Kollias
- Biomechanics Laboratory, School of Physical Education and Sport Science at Thessaloniki, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
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Stöwhas K, Droppelmann G, Jorquera C, Feijoo F. Postural and Lumbopelvic Control: Crucial Factors in the Functionality of Patients with Low Back Pain-A Descriptive Cross-Sectional Study. J Clin Med 2024; 13:3836. [PMID: 38999405 PMCID: PMC11242385 DOI: 10.3390/jcm13133836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Low back pain (LBP) is one of the most prevalent musculoskeletal disorders in adults worldwide. Alterations in postural and lumbopelvic control and functionality appear to be determining factors in its resolution. Methods: A cross-sectional study was performed. Patients with LBP were enrolled. Lumbar pain; postural control (PC), total area of the center of pressure (TACOP), and the velocity of the center of pressure (VCOP); lumbopelvic control (LPC); and functionality were evaluated. Statistical tests were implemented to determine differences between sex and age and correlation models among the variables. Results: Thirty adult patients with LBP were analyzed. A strong relationship was found between pain and functionality [r = 0.64; p < 0.001]. A moderate relationship was found between pain and TACOP [r = 0.395; p = 0.031]. A moderate relationship was observed between TACOP and functionality [0.413; p = 0.023] and between LPC and TACOP [r = 0.416; p = 0.001]. Conclusions: This study demonstrates the significant impact of LBP on postural control, lumbopelvic control, and functionality. These results highlight the importance of addressing postural and lumbopelvic control in LBP treatment. No significant differences based on gender and age were found, but all clinical variables differed significantly between the LBP and control groups, underscoring the unique impairments associated with LBP.
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Affiliation(s)
- Katherine Stöwhas
- Department of Rehabilitation, Clínica MEDS, Santiago 7691236, Chile;
- Facultad de Medicina, Escuela de Kinesiología, Universidad Finis Terrae, Santiago 7501014, Chile
| | - Guillermo Droppelmann
- Department of Rehabilitation, Clínica MEDS, Santiago 7691236, Chile;
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Carlos Jorquera
- Facultad de Ciencias, Escuela de Nutrición y Dietética, Universidad Mayor, Santiago 8580745, Chile;
| | - Felipe Feijoo
- School of Industrial Engineering, Pontificia Universidad Católica de Valparaíso, Valparaíso 2362807, Chile;
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Lomond KV, Sansom JK. Effects of non-specific low back pain on static balance in emerging adults. Physiother Theory Pract 2024:1-11. [PMID: 38855981 DOI: 10.1080/09593985.2024.2364805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/31/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Postural control impairments in middle-aged or older people with chronic low back pain (CLBP) have been extensively documented. However, little is known about changes in postural control early in the disease process which may underlie compensatory movement strategies. OBJECTIVE Our purpose was to quantify postural sway and sensory weighting in emerging adults with and without CLBP. METHODS Nineteen emerging adults with CLBP (age = 18-26 years (21.11 ± 1.73)) and 19 matched peers without CLBP (18-27 years (22.20 ± 1.97)) participated in a cross-sectional study. Displacement of the center of mass during Quiet stance (QS), Tandem stance (TS), and Unilateral stance (US) on 2 surfaces (stable, unstable) were used to assess postural sway. Sensory Organization Test (SOT) was used to assess sensory weighting. RESULTS Emerging adults with CLBP showed large, significant increases in postural sway during unstable TS (p ≤ .020). Participants with CLBP relied more on somatosensory input, as evidenced by lower equilibrium scores during conditions favoring visual (p = .020) or vestibular (p < .001) input during the SOT. CONCLUSION Emerging adults with CLBP showed postural control impairments related to altered sensory weighting. These findings provide insights into the development of CLBP and its effects on postural control. This information may aid early identification, monitoring, and treatment of individuals in the initial stages of disease development who may have unrecognized postural impairments.
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Affiliation(s)
- Karen V Lomond
- Department of Physical Therapy, Center for Health Sciences, Ithaca, NY, USA
| | - Jennifer K Sansom
- Doctoral Program in Physical Therapy, College of Health Professions, Central Michigan University, Mount Pleasant, MI, USA
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Alshehri MA, van den Hoorn W, Klyne DM, van Dieën JH, Cholewicki J, Hodges PW. Poor lumbar spine coordination in acute low back pain predicts persistent long-term pain and disability. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:2380-2394. [PMID: 38483640 DOI: 10.1007/s00586-024-08205-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/22/2023] [Accepted: 02/23/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE Sitting balance on an unstable surface requires coordinated out-of-phase lumbar spine and provides sufficient challenge to expose quality of spine control. We investigated whether the quality of spine coordination to maintain balance in acute low back pain (LBP) predicts recovery at 6 months. METHODS Participants in an acute LBP episode (n = 94) underwent assessment of sitting balance on an unstable surface. Seat, hip and spine (lower lumbar, lumbar, upper lumbar, thoracic) angular motion and force plate data were recorded. Coordination between the seat and hip/spine segments to maintain balance was quantified in the frequency domain to evaluate coordination (coherence) and relative timing (phase angle: in-phase [segments move together]; out-of-phase [segments move opposite]). Center of pressure (CoP) and upper thorax motion assessed overall balance performance. Hip and spine coordination with the seat were compared between those who did not recover (increased/unchanged pain/disability), partially recovered (reduced pain/disability) or recovered (no pain and disability) at 6 months. RESULTS In both planes, coherence between the seat and lower lumbar spine was lower (and in-phase-unhelpful for balance) at baseline in those who did not recover than those who recovered. Coherence between the seat and hip was higher in partially recovered in both planes, suggesting compensation by the hip. LBP groups had equal overall balance performance (CoP, upper thorax motion), but non-recovery groups used a less optimal strategy that might have consequences for long-term spine health. CONCLUSION These longitudinal data revealed that individuals with compromised contribution of the lumbar spine to the balance during unstable sitting during acute LBP are less likely to recover.
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Affiliation(s)
- Mansour Abdullah Alshehri
- The University of Queensland, Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Wolbert van den Hoorn
- The University of Queensland, Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - David M Klyne
- The University of Queensland, Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia
| | - Jaap H van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jacek Cholewicki
- Center for Neuromusculoskeletal Clinical Research, Michigan State University, Lansing, MI, USA
- Department of Osteopathic Manipulative Medicine, Michigan State University, East Lansing, MI, USA
| | - Paul W Hodges
- The University of Queensland, Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, QLD, Australia.
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Tsai YC, Hsu WL, Kantha P, Chen PJ, Lai DM. Virtual reality skateboarding training for balance and functional performance in degenerative lumbar spine disease. J Neuroeng Rehabil 2024; 21:74. [PMID: 38724981 PMCID: PMC11080234 DOI: 10.1186/s12984-024-01357-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/11/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Degenerative lumbar spine disease (DLD) is a prevalent condition in middle-aged and elderly individuals. DLD frequently results in pain, muscle weakness, and motor impairment, which affect postural stability and functional performance in daily activities. Simulated skateboarding training could enable patients with DLD to engage in exercise with less pain and focus on single-leg weight-bearing. The purpose of this study was to investigate the effects of virtual reality (VR) skateboarding training on balance and functional performance in patients with DLD. METHODS Fourteen patients with DLD and 21 age-matched healthy individuals completed a 6-week program of VR skateboarding training. The motion capture and force platform systems were synchronized to collect data during a single-leg stance test (SLST). Musculoskeletal simulation was utilized to calculate muscle force based on the data. Four functional performance tests were conducted to evaluate the improvement after the training. A Visual Analogue Scale (VAS) was also employed for pain assessment. RESULTS After the training, pain intensity significantly decreased in patients with DLD (p = 0.024). Before the training, patients with DLD took longer than healthy individuals on the five times sit-to-stand test (p = 0.024). After the training, no significant between-group differences were observed in any of the functional performance tests (p > 0.05). In balance, patients with DLD were similar to healthy individuals after the training, except that the mean frequency (p = 0.014) was higher. Patients with DLD initially had higher biceps femoris force demands (p = 0.028) but shifted to increased gluteus maximus demand after the training (p = 0.037). Gluteus medius strength significantly improved in patients with DLD (p = 0.039), while healthy individuals showed consistent muscle force (p > 0.05). CONCLUSION This is the first study to apply the novel VR skateboarding training to patients with DLD. VR skateboarding training enabled patients with DLD to achieve the training effects in a posture that relieves lumbar spine pressure. The results also emphasized the significant benefits to patients with DLD, such as reduced pain, enhanced balance, and improved muscle performance.
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Affiliation(s)
- Yi-Ching Tsai
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F., No. 17, Xuzhou Rd., Zhongzheng Dist, Taipei, Taiwan
| | - Wei-Li Hsu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F., No. 17, Xuzhou Rd., Zhongzheng Dist, Taipei, Taiwan.
- Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan.
| | - Phunsuk Kantha
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F., No. 17, Xuzhou Rd., Zhongzheng Dist, Taipei, Taiwan
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Po-Jung Chen
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F., No. 17, Xuzhou Rd., Zhongzheng Dist, Taipei, Taiwan
| | - Dar-Ming Lai
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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Benistan K, Foy M, Gillas F, Genet F, Kane M, Barbot F, Vaugier I, Bonnyaud C, Gader N. Effects of compression garments on balance in hypermobile Ehlers-Danlos syndrome: a randomized controlled trial. Disabil Rehabil 2024; 46:1841-1850. [PMID: 37194618 DOI: 10.1080/09638288.2023.2209742] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 04/28/2023] [Indexed: 05/18/2023]
Abstract
PURPOSE To evaluate the immediate and 4-week effects of compression garments (CG) on balance using a force platform during 8 different visual, static, and dynamic conditions in hypermobile Ehlers-Danlos Syndrome (hEDS) patients. METHODS Thirty-six participants were randomly assigned to a group: physiotherapy alone (PT, n = 19) or physiotherapy and daily CG wearing for 4 weeks (PT + CG, n = 17). Both attended 12 physiotherapy sessions (strengthening, proprioception, and balance exercises) for 4 weeks. Primary outcome: sway velocity of the centre of pressure (COP) measured before, immediately with the CG, and at 4 weeks. Secondary outcomes: ellipse area, Romberg quotient, and pain. RESULTS Sway velocity in dynamic conditions decreased immediately with the CG. After 4 weeks of intervention, sway velocity (95% CI 4.36-39.23, effect size 0.93) and area (95% CI 146-3274, effect size 0.45) on the laterally oscillating platform with eyes-closed improved more in the PT + CG group than the PT group. Romberg quotient on foam cushion improved more in the PT + CG than the PT group. Pain decreased in both groups after 4 weeks with no between-group difference. CONCLUSION CG combined with physiotherapy improved dynamic balance measured with COP variables significantly more than physiotherapy alone in people with hEDS. TRIAL REGISTRATION NCT03359135.
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Affiliation(s)
- Karelle Benistan
- AP-HP, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers-Danlos non vasculaires, Université Paris Saclay, Garches, France
- UMR1179 INSERM, UFR Simone Veil-Santé, Versailles, France
| | - Malika Foy
- AP-HP, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers-Danlos non vasculaires, Université Paris Saclay, Garches, France
| | - Fabrice Gillas
- AP-HP, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers-Danlos non vasculaires, Université Paris Saclay, Garches, France
| | - François Genet
- UMR1179 INSERM, UFR Simone Veil-Santé, Versailles, France
- AP-HP, Hôpital Raymond-Poincaré, Service de médecine physique et de réadaptation, Université Paris Saclay, Garches, France
| | - Maimouna Kane
- AP-HP, Hôpital Raymond Poincaré, Centre d'investigation Clinique, Garches, France
| | - Frédéric Barbot
- AP-HP, Hôpital Raymond Poincaré, Centre d'investigation Clinique, Garches, France
| | - Isabelle Vaugier
- AP-HP, Hôpital Raymond Poincaré, Centre d'investigation Clinique, Garches, France
| | - Céline Bonnyaud
- AP-HP, Hôpital Raymond Poincaré, Laboratoire d'analyse du mouvement, Université Paris-Saclay, Garches
- Université de Versailles Saint Quentin en Yvelines, ERPHAN, Versailles, France
| | - Nadra Gader
- AP-HP, Hôpital Raymond Poincaré, Centre de référence des syndromes d'Ehlers-Danlos non vasculaires, Université Paris Saclay, Garches, France
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Sung PS, Lee D. Postural control and trunk stability on sway parameters in adults with and without chronic low back pain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:1455-1464. [PMID: 38374241 DOI: 10.1007/s00586-024-08147-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/16/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Postural sway changes often reflect functional impairments in adults with chronic low back pain (LBP). However, there is a gap in understanding how these individuals adapt their postural strategies to maintain stability. PURPOSE This study investigated postural sway distance and velocity, utilizing the center of pressure (COP) and center of gravity (COG), between adults with and without LBP during repeated unilateral standing trials. METHODS Twenty-six subjects with LBP and 39 control subjects participated in the study. Postural sway ranges, COP/COG sways, and sway velocities (computed by dividing path length by time in anteroposterior (AP) and mediolateral (ML) directions over 10 s) were analyzed across three unilateral standing trials. RESULTS A significant group interaction in sway range difference was observed following repeated trials (F = 5.90, p = 0.02). For COG sway range, significant group interactions were demonstrated in both directions (F = 4.28, p = 0.04) and repeated trials (F = 5.79, p = 0.02). The LBP group demonstrated reduced ML sway velocities in the first (5.21 ± 2.43 for the control group, 4.16 ± 2.33 for the LBP group; t = 1.72, p = 0.04) and second (4.87 ± 2.62 for the control group, 3.79 ± 2.22 for the LBP group; t = 1.73, p = 0.04) trials. CONCLUSION The LBP group demonstrated decreased ML sway velocities to enhance trunk stability in the initial two trials. The COG results emphasized the potential use of trunk strategies in augmenting postural stability and optimizing neuromuscular control during unilateral standing.
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Affiliation(s)
- Paul S Sung
- Department of Physical Therapy, Indiana Wesleyan University, 4201 South Washington Street, Marion, IN, 46953, USA.
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12
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Hao Z, Cheng X, Jiang H, Yang J, Li Y, Ambrose Lo WL, Yu Q, Wang C. The associations between lumbar proprioception and postural control during and after calf vibration in people with and without chronic low back pain. Front Bioeng Biotechnol 2024; 12:1329437. [PMID: 38572361 PMCID: PMC10987701 DOI: 10.3389/fbioe.2024.1329437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/19/2024] [Indexed: 04/05/2024] Open
Abstract
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.
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Affiliation(s)
- Zengming Hao
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xue Cheng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haimei Jiang
- Department of Rehabilitation Medicine, The 10th Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan, China
| | - Jiajia Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiuhua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chuhuai Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Jecko V, Garcia L, Doat E, Leconte V, Liguoro D, Cazalets JR, Guillaud E. Vestibulospinal reflexes elicited with a tone burst method are dependent on spatial orientation. PeerJ 2024; 12:e17056. [PMID: 38436036 PMCID: PMC10906260 DOI: 10.7717/peerj.17056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
Balance involves several sensory modalities including vision, proprioception and the vestibular system. This study aims to investigate vestibulospinal activation elicited by tone burst stimulation in various muscles and how head position influences these responses. We recorded electromyogram (EMG) responses in different muscles (sternocleidomastoid-SCM, cervical erector spinae-ES-C, lumbar erector spinae-ES-L, gastrocnemius-G, and tibialis anterior-TA) of healthy participants using tone burst stimulation applied to the vestibular system. We also evaluated how head position affected the responses. Tone burst stimulation elicited reproducible vestibulospinal reflexes in the SCM and ES-C muscles, while responses in the distal muscles (ES-L, G, and TA) were less consistent among participants. The magnitude and polarity of the responses were influenced by the head position relative to the cervical spine. When the head was rotated or tilted, the polarity of the vestibulospinal responses changed, indicating the integration of vestibular and proprioceptive inputs in generating these reflexes. Overall, our study provides valuable insights into the complexity of vestibulospinal reflexes and their modulation by head position. However, the high variability in responses in some muscles limits their clinical application. These findings may have implications for future research in understanding vestibular function and its role in posture and movement control.
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Affiliation(s)
- Vincent Jecko
- Department of Neurosurgery A, University Hospital of Bordeaux, Bordeaux, France
- Univ. Bordeaux, CNRS, INCIA, UMR 5287, Bordeaux, France
| | - Léa Garcia
- Univ. Bordeaux, CNRS, INCIA, UMR 5287, Bordeaux, France
| | - Emilie Doat
- Univ. Bordeaux, CNRS, INCIA, UMR 5287, Bordeaux, France
| | | | - Dominique Liguoro
- Department of Neurosurgery A, University Hospital of Bordeaux, Bordeaux, France
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Alshehri MA, Alzahrani H, van den Hoorn W, Klyne DM, Vette AH, Hendershot BD, Roberts BWR, Larivière C, Barbado D, Vera-Garcia FJ, van Dieen JH, Cholewicki J, Nussbaum MA, Madigan ML, Reeves NP, Silfies SP, Brown SHM, Hodges PW. Trunk postural control during unstable sitting among individuals with and without low back pain: A systematic review with an individual participant data meta-analysis. PLoS One 2024; 19:e0296968. [PMID: 38265999 PMCID: PMC10807788 DOI: 10.1371/journal.pone.0296968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Sitting on an unstable surface is a common paradigm to investigate trunk postural control among individuals with low back pain (LBP), by minimizing the influence lower extremities on balance control. Outcomes of many small studies are inconsistent (e.g., some find differences between groups while others do not), potentially due to confounding factors such as age, sex, body mass index [BMI], or clinical presentations. We conducted a systematic review with an individual participant data (IPD) meta-analysis to investigate whether trunk postural control differs between those with and without LBP, and whether the difference between groups is impacted by vision and potential confounding factors. METHODS We completed this review according to PRISMA-IPD guidelines. The literature was screened (up to 7th September 2023) from five electronic databases: MEDLINE, CINAHL, Embase, Scopus, and Web of Science Core Collection. Outcome measures were extracted that describe unstable seat movements, specifically centre of pressure or seat angle. Our main analyses included: 1) a two-stage IPD meta-analysis to assess the difference between groups and their interaction with age, sex, BMI, and vision on trunk postural control; 2) and a two-stage IPD meta-regression to determine the effects of LBP clinical features (pain intensity, disability, pain catastrophizing, and fear-avoidance beliefs) on trunk postural control. RESULTS Forty studies (1,821 participants) were included for the descriptive analysis and 24 studies (1,050 participants) were included for the IPD analysis. IPD meta-analyses revealed three main findings: (a) trunk postural control was worse (higher root mean square displacement [RMSdispl], range, and long-term diffusion; lower mean power frequency) among individuals with than without LBP; (b) trunk postural control deteriorated more (higher RMSdispl, short- and long-term diffusion) among individuals with than without LBP when vision was removed; and (c) older age and higher BMI had greater adverse impacts on trunk postural control (higher short-term diffusion; longer time and distance coordinates of the critical point) among individuals with than without LBP. IPD meta-regressions indicated no associations between the limited LBP clinical features that could be considered and trunk postural control. CONCLUSION Trunk postural control appears to be inferior among individuals with LBP, which was indicated by increased seat movements and some evidence of trunk stiffening. These findings are likely explained by delayed or less accurate corrective responses. SYSTEMATIC REVIEW REGISTRATION This review has been registered in PROSPERO (registration number: CRD42021124658).
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Affiliation(s)
- Mansour Abdullah Alshehri
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Hosam Alzahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Wolbert van den Hoorn
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - David M. Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Albert H. Vette
- Department of Mechanical Engineering, Donadeo Innovation Centre for Engineering, University of Alberta, Edmonton, Canada
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Canada
| | - Brad D. Hendershot
- Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, United States of America
| | - Brad W. R. Roberts
- Department of Mechanical Engineering, Donadeo Innovation Centre for Engineering, University of Alberta, Edmonton, Canada
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada
| | - David Barbado
- Sport Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
- Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernández University of Elche, Alicante, Spain
| | - Francisco J. Vera-Garcia
- Sport Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Alicante, Spain
- Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernández University of Elche, Alicante, Spain
| | - Jaap H. van Dieen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Jacek Cholewicki
- Center for Neuromusculoskeletal Clinical Research, Michigan State University, Lansing, Michigan, United States of America
- Department of Osteopathic Manipulative Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Maury A. Nussbaum
- Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia, United States of America
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia, United States of America
| | - Michael L. Madigan
- Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, Virginia, United States of America
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia, United States of America
| | | | - Sheri P. Silfies
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States of America
| | - Stephen H. M. Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Paul W. Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Chen Z, Tirosh O, Han J, Adams RD, El-Ansary D, Pranata A. Voluntary postural sway control and mobility in adults with low back pain. Front Neurosci 2024; 17:1285747. [PMID: 38235390 PMCID: PMC10793656 DOI: 10.3389/fnins.2023.1285747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/08/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction Low back pain (LBP) is associated with altered somatosensory perception, which is involved in both involuntary and voluntary control of posture. Currently, there is a lack of methods and tools for assessing somatosensory acuity in patients with LBP. The purpose of this study was (1) to assess the reliability of the sway discrimination apparatus (SwayDA) (2) to evaluate the differences in somatosensory acuity between patients with LBP and pain-free individuals, and (3) to examine relationships between somatosensory acuity, severity of LBP, and mobility in patients with LBP. Methods Twenty participants (10 patients with LBP and 10 matched asymptomatic controls) were recruited in a test-retest reliability test. Another 56 participants were recruited for this study with 28 individuals presenting with LBP and a further twenty-eight being asymptomatic. The SwayDA was custom-built to measure somatosensory perception during voluntary anterior-posterior (SwayDA-AP), medial-lateral to the dominant side (SwayDA-ML-D), and non-dominant side (SwayDA-ML-ND) postural sway control. Participants also completed mobility tests, including 10 times and 1-min sit-to-stand tests (10-STS, 1 m-STS). The area under the receiver operating characteristic curve (AUC) was calculated to quantify somatosensory acuity in discriminating different voluntary postural sway extents. Results The ICC (2.1) for the SwayDA-AP, SwayDA-ML-D, and SwayDA-ML-ND were 0.741, 0.717, and 0.805 with MDC95 0.071, 0.043, and 0.050. Patients with LBP demonstrated significantly lower SwayDA scores (tSwayDA-AP = -2.142, p = 0.037; tSwayDA-ML-D = -2.266, p = 0.027) than asymptomatic controls. The AUC values of the SwayDA-AP test were significantly correlated with ODI (rSwayDA-AP-ODI = -0.391, p = 0.039). Performances on the 1 m-STS and the 10-STS were significantly correlated with the AUC scores from all the SwayDA tests (-0.513 ≤ r ≤ 0.441, all p < 0.05). Discussion The SwayDA tests evaluated showed acceptable reliability in assessing somatosensory acuity during voluntary postural sway. Somatosensory acuity was diminished in patients with LBP compared to asymptomatic controls. In patients with LBP, lower somatosensory acuity was associated with increased LBP-related disability. Future research could focus on investigating the factors contributing to the decreased somatosensory perception and mobility in individuals with LBP.
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Affiliation(s)
- Zhengquan Chen
- Shanghai Yangpu District Mental Health Center, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Oren Tirosh
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Jia Han
- Shanghai Yangpu District Mental Health Center, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Roger David Adams
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Doa El-Ansary
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Department of Surgery, Melbourne Medical School, Melbourne, VIC, Australia
| | - Adrian Pranata
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
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Van Wesemael S, Bogaerts K, De Baets L, Goossens N, Vlemincx E, Amerijckx C, Sohail S, Matheve T, Janssens L. The association between pain-related psychological variables and postural control in low back pain: A systematic review and meta-analysis. Gait Posture 2024; 107:253-268. [PMID: 37925241 DOI: 10.1016/j.gaitpost.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/13/2023] [Accepted: 10/17/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Alterations in postural control have been found in individuals with low back pain (LBP), particularly during challenging postural tasks. Moreover, higher levels of negative pain-related psychological variables are associated with increased trunk muscle activity, reduced spinal movement, and worse maximal physical performance in individuals with LBP. RESEARCH QUESTION Are pain-related psychological variables associated with postural control during static bipedal standing tasks in individuals with LBP? METHODS A systematic review and meta-analysis were conducted. Pubmed, Web of Science, and PsycINFO were searched until March 2023. Studies were included if they evaluated postural control during static bipedal standing in individuals with LBP by measuring center of pressure (CoP) variables, and reported at least one pain-related psychological variable. Correlation coefficients between pain-related psychological variables and CoP variables were extracted. Study quality was assessed with the "Quality In Prognosis Studies" tool (QUIPS). Random-effect models were used to calculate pooled correlation coefficients for different postural tasks. Sub-analyses were performed for positional or dynamic CoP variables. Certainty of evidence was assessed with an adjusted "Grading of Recommendations, Assessment, Development, and Evaluations" tool (GRADE). The protocol was registered on PROSPERO (CRD42021241739). RESULTS Sixteen studies (n = 723 participants) were included. Pain-related fear (16 studies) and pain catastrophizing (three studies) were the only reported pain-related psychological variables. Both pain-related fear (-0.04 < pooled r < 0.14) and pain catastrophizing (0.28 < pooled r < 0.29) were weakly associated with CoP variables during different postural tasks. For all associations, the certainty of evidence was very low. SIGNIFICANCE Pain-related fear and pain catastrophizing are only weakly associated with postural control during static bipedal standing in individuals with LBP, regardless of postural task difficulty. Certainty of evidence is very low thus it is conceivable that future studies accounting for current study limitations might reveal different findings.
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Affiliation(s)
- Sofie Van Wesemael
- UHasselt, REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Agoralaan Gebouw A, 3590 Diepenbeek, Belgium.
| | - Katleen Bogaerts
- UHasselt, REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Agoralaan Gebouw A, 3590 Diepenbeek, Belgium; KU Leuven, Health Psychology, Faculty of Psychology and Educational Sciences, Tiensestraat 102, 3000 Leuven, Belgium
| | - Liesbet De Baets
- Vrije Universiteit Brussel, Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Pleinlaan 2, 1050 Brussels, Belgium
| | - Nina Goossens
- UHasselt, REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Agoralaan Gebouw A, 3590 Diepenbeek, Belgium
| | - Elke Vlemincx
- KU Leuven, Health Psychology, Faculty of Psychology and Educational Sciences, Tiensestraat 102, 3000 Leuven, Belgium; Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences Research Institute, Department of Health Sciences, De Boelelaan 1105, 1081 HV Amsterdam, the Netherlands
| | - Charlotte Amerijckx
- UHasselt, REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Agoralaan Gebouw A, 3590 Diepenbeek, Belgium
| | - Suniya Sohail
- UHasselt, REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Agoralaan Gebouw A, 3590 Diepenbeek, Belgium; Foundation University Islamabad, Department of Rehabilitation Sciences, Defence Avenue, Phase-I, DHA, 44000 Islamabad, Pakistan
| | - Thomas Matheve
- UHasselt, REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Agoralaan Gebouw A, 3590 Diepenbeek, Belgium; Ghent University, Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Lotte Janssens
- UHasselt, REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Agoralaan Gebouw A, 3590 Diepenbeek, Belgium
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Toprak Celenay S, Bayramoglu Demirdogen E, Barut O, Cigdem Karacay B, Ozer Kaya D. Postural stability, spinal alignment, mobility, and postural competency in women with unilateral lower extremity lymphedema after radical hysterectomy following gynecologic cancer: A case-control study. Eur J Oncol Nurs 2023; 67:102416. [PMID: 37879191 DOI: 10.1016/j.ejon.2023.102416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/07/2023] [Accepted: 09/07/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE To compare postural stability, spinal alignment, mobility, and postural competency in women with unilateral lower extremity lymphedema after radical hysterectomy following gynecologic cancer with a matched control group. METHODS Twenty-seven women with unilateral lower extremity lymphedema (lymphedema group, age: 54.14 ± 5.80 years) and 30 healthy women (control group, age: 51.90 ± 6.54 years) were included. The lymphedema severity was evaluated with circumferential measurements. Postural stability with the Biodex Balance System SD and the spinal alignment, mobility, and postural competency with the Spinal Mouse device were assessed. RESULTS In the lymphedema group, it was found that 3.7% of the women had mild lymphedema, 7.4% had moderate lymphedema, and 88.9% had severe lymphedema. Static eyes open (EO) (overall, medio-lateral and antero-posterior) and eyes closed (EC) (antero-posterior) stability scores and dynamic EO and EC stability scores (overall and antero-posterior) were detected to be higher in the lymphedema group than in the controls (p < 0.05). Spinal mobility and postural competency scores were lower in the lymphedema group than in the control group (p < 0.05). In other parameters, there were no significant differences between the groups (p > 0.05). CONCLUSION Decreased postural stability, spinal mobility, and postural competency were detected in women with unilateral lower extremity lymphedema; however, no difference was seen in spinal alignment. These changes should be taken into account in the assessment and the treatment of unilateral lower extremity lymphedema.
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Affiliation(s)
- Seyda Toprak Celenay
- Ankara Yildirim Beyazit University, Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Ankara, Turkey.
| | | | - Ozge Barut
- Kirsehir Ahi Evran University, Rectorship, Pilot University Coordinatorship of Health, Kirsehir, Turkey
| | - Basak Cigdem Karacay
- Kirsehir Ahi Evran University, Faculty of Medicine, Department of Physical Therapy and Rehabilitation, Kirsehir, Turkey
| | - Derya Ozer Kaya
- Izmir Katip Celebi University, Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Izmir, Turkey
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Madsen AL, Gyntelberg F, Marott JL, Schnohr P, Astrup J. Cohort study of postural sway and low back pain: the Copenhagen City Heart Study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:4390-4396. [PMID: 37740785 DOI: 10.1007/s00586-023-07925-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 08/07/2023] [Accepted: 08/28/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE Low back pain is a significant health problem with a high prevalence. Studies of smaller cohorts of low back pain patients have indicated increased body sway. The present paper tests the hypothesis of an association between low back pain and postural sway in a large randomly selected population. METHODS The current study used the fifth examination (2011-2015) of The Copenhagen City Heart Study where 4543 participated. The participants answered a self-administered questionnaire regarding pain, physical activity, smoking, alcohol consumption, education, and other lifestyle factors. Measurement of postural body sway was performed using the CATSYS system. RESULTS Totally 1134 participants (25%) reported to have low back pain. Subjects with low back pain had higher sway area and sway velocity than subjects without. CONCLUSION When using multivariate statistical analysis, confounding factors such as male gender, higher age, larger body height, low education level, smoking, and low activity level explained the association between low back pain and postural sway.
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Affiliation(s)
- Anja Lykke Madsen
- Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Finn Gyntelberg
- The National Research Centre of Working Environment, Copenhagen East, Denmark
| | - Jacob Louis Marott
- Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Schnohr
- Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jens Astrup
- Danish Headache Center, Rigshospitalet Glostrup, Glostrup, Denmark
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Mahmud MR, Cordova A, Quarles J. Visual Cues for a Steadier You: Visual Feedback Methods Improved Standing Balance in Virtual Reality for People with Balance Impairments. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2023; 29:4666-4675. [PMID: 37788203 DOI: 10.1109/tvcg.2023.3320244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Users of head-mounted displays (HMDs) for virtual reality (VR) sometimes have balance issues since HMDs impede their view of the outside world. This has a greater impact on people with balance impairments since many rely more heavily on their visual cues to keep their balance. This is a significant obstacle to the universal usability and accessibility of VR. Although previous studies have verified the imbalance issue, not much work has been done to diminish it. In this study, we investigated how to increase VR balance by utilizing additional visual cues. To examine how different visual approaches (static, rhythmic, spatial, and center of pressure (CoP) based feedback) affect balance in VR, we recruited 100 people (50 with balance impairments due to multiple sclerosis and 50 without balance impairments) across two different geographic locations (United States and Bangladesh). All people completed both standing visual exploration as well as standing reach and grasp tasks. Results demonstrated that static, rhythmic, and CoP visual feedback approaches enhanced balance significantly ( ) in VR for people with balance impairments. The methods described in this study could be applied to design more accessible virtual environments for people with balance impairments.
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Jensen E, Mirjalili R, Peper K, Ossadnik D, Wu F, Lang J, Martin M, Hetfleisch F, Burgkart R, Haddadin S. Individualized Training of Back Muscles Using Iterative Learning Control of a Compliant Balance Board. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941217 DOI: 10.1109/icorr58425.2023.10304810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Here we present the GyroTrainer, a bespoke mechatronic balance board system designed to trigger activation of the back muscles while the user engages in a balance-challenging game. The GyroTrainer uses admittance control coupled with an iterative learning approach so as to tailor the admittance control parameters, i.e. difficulty level, according to the user's skill. Our experimental evaluation demonstrated that an individualized admittance control stiffness could be identified for each user, which corresponds with a desired level of difficulty and increased back muscle activity. A first game implementation demonstrates the feasibility of utilizing the GyroTrainer system and the individually identified admittance control stiffness for gamification of back muscle training.
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Porwal S, Rizvi MR, Sharma A, Ahmad F, Alshahrani MS, Raizah A, Shaik AR, Seyam MK, Miraj M, Alkhamis BA, Mukherjee D, Ahmad I. Enhancing Functional Ability in Chronic Nonspecific Lower Back Pain: The Impact of EMG-Guided Trunk Stabilization Exercises. Healthcare (Basel) 2023; 11:2153. [PMID: 37570393 PMCID: PMC10418369 DOI: 10.3390/healthcare11152153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/16/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Nonspecific lower back pain (NSLBP) is described as pain that is not caused by an identifiable, well-known disease, such as infection, tumor, osteoporosis, fracture, structural deformity, inflammatory condition, radicular syndrome, or cauda equina syndrome. AIM The aim of this study was to determine the effect of EMG-guided trunk stabilization exercises on functional disability associated with LBP. MATERIALS AND METHODS A single-blinded pre- and post-test experimental comparative design was used for this study. Fifty individuals with chronic NSLBP were screened for inclusion criteria. Of these, forty were randomly grouped into the EMG group receiving trunk-stability exercises with electromyography biofeedback and non-EMG group receiving trunk-stabilization exercises without EMG biofeedback. Participants performed five trunk-stability exercises 3 days a week for 4 weeks. The intensity of pain, range of motion, functional disability, and balance were measured at baseline and after 4 weeks. RESULTS Both techniques indicated a significant effect on chronic NSLBP; however, trunk-stability exercises combined with EMG biofeedback produced better results in alleviating the intensity of pain, increasing the range of motion, and improving functional disabilities and static balance. CONCLUSION The present study confirms that trunk-stability exercises with EMG biofeedback can be practiced safely, contributes to a greater boost in neuromuscular efficiency in the lumbar flexors and extensors, and is effective in modifying functional disability for patients with NSLBP.
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Affiliation(s)
- Shivani Porwal
- Department of Physiotherapy, School of Allied Health Sciences, Manav Rachna International Institute and Studies (MRIIRS), Faridabad 121001, India; (S.P.); (A.S.)
| | - Moattar Raza Rizvi
- School of Allied Health Sciences, Manav Rachna International Institute and Studies (MRIIRS), Faridabad 121001, India;
| | - Ankita Sharma
- Department of Physiotherapy, School of Allied Health Sciences, Manav Rachna International Institute and Studies (MRIIRS), Faridabad 121001, India; (S.P.); (A.S.)
| | - Fuzail Ahmad
- Respiratory Care Department, College of Applied Sciences, Almaarefa University, Diriya, Riyadh 13713, Saudi Arabia
| | - Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia; (M.S.A.); (B.A.A.); (D.M.)
| | - Abdullah Raizah
- Department of Orthopaedics, College of Medicine, King Khalid University, Abha 61413, Saudi Arabia;
| | - Abdul Rahim Shaik
- Department of Physical Therapy & Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majma’ah 15431, Saudi Arabia; (A.R.S.); (M.K.S.); (M.M.)
| | - Mohamed K. Seyam
- Department of Physical Therapy & Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majma’ah 15431, Saudi Arabia; (A.R.S.); (M.K.S.); (M.M.)
| | - Mohammad Miraj
- Department of Physical Therapy & Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majma’ah 15431, Saudi Arabia; (A.R.S.); (M.K.S.); (M.M.)
| | - Batool Abdulelah Alkhamis
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia; (M.S.A.); (B.A.A.); (D.M.)
| | - Debjani Mukherjee
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia; (M.S.A.); (B.A.A.); (D.M.)
| | - Irshad Ahmad
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia; (M.S.A.); (B.A.A.); (D.M.)
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Robinault L, Niazi IK, Kumari N, Amjad I, Menard V, Haavik H. Non-Specific Low Back Pain: An Inductive Exploratory Analysis through Factor Analysis and Deep Learning for Better Clustering. Brain Sci 2023; 13:946. [PMID: 37371424 DOI: 10.3390/brainsci13060946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Non-specific low back pain (NSLBP) is a significant and pervasive public health issue in contemporary society. Despite the widespread prevalence of NSLBP, our understanding of its underlying causes, as well as our capacity to provide effective treatments, remains limited due to the high diversity in the population that does not respond to generic treatments. Clustering the NSLBP population based on shared characteristics offers a potential solution for developing personalized interventions. However, the complexity of NSLBP and the reliance on subjective categorical data in previous attempts present challenges in achieving reliable and clinically meaningful clusters. This study aims to explore the influence and importance of objective, continuous variables related to NSLBP and how to use these variables effectively to facilitate the clustering of NSLBP patients into meaningful subgroups. Data were acquired from 46 subjects who performed six simple movement tasks (back extension, back flexion, lateral trunk flexion right, lateral trunk flexion left, trunk rotation right, and trunk rotation left) at two different speeds (maximum and preferred). High-density electromyography (HD EMG) data from the lower back region were acquired, jointly with motion capture data, using passive reflective markers on the subject's body and clusters of markers on the subject's spine. An exploratory analysis was conducted using a deep neural network and factor analysis. Based on selected variables, various models were trained to classify individuals as healthy or having NSLBP in order to assess the importance of different variables. The models were trained using different subsets of data, including all variables, only anthropometric data (e.g., age, BMI, height, weight, and sex), only biomechanical data (e.g., shoulder and lower back movement), only neuromuscular data (e.g., HD EMG activity), or only balance-related data. The models achieved high accuracy in categorizing individuals as healthy or having NSLBP (full model: 93.30%, anthropometric model: 94.40%, biomechanical model: 84.47%, neuromuscular model: 88.07%, and balance model: 74.73%). Factor analysis revealed that individuals with NSLBP exhibited different movement patterns to healthy individuals, characterized by slower and more rigid movements. Anthropometric variables (age, sex, and BMI) were significantly correlated with NSLBP components. In conclusion, different data types, such as body measurements, movement patterns, and neuromuscular activity, can provide valuable information for identifying individuals with NSLBP. To gain a comprehensive understanding of NSLBP, it is crucial to investigate the main domains influencing its prognosis as a cohesive unit rather than studying them in isolation. Simplifying the conditions for acquiring dynamic data is recommended to reduce data complexity, and using back flexion and trunk rotation as effective options should be further explored.
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Affiliation(s)
- Lucien Robinault
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
| | - Imran Khan Niazi
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
- Faculty of Health and Environmental Sciences, Health and Rehabilitation Research Institute, AUT University, Auckland 1010, New Zealand
- Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Nitika Kumari
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
| | - Imran Amjad
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
- Faculty of Rehabilitation and Allied Health Sciences and Department of Biomedical Engineering, Riphah International University, Islamabad 46000, Pakistan
| | - Vincent Menard
- M2S Laboratory, ENS Rennes, University of Rennes 2, 35065 Rennes, France
| | - Heidi Haavik
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
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Koltermann JJ, Floessel P, Hammerschmidt F, Disch AC. The Influence of Anthropometric Variables and Filtering Frequency on Center of Pressure Data. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23115105. [PMID: 37299831 DOI: 10.3390/s23115105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/26/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
Good postural control is considered to be a key component of an active lifestyle, and numerous studies have investigated the Center of Pressure (CoP) as a way of identifying motor deficits. However, the optimal frequency range for assessing CoP variables and the effect of filtering on the relationships between anthropometric variables and CoP are unclear. The aim of this work is to show the relationship between anthropometric variables and different ways of filtering the CoP data. CoP was measured in 221 healthy volunteers using a KISTLER force plate in four different test conditions, both mono and bipedal. The results show no significant changes in the existing correlations of the anthropometric variable values over different filter frequencies between 10 Hz and 13 Hz. Therefore, the findings with regard to anthropometric influences on CoP, with a reasonable but less than ideal filtering of the data, can be applied to other study settings.
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Affiliation(s)
- Jan Jens Koltermann
- Consulting Engineer for Metrology and Data Science, Bahnhofstraße 33, 03046 Cottbus, Germany
| | - Philipp Floessel
- TU Dresden-University Hospital Carl Gustav Carus, University Center of Orthopedics, Trauma & Plastic Surgery, 01307 Dresden, Germany
| | - Franziska Hammerschmidt
- TU Dresden-University Hospital Carl Gustav Carus, University Center of Orthopedics, Trauma & Plastic Surgery, 01307 Dresden, Germany
| | - Alexander Carl Disch
- TU Dresden-University Hospital Carl Gustav Carus, University Center of Orthopedics, Trauma & Plastic Surgery, 01307 Dresden, Germany
- TU Dresden-University Hospital Carl Gustav Carus, University Comprehensive Spine Center (UCSC), 01307 Dresden, Germany
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Schilaty N, Bates N, Holmes B, Nagai T. Group differences and associations between patient-reported outcomes and physical characteristics in chronic low back pain patients and healthy controls. Clin Biomech (Bristol, Avon) 2023; 106:106009. [PMID: 37245281 DOI: 10.1016/j.clinbiomech.2023.106009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 04/11/2023] [Accepted: 05/18/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Patients with chronic low back pain can exhibit altered slower gait, poor balance, and lower strength/power, and psychological dysfunctions such as pain catastrophizing and fear of movement. Few studies have investigated the relationships between physical and psychological dysfunctions. This study examined associations between patient-reported outcomes (pain interference, physical function, central sensitization, and kinesiophobia) and physical characteristics (gait, balance, and trunk sensorimotor characteristics). METHODS Laboratory testing included a 4-m walk, balance, and trunk sensorimotor testing with 18 patients and 15 controls. Gait and balance were collected with inertial measurement units. Isokinetic dynamometry measured trunk sensorimotor characteristics. Patient-reported outcomes included PROMIS Pain Interference / Physical Function, Central Sensitization Inventory, and Tampa Scale of Kinesiophobia. Independent t-tests or Mann-Whitney U tests were used to compare between groups. Additionally, Spearman's rank correlation coefficient (rs) established associations between physical and psychological domains, and Fisher z-tests compared correlation coefficient values between groups (significance P < 0.05). FINDINGS The patient group had worse tandem balance and all patient-reported outcomes (P < 0.05) while no group differences were observed in gait and trunk sensorimotor characteristics. There were significant correlations between worse central sensitization and poor tandem balance (rs = 0.446-0.619, P < 0.05) and lower peak force and rate of force development (rs = -0.429-0.702, P < 0.05). INTERPRETATION Observed group differences in tandem balance agree with previous studies, indicating impaired proprioception. The current findings provide preliminary evidence that balance and trunk sensorimotor characteristics were significantly associated with patient-reported outcomes in patients. Early and period screening could help clinicians further categorize patients and develop objective treatment plans.
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Affiliation(s)
- Nathan Schilaty
- University of South Florida, Tampa, FL, USA; Mayo Clinic, Rochester, MN, USA.
| | - Nathaniel Bates
- Mayo Clinic, Rochester, MN, USA; Ohio State University, Columbus, OH, USA
| | | | - Takashi Nagai
- Mayo Clinic, Rochester, MN, USA; United States Army Research Institute of Environmental Medicine, Natick, MA, USA
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Park J, Nguyen VQ, Ho RLM, Coombes SA. The effect of chronic low back pain on postural control during quiet standing: A meta-analysis. Sci Rep 2023; 13:7928. [PMID: 37193730 DOI: 10.1038/s41598-023-34692-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/05/2023] [Indexed: 05/18/2023] Open
Abstract
Low back pain (LBP) has been associated with altered body sway during quiet standing, but the pattern of results is inconsistent. The purpose of this meta-analysis is to examine the effects of vision (eyes open, eyes closed) and changing the support surface (foam surface, firm surface) on postural sway during quiet standing in individuals with chronic LBP (cLBP). Five electronic databases were searched on March 27th, 2022. Of 2,856, 16 studies (n = 663) were included. Across all conditions, we found a positive and medium effect size (g = 0.77 [0.50, 1.04]) that represented greater body sway in individuals with cLBP. Subgroup analyses revealed medium effects during eyes open conditions (firm surface: g = 0.60 [0.33, 0.87]; foam surface: g = 0.68 [0.38, 0.97]), and large effects during eyes closed conditions (firm surface: g = 0.97 [0.60, 1.35]; foam surface: g = 0.89 [0.28, 1.51]). We quantified effects of self-reported pain and found a moderate effect during eyes closed plus firm surface conditions (Q = 3.28; p = 0.070). We conclude that cLBP is associated with increased postural sway, with largest effect sizes evident when vision is removed and when self-reported pain intensity is higher.
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Affiliation(s)
- Jinhan Park
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL, 32611, USA
| | - Vinh Q Nguyen
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL, 32611, USA
| | - Rachel L M Ho
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL, 32611, USA
| | - Stephen A Coombes
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, PO Box 118206, Gainesville, FL, 32611, USA.
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA.
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Cuenca-Martínez F, Sempere-Rubio N, Muñoz-Gómez E, Mollà-Casanova S, Carrasco-González E, Martínez-Arnau FM. Respiratory Function Analysis in Patients with Chronic Pain: An Umbrella Review and Meta-Analysis of Pooled Findings. Healthcare (Basel) 2023; 11:healthcare11091358. [PMID: 37174900 PMCID: PMC10178598 DOI: 10.3390/healthcare11091358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/04/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The main aim of this umbrella review was to assess the respiratory function in patients with chronic pain (CP), including patients with chronic neck pain (CNP), chronic low back pain (CLBP), and fibromyalgia syndrome (FMS). METHODS We searched in PubMed, PEDro, EMBASE, CINAHL, and Google Scholar (4 February 2023). The outcome measures were respiratory muscle strength (MIP/MEP) and pulmonary function (VC, MVV, FVC, FEV1, FEV1/FVC ratio, FEV25-75, and PEF). This review was previously registered in the international prospective register of systematic reviews, PROSPERO (CRD42023396722). The methodological quality was analyzed using AMSTAR and ROBIS scales, and the strength of the evidence was established according to the guidelines advisory committee grading criteria. To compare the outcomes reported by the studies, we calculated the standardized mean differences and the corresponding 95% confidence interval for the continuous variables. RESULTS Four systematic reviews with and without meta-analysis were included, from which a total of 15 primary studies were extracted. Five meta-analyses were carried out, using analyses by subgroup according to the type of CP. The meta-analyzing variables were MIP, MEP, MVV, FEV1, and FVC. CONCLUSIONS Overall, patients with CP have decreased respiratory muscle strength with a moderate quality of evidence. Regarding the pulmonary function, patients with CNP showed a diminished VC, PEF, MVV, FEV1, and FVC, while FEV25-75 and the FEV1/FVC ratio were conserved with a limited to moderate quality of evidence. Finally, patients with FMS and CLBP only showed a decrease in MVV with a limited quality of evidence.
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Affiliation(s)
| | | | - Elena Muñoz-Gómez
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | | | - Enrique Carrasco-González
- Department of Physiotherapy, Universidad Europea Miguel de Cervantes, c/del Padre Julio Chevalier nº2, 47012 Valladolid, Spain
- Clínica Neuron Paseo De La Habana, c/Fray Bernardino Sahagún 9, 28036 Madrid, Spain
| | - Francisco M Martínez-Arnau
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
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Faes Y, Rolli Salathé C, Herlig ML, Elfering A. Beyond physiology: Acute effects of side-alternating whole-body vibration on well-being, flexibility, balance, and cognition using a light and portable platform A randomized controlled trial. Front Sports Act Living 2023; 5:1090119. [PMID: 36793620 PMCID: PMC9922907 DOI: 10.3389/fspor.2023.1090119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/03/2023] [Indexed: 02/03/2023] Open
Abstract
A good body-balance helps to prevent slips, trips and falls. New body-balance interventions must be explored, because effective methods to implement daily training are sparse. The purpose of the current study was to investigate acute effects of side-alternating whole-body vibration (SS-WBV) training on musculoskeletal well-being, flexibility, body balance, and cognition. In this randomized controlled trial, participants were randomly allocated into a verum (8.5 Hz, SS-WBV, N = 28) or sham (6 Hz, SS-WBV, N = 27) condition. The training consisted of three SS-WBV series that lasted one-minute each with two one-minute breaks in between. During the SS-WBV series, participants stood in the middle of the platform with slightly bent knees. During the breaks in between, participants could loosen up. Flexibility (modified fingertip-to-floor method), balance (modified Star Excursion Balance Test), and cognitive interference (Stroop Color Word Test) were tested before and after the exercise. Also, musculoskeletal well-being, muscle relaxation, sense of flexibility, sense of balance, and surefootedness were assessed in a questionnaire before and after the exercise. Musculoskeletal well-being was significantly increased only after verum. Also, muscle relaxation was significantly higher only after verum. The Flexibility-Test showed significant improvement after both conditions. Accordingly, sense of flexibility was significantly increased after both conditions. The Balance-Test showed significant improvement after verum, and after sham. Accordingly, increased sense of balance was significant after both conditions. However, surefootedness was significantly higher only after verum. The Stroop-Test showed significant improvement only after verum. The current study shows that one SS-WBV training session increases musculoskeletal well-being, flexibility, body balance and cognition. The abundance of improvements on a light and portable platform has great influence on the practicability of training in daily life, aiming to prevent slip trips and falls at work.
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Affiliation(s)
- Yannik Faes
- Business Psychology, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
- Faculty of Psychology, Distance University, Brig, Switzerland
- Department of Work and Organizational Psychology, University of Bern, Bern, Switzerland
| | - Cornelia Rolli Salathé
- Faculty of Psychology, Distance University, Brig, Switzerland
- Department of Work and Organizational Psychology, University of Bern, Bern, Switzerland
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Marina Luna Herlig
- Department of Work and Organizational Psychology, University of Bern, Bern, Switzerland
| | - Achim Elfering
- Faculty of Psychology, Distance University, Brig, Switzerland
- Department of Work and Organizational Psychology, University of Bern, Bern, Switzerland
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Van Humbeeck N, Kliegl R, Krampe RT. Lifespan changes in postural control. Sci Rep 2023; 13:541. [PMID: 36631521 PMCID: PMC9834247 DOI: 10.1038/s41598-022-26934-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/22/2022] [Indexed: 01/13/2023] Open
Abstract
Lifespan development of postural control shows as an inverted U-shaped function with optimal performance in young adults and similar levels of underperformance in children and older adults. However, similarities in children and older adults might conceal differences in underlying control processes. We mapped out age-related differences in postural control using center-of-pressure trajectories of 299 participants ranging from 7 to 81 years old in three tasks: stable stance, compromised vision, and narrowed base of support. Summary statistics (path length, ellipse area) replicated the well-known U-shape function also showing that compromising vision and narrowing the base of support affected older adults more than children. Stabilogram diffusion analysis (SDA) allows to assess postural control performance in terms of diffusion at short (< 1 s) and longer timescales. SDA parameters showed the strongest short-term drift in older adults, especially under compromised vision or narrowed base of support conditions. However, older adults accommodated their poor short-term control by corrective adjustments as reflected in long-term diffusion under eyes closed conditions and initiating anti-persistent behavior earlier compared with children and young adults in tandem stance. We argue that these results highlight the adaptability of the postural control system and warrant a reinterpretation of previous postural control frameworks.
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Affiliation(s)
- Nathan Van Humbeeck
- Brain and Cognition Group, University of Leuven (KU Leuven), Leuven, Belgium.
| | - Reinhold Kliegl
- grid.11348.3f0000 0001 0942 1117Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Ralf T. Krampe
- grid.5596.f0000 0001 0668 7884Brain and Cognition Group, University of Leuven (KU Leuven), Leuven, Belgium
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Saraiva M, Vilas-Boas JP, Fernandes OJ, Castro MA. Effects of Motor Task Difficulty on Postural Control Complexity during Dual Tasks in Young Adults: A Nonlinear Approach. SENSORS (BASEL, SWITZERLAND) 2023; 23:628. [PMID: 36679423 PMCID: PMC9866022 DOI: 10.3390/s23020628] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/11/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Few studies have evaluated the effect of a secondary motor task on the standing posture based on nonlinear analysis. However, it is helpful to extract information related to the complexity, stability, and adaptability to the environment of the human postural system. This study aimed to analyze the effect of two motor tasks with different difficulty levels in motor performance complexity on the static standing posture in healthy young adults. Thirty-five healthy participants (23.08 ± 3.92 years) performed a postural single task (ST: keep a quiet standing posture) and two motor dual tasks (DT). i.e., mot-DT(A)—perform the ST while performing simultaneously an easy motor task (taking a smartphone out of a bag, bringing it to the ear, and putting it back in the bag)—and mot-DT(T)—perform the ST while performing a concurrent difficult motor task (typing on the smartphone keyboard). The approximate entropy (ApEn), Lyapunov exponent (LyE), correlation dimension (CoDim), and fractal dimension (detrending fluctuation analysis, DFA) for the mediolateral (ML) and anterior-posterior (AP) center-of-pressure (CoP) displacement were measured with a force plate while performing the tasks. A significant difference was found between the two motor dual tasks in ApEn, DFA, and CoDim-AP (p < 0.05). For the ML CoP direction, all nonlinear variables in the study were significantly different (p < 0.05) between ST and mot-DT(T), showing impairment in postural control during mot-DT(T) compared to ST. Differences were found across ST and mot-DT(A) in ApEn-AP and DFA (p < 0.05). The mot-DT(T) was associated with less effectiveness in postural control, a lower number of degrees of freedom, less complexity and adaptability of the dynamic system than the postural single task and the mot-DT(A).
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Affiliation(s)
- Marina Saraiva
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal
- Faculty of Sports, University of Porto, 4200-450 Porto, Portugal
| | - João Paulo Vilas-Boas
- Faculty of Sports, University of Porto, 4200-450 Porto, Portugal
- LABIOMEP-UP, Faculty of Sports and CIFI2D, University of Porto, 4200-450 Porto, Portugal
| | - Orlando J. Fernandes
- Sport and Health Department, School of Health and Human Development, University of Évora, 7000-671 Évora, Portugal
- Comprehensive Health Research Center (CHRC), University of Évora, 7000-671 Évora, Portugal
| | - Maria António Castro
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal
- Department of Mechanical Engineering, University of Coimbra, CEMMPRE, 3030-788 Coimbra, Portugal
- Sector of Physiotherapy, School of Health Sciences, Polytechnic Institute of Leiria, 2411-901 Leiria, Portugal
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Yan S, Yeomans MA, Hondzinski JM. Vertical-horizontal illusory effects with gaze restrictions do not change length estimations using the lower limb. Exp Brain Res 2023; 241:67-80. [PMID: 36355211 DOI: 10.1007/s00221-022-06504-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/03/2022] [Indexed: 11/11/2022]
Abstract
Gaze direction and use of visual feedback can affect illusory influences over perceptions and manual length size estimates of the vertical-horizontal (V-H) illusion, in which the vertical, bisecting segment of an inverted T (IT) appears longer than the horizontal, bisected segment. We questioned whether V-H illusory influences would also exist for the lower limb. Participants stepped forward in an attempt to make the toe-to-toe distance of their dominant foot equal to a short or long bisecting segment length of a vertically projected IT. Performances under three gaze conditions included: maintaining gaze on the IT intersection throughout a trial for target fixation (TF); viewing the intersection for 4 s then looking down and performing the step for movement fixation (MF); and viewing the intersection for 4 s then maintaining gaze on the remembered location of the intersection and performing the step for remembered target fixation (RTF). Variables included step displacement, peak velocity (PV), and normalized ground reaction force amplitude (GRFampN), as well as time to peak and peak amplitude of the center of pressure (COPtime and COPamp, respectively). Main effects of gaze on PV, GRFampN, COPtime, and COPamp revealed lower values for MF compared to TF and RTF, which did not exist for step displacement. No significant correlations existed between step displacement and other variables across participants. Together, we found evidence to suggest differences between movement planning and movement completion. Exploitation of deceptive visual cues can guide step planning and early step execution, but do not guide final step estimations.
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Affiliation(s)
- Shijun Yan
- School of Kinesiology, Louisiana State University, 1246 Pleasant Hall, Baton Rouge, LA, 70803, USA.,Legs and Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, USA.,Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA
| | - Matthew A Yeomans
- School of Kinesiology, Louisiana State University, 1246 Pleasant Hall, Baton Rouge, LA, 70803, USA.,Department of Health and Human Performance, University of Tennessee at Martin, Martin, TN, USA
| | - Jan M Hondzinski
- School of Kinesiology, Louisiana State University, 1246 Pleasant Hall, Baton Rouge, LA, 70803, USA.
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Ramadurai S, Jeong H, Kim M. Predicting the metabolic cost of exoskeleton-assisted squatting using foot pressure features and machine learning. Front Robot AI 2023; 10:1166248. [PMID: 37151375 PMCID: PMC10154631 DOI: 10.3389/frobt.2023.1166248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/05/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction: Recent studies found that wearable exoskeletons can reduce physical effort and fatigue during squatting. In particular, subject-specific assistance helped to significantly reduce physical effort, shown by reduced metabolic cost, using human-in-the-loop optimization of the exoskeleton parameters. However, measuring metabolic cost using respiratory data has limitations, such as long estimation times, presence of noise, and user discomfort. A recent study suggests that foot contact forces can address those challenges and be used as an alternative metric to the metabolic cost to personalize wearable robot assistance during walking. Methods: In this study, we propose that foot center of pressure (CoP) features can be used to estimate the metabolic cost of squatting using a machine learning method. Five subjects' foot pressure and metabolic cost data were collected as they performed squats with an ankle exoskeleton at different assistance conditions in our prior study. In this study, we extracted statistical features from the CoP squat trajectories and fed them as input to a random forest model, with the metabolic cost as the output. Results: The model predicted the metabolic cost with a mean error of 0.55 W/kg on unseen test data, with a high correlation (r = 0.89, p < 0.01) between the true and predicted cost. The features of the CoP trajectory in the medial-lateral direction of the foot (xCoP), which relate to ankle eversion-inversion, were found to be important and highly correlated with metabolic cost. Conclusion: Our findings indicate that increased ankle eversion (outward roll of the ankle), which reflects a suboptimal squatting strategy, results in higher metabolic cost. Higher ankle eversion has been linked with the etiology of chronic lower limb injuries. Hence, a CoP-based cost function in human-in-the-loop optimization could offer several advantages, such as reduced estimation time, injury risk mitigation, and better user comfort.
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Affiliation(s)
- Sruthi Ramadurai
- Rehabilitation Robotics Laboratory, Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, Chicago, IL, United States
| | - Heejin Jeong
- The Polytechnic School, Ira A. Fulton Schools of Engineering, Arizona State University, Mesa, AZ, United States
- *Correspondence: Myunghee Kim, ; Heejin Jeong,
| | - Myunghee Kim
- Rehabilitation Robotics Laboratory, Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, Chicago, IL, United States
- *Correspondence: Myunghee Kim, ; Heejin Jeong,
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Cutoff Point of Mini-Balance Evaluation Systems Test Scores for Elderly Estimated by Center of Pressure Measurements by Linear Regression and Decision Tree Classification. LIFE (BASEL, SWITZERLAND) 2022; 12:life12122133. [PMID: 36556499 PMCID: PMC9784881 DOI: 10.3390/life12122133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Understanding balance ability and assessing the risk of possible falls are very important for elderly rehabilitation. The Mini-Balanced Evaluation System Test (Mini-BESTest) is an important survey for older adults to evaluate subject balance, but it is not easy to complete due to various limitations of physical activities, including occasional fear of injury. A center of pressure (CoP) signal can be extracted from a force pressure plate with a short recording time, and it is relatively achievable to ask subjects to stand on a force pressure plate in a clinical environment. The goal of this study is to estimate the cutoff score of Mini-BESTest scores from CoP data. METHODS CoP signals from a human balance evaluation database with data from 75 people were used. Time domain, frequency domain, and nonlinear domain parameters of 60 s CoP signals were extracted to classify different cutoff point scores for both linear regression and a decision tree algorithm. Classification performances were evaluated by accuracy and area under a receiver operating characteristic curve. RESULTS The correlation coefficient between real and estimated Mini-BESTest scores by linear regression is 0.16. Instead of linear regression, binary classification accuracy above or below a cutoff point score was developed to examine the CoP classification performance for Mini-BESTest scores. The decision tree algorithm is superior to regression analysis among scores from 16 to 20. The highest area under the curve is 0.76 at a cutoff point score of 21 for the CoP measurement condition of eyes opened on the foam, and the corresponding classification accuracy is 76.15%. CONCLUSIONS CoP measurement is a potential tool to estimate corresponding balance and fall survey scores for elderly rehabilitation and is useful for clinical users.
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Shokouhyan SM, Davoudi M, Hoviattalab M, Abedi M, Bervis S, Parnianpour M, Brumagne S, Khalaf K. Distinction of non-specific low back pain patients with proprioceptive disorders from healthy individuals by linear discriminant analysis. Front Bioeng Biotechnol 2022; 10:1078805. [PMID: 36582840 PMCID: PMC9792676 DOI: 10.3389/fbioe.2022.1078805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
The central nervous system (CNS) dynamically employs a sophisticated weighting strategy of sensory input, including vision, vestibular and proprioception signals, towards attaining optimal postural control during different conditions. Non-specific low back pain (NSLBP) patients frequently demonstrate postural control deficiencies which are generally attributed to challenges in proprioceptive reweighting, where they often rely on an ankle strategy regardless of postural conditions. Such impairment could lead to potential loss of balance, increased risk of falling, and Low back pain recurrence. In this study, linear and non-linear indicators were extracted from center-of-pressure (COP) and trunk sagittal angle data based on 4 conditions of vibration positioning (vibration on the back, ankle, none or both), 2 surface conditions (foam or rigid), and 2 different groups (healthy and non-specific low back pain patients). Linear discriminant analysis (LDA) was performed on linear and non-linear indicators to identify the best sensory condition towards accurate distinction of non-specific low back pain patients from healthy controls. Two indicators: Phase Plane Portrait ML and Entropy ML with foam surface condition and both ankle and back vibration on, were able to completely differentiate the non-specific low back pain groups. The proposed methodology can help clinicians quantitatively assess the sensory status of non-specific low back pain patients at the initial phase of diagnosis and throughout treatment. Although the results demonstrated the potential effectiveness of our approach in Low back pain patient distinction, a larger and more diverse population is required for comprehensive validation.
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Affiliation(s)
| | - Mehrdad Davoudi
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
- Clinic for Orthopaedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Maryam Hoviattalab
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Mohsen Abedi
- Department of Physiotherapy, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soha Bervis
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohamad Parnianpour
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Simon Brumagne
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Kinda Khalaf
- Department of Biomedical Engineering, Healthcare Engineering Innovation Center, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
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van Benten E, Coppieters MW, Pool JJM, Pool-Goudzwaard AL. Differences in balance control despite self-reported resolution of pregnancy-related pelvic girdle pain. A cross-sectional study. Musculoskelet Sci Pract 2022; 62:102620. [PMID: 35839702 DOI: 10.1016/j.msksp.2022.102620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Motor control patterns are altered when women with pregnancy-related pelvic girdle pain (PGP) experience pain. In low back pain, these adaptations can persist after recovery. OBJECTIVES This study aimed to assess balance control in postpartum women with and without a history of PGP during pregnancy. DESIGN Cross-sectional study. METHOD Eighteen postpartum women who reported to be recovered from PGP, and twelve postpartum women without a history of PGP during pregnancy performed two clinical tests: the single leg stance and active straight leg raise test. Primary outcomes were ground reaction forces measured with a force platform. RESULTS Multiple linear regression analyses showed smaller lateral displacement (β = -11cm; 95%CI: 19 to -3; p = 0.008) and lower displacement velocity of the Centre of Pressure (COP) (Ratio of Geometric Means (RGM) 0.76; 95%CI: 0.59 to 0.99; p = 0.043) during single leg stance in the participants with a history of PGP compared to participants without a history of PGP. Push-off force (β = -4.8 N; 95%CI: 22.0 to 12.5; p = 0.57) and asymmetry of push-off force (RGM 1.77; 95%CI: 0.62 to 5.04; p = 0.27) did not differ between groups. During the active straight leg raise test, no differences in lateral displacement (β = 3 cm; 95%CI: 3 to 8; p = 0.30) and COP displacement velocity (RGM 1.03; 95%CI: 0.70 to 1.52; p = 0.87) were observed. CONCLUSIONS Although the women with a history of PGP considered themselves recovered, their balance control during single leg stance was poorer compared to those without a history of PGP. No differences were found during the active straight leg raise test.
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Affiliation(s)
- Esther van Benten
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van den Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; HU University of Applied Sciences Utrecht, Heidelberglaan 7, 3501 AA, Utrecht, the Netherlands.
| | - Michel W Coppieters
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van den Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; Menzies Health Institute Queensland, Brisbane and Gold Coast Campus, Griffith University, 170 Kessels Road, QLD 4111, Nathan, Australia
| | - Jan J M Pool
- HU University of Applied Sciences Utrecht, Heidelberglaan 7, 3501 AA, Utrecht, the Netherlands
| | - Annelies L Pool-Goudzwaard
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van den Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands; SOMT University of Physiotherapy, Softwareweg 5, 3821 BN, Amersfoort, the Netherlands
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Meinke A, Maschio C, Meier ML, Karlen W, Swanenburg J. The association of fear of movement and postural sway in people with low back pain. Front Psychol 2022; 13:1006034. [PMID: 36467232 PMCID: PMC9716132 DOI: 10.3389/fpsyg.2022.1006034] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/28/2022] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND Fear of movement is thought to interfere with the recovery from low back pain (LBP). To date, the relationship between fear of movement and postural balance has not been adequately elucidated. Recent findings suggest that more specific fears need to be assessed and put in relation to a specific movement task. We propose that the fear to bend the trunk in a certain direction is distinctly related to the amount of postural sway in different directions. Therefore, our aim was to investigate whether fear of movement in general and fear of bending the trunk in a certain plane is related to postural sway. METHODS Data was collected from participants with LBP during two assessments ~3 weeks apart. Postural sway was measured with a force-platform during quiet standing with the eyes closed. Fear of movement was assessed with an abbreviated version of the Tampa Scale of Kinesiophobia (TSK-11) and custom items referring to fear of bending the trunk in the sagittal and the frontal plane. RESULTS Based on data from 25 participants, fear of bending the trunk in the frontal plane was positively related to displacement in the sagittal and frontal plane and to velocity in the frontal plane (χ 2 = 4.35, p = 0.04; χ 2 = 8.15, p = 0.004; χ 2 = 9.79, p = 0.002). Fear of bending the trunk in the sagittal plane was not associated with any direction specific measure of sway. A positive relation of the TSK-11 with velocity of the frontal plane (χ 2 = 7.14, p = 0.008) was found, but no association with undirected measures of sway. DISCUSSION Fear of bending the trunk in the frontal plane may be especially relevant to postural sway under the investigated stance conditions. It is possible that fear of bending the trunk in the frontal plane could interfere with balance control at the hip, shifting the weight from side to side to control balance. CONCLUSION For the first time the directional relationship of fear of movement and postural sway was studied. Fear of bending the trunk in the frontal plane was positively associated with several measures of postural sway.
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Affiliation(s)
- Anita Meinke
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Cinzia Maschio
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
| | - Michael L Meier
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland
| | - Walter Karlen
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Institute of Biomedical Engineering, University of Ulm, Ulm, Germany
| | - Jaap Swanenburg
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland
- Directorate of Research and Education, Physiotherapy Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland
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McLaren R, Smith PF, Taylor RL, Ravindran S, Rashid U, Taylor D. Efficacy of nGVS to improve postural stability in people with bilateral vestibulopathy: A systematic review and meta-analysis. Front Neurosci 2022; 16:1010239. [PMID: 36248647 PMCID: PMC9553993 DOI: 10.3389/fnins.2022.1010239] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/24/2022] [Indexed: 11/25/2022] Open
Abstract
Objective Noisy galvanic vestibular stimulation (nGVS) has been used to boost vestibular afferent information to the central nervous system. This has the potential to improve postural control for people for whom vestibular signals are weak, such as in bilateral vestibulopathy (BVP). The aim of this systematic review and meta-analysis is to investigate the evidence for nGVS as a modality to improve postural control in people with BVP. Methods A comprehensive systematic search was conducted of five databases up to July 2022 to find studies applying nGVS to people with BVP, with the aim of improving postural control. Two independent reviewers screened and identified eligible studies, completed a risk of bias evaluation (Cochrane) and extracted relevant data. The standardized mean difference (SMD) based on Hedges' g was calculated as a measure of effect size for the primary outcome measure that best identified postural control, and a forest plot generated. Results Seven studies met the eligibility criteria, with five being suitable for meta-analysis. Meta-analysis revealed a moderate effect in favor of nGVS improving postural control during standing and walking [pooled SMD = 0.47 95% CI (0.25, 0.7)]. nGVS-mediated improvements in postural control were most evident in observations of reduced sway velocity when standing on a firm surface with eyes closed, and in the reduced variability of gait parameters, particularly those measuring lateral stability. Conclusions Coincident nGVS in people with BVP improves postural control during standing and walking. This improvement appears to be context specific, in that vestibular augmentation is most effective in situations where visual inputs are limited, and where reliable context specific proprioceptive cues are available. Further research is warranted investigating additional circumstances in which nGVS improves postural control, including investigating the residual, and sustained effects of nGVS. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=342147, identifier: 342147.
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Affiliation(s)
- Ruth McLaren
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, School of Clinical Science, Auckland University of Technology, Auckland, New Zealand
- *Correspondence: Ruth McLaren
| | - Paul F. Smith
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, The Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand
| | - Rachael L. Taylor
- Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand
- Department of Physiology, University of Auckland, Auckland, New Zealand
| | - Shobika Ravindran
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, School of Clinical Science, Auckland University of Technology, Auckland, New Zealand
| | - Usman Rashid
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, School of Clinical Science, Auckland University of Technology, Auckland, New Zealand
| | - Denise Taylor
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, School of Clinical Science, Auckland University of Technology, Auckland, New Zealand
- Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand
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Sozzi S, Do MC, Schieppati M. Vertical ground reaction force oscillation during standing on hard and compliant surfaces: The “postural rhythm”. Front Neurol 2022; 13:975752. [PMID: 36119676 PMCID: PMC9475112 DOI: 10.3389/fneur.2022.975752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/10/2022] [Indexed: 11/14/2022] Open
Abstract
When a person stands upright quietly, the position of the Centre of Mass (CoM), the vertical force acting on the ground and the geometrical configuration of body segments is accurately controlled around to the direction of gravity by multiple feedback mechanisms and by integrative brain centres that coordinate multi-joint movements. This is not always easy and the postural muscles continuously produce appropriate torques, recorded as ground reaction force by a force platform. We studied 23 young adults during a 90 s period, standing at ease on a hard (Solid) and on a compliant support (Foam) with eyes open (EO) and with eyes closed (EC), focusing on the vertical component of the ground reaction force (VGRF). Analysis of VGRF time series gave the amplitude of their rhythmic oscillations (the root mean square, RMS) and of their frequency spectrum. Sway Area and Path Length of the Centre of Pressure (CoP) were also calculated. VGRF RMS (as well as CoP sway measures) increased in the order EO Solid ≈ EC Solid < EO Foam < EC Foam. The VGRF frequency spectra featured prevailing frequencies around 4–5 Hz under all tested conditions, slightly higher on Solid than Foam support. Around that value, the VGRF frequencies varied in a larger range on hard than on compliant support. Sway Area and Path Length were inversely related to the prevailing VGRF frequency. Vision compared to no-vision decreased Sway Area and Path Length and VGRF RMS on Foam support. However, no significant effect of vision was found on VGRF mean frequency for either base of support condition. A description of the VGRF, at the interface between balance control mechanisms and sway of the CoP, can contribute information on how upright balance is maintained. Analysis of the frequency pattern of VGRF oscillations and its role in the maintenance of upright stance should complement the traditional measures of CoP excursions in the horizontal plane.
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Affiliation(s)
- Stefania Sozzi
- Istituti Clinici Scientifici Maugeri IRCCS, Centro Studi Attività Motorie (CSAM), Pavia, Italy
| | - Manh-Cuong Do
- Complexité, Innovation, Activités Motrices et Sportives (CIAMS), Université Paris-Saclay, Orsay, France
- Complexité, Innovation, Activités Motrices et Sportives (CIAMS), Université d'Orléans, Orléans, France
| | - Marco Schieppati
- Istituti Clinici Scientifici Maugeri IRCCS, Centro Studi Attività Motorie (CSAM), Pavia, Italy
- *Correspondence: Marco Schieppati ;
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Ansari S, Sharma S, Kumar S, Sharma S. Effect of stabilization exercises on balance parameters in chronic low back pain: a systematic review. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-021-00864-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Postural sway does not differentiate individuals with chronic low back pain, single and multisite chronic musculoskeletal pain, or pain-free controls: a cross-sectional study of 229 subjects. Spine J 2022; 22:1523-1534. [PMID: 35504568 DOI: 10.1016/j.spinee.2022.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/16/2022] [Accepted: 04/26/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Physical activity in its various forms are the most recommended prevention and treatment strategy for chronic low back pain (CLBP). Standing postural stability is a prerequisite for many types of physical activities. Systematic reviews have investigated the evidence for an association between CLBP and postural stability but results remain inconclusive. PURPOSE Our primary objective was to compare postural stability between pain-free controls and subjects with CLBP with or without leg pain and single and multisite chronic musculoskeletal pain subjects. The secondary objectives were to evaluate the association between postural stability with CLBP intensity and duration, demographics, physical characteristics and validated health and pain-related patient-reported outcome measures (PROMs). STUDY DESIGN/SETTING Cross-sectional study in a private chiropractic clinic setting PATIENT SAMPLE: Subjects included 42 pain-free controls and 187 patients with chronic musculoskeletal pain divided into CLBP with or without leg pain and single and multisite pain groups. OUTCOME MEASURES Pain intensity was measured using the numerical pain rating scale, PROMs Central Sensitization Inventory, Tampa Scale of Kinesiophobia, The Depression Scale, EuroQol-5D, Roland-Morris Disability Questionnaire, and Pain and Sleep Questionnaire Three-Item Index disability. Group differences were measured using area and velocity of sway on the force plate. METHODS Postural stability was assessed using a force plate on four 60-second bipedal quiet stance tests: eyes open on a stable surface, eyes closed on a stable surface, eyes open on an unstable foam surface, eyes closed on an unstable foam surface. Following the clinic visit, subjects completed an online web-based data entry detailing pain history, demographic data, physical characteristics, pain intensity via the numerical pain rating scale, and PROMS. RESULTS Postural sway parameters did not differ between pain-free controls and subjects with CLBP with or without leg pain and single and multisite chronic musculoskeletal pain subjects. Furthermore, severity and duration of CLBP pain in addition to central sensitization, kinesiophobia, depression, quality of life, disability, and effect of pain on sleep only had very weak associations with postural stability. CONCLUSIONS Chronic musculoskeletal pain appears not to influence bipedal postural stability.
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Kujach S, Chroboczek M, Jaworska J, Sawicka A, Smaruj M, Winklewski P, Laskowski R. Judo training program improves brain and muscle function and elevates the peripheral BDNF concentration among the elderly. Sci Rep 2022; 12:13900. [PMID: 35974038 PMCID: PMC9381784 DOI: 10.1038/s41598-022-17719-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/29/2022] [Indexed: 11/20/2022] Open
Abstract
Programmed exercise interventions modulating both physical fitness and cognitive functions have become a promising tool to support healthy aging. The aim of this experiment was to determine the effect of a 12-week judo training (JEX) on cognitive processing and muscle function among the elderly. Forty participants were divided into two groups: the JEX group and the control group (CTL). Before and after 12-week of JEX, participants performed a battery of physiological and psychological tests. The peripheral level of brain-derived neurotrophic factor (BDNF) was analyzed. A 12-week JEX intervention led to improved Stroop performance reflected by a shortening of the response time related to Stroop “naming” interference. In addition, the peripheral concentration of BDNF was significantly increased following the JEX compared with the CTL group. In response to JEX, balance and lower limb strength significantly increased. The current results suggest that JEX could have beneficial effects on cognitive functions, denoted by elevated peripheral BDNF, as well as on balance and strength abilities. A combination of positive effects with respect to movement and cognition makes JEX an ideal preventive lifestyle modification for the aging population.
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Affiliation(s)
- Sylwester Kujach
- Department of Human Physiology, Medical University of Gdańsk, Gdańsk, Poland. .,Department of Physiology, Gdansk University of Physical Education and Sport, Gdańsk, Poland.
| | - Maciej Chroboczek
- Department of Physiology, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Joanna Jaworska
- Department of Physiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Angelika Sawicka
- Applied Cognitive Neuroscience Lab, Department of Human Physiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Miroslaw Smaruj
- Department of Theory of Sport and Human Motorics, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Pawel Winklewski
- Department of Human Physiology, Medical University of Gdańsk, Gdańsk, Poland.,2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Radoslaw Laskowski
- Department of Physiology, Gdansk University of Physical Education and Sport, Gdańsk, Poland
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Vij N, Naron I, Tolson H, Rezayev A, Kaye AD, Viswanath O, Urits I. Back pain in adolescent athletes: a narrative review. Orthop Rev (Pavia) 2022; 14:37097. [PMID: 35936806 PMCID: PMC9353696 DOI: 10.52965/001c.37097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/25/2022] [Indexed: 04/28/2024] Open
Abstract
Background Back pain in young athletes is common. Adolescents are at an increased risk for back pain related to several factors including rapid growth. Traditionally, the conversation around back pain in the adolescent age group has been centered around diagnosis and treatment; however, there are emerging studies regarding prevention. Objective The purpose of the present investigation is to summarize sport-specific risk factors, to describe the growing emphasis on prevention/screening, and report results on minimally invasive and surgical options. Methods The literature search was performed in Mendeley. Search fields were varied until redundant. All articles were screened by title and abstract and a preliminary decision to include an article was made. The full-text screening was performed on the selected articles. Any question regarding the inclusion of an article was discussed by at least 3 authors until an agreement was reached. Results Adolescent athletes have a higher risk of developing spondylolysis and spondylolisthesis than their non-athletic counterparts. Participation in athletic activity alone, increased body mass index, varsity status, and nationally/internationally competitive status are identified are demographic risk factors. Weightlifters, gymnasts, football players, and combat athletes may be at higher risks. Increased lumbar lordosis, abdominal muscle weakness, hip flexor tightness, hamstring tightness, thoracolumbar fascia tightness, femoral anteversion, genu recurvatum, and thoracic kyphosis also predispose. Recent cadaveric and kinematic studies have furthered our understanding of pathoanatomic. There is some evidence to suggest that isokinetic testing and electromyographic data may be able to identify at-risk individuals. Perturbation-based exercise interventions can reduce the incidence of adolescent athletic back pain. There is a large body of evidence to support the efficacy of physical therapy. There is some data to support minimally invasive treatments including external bone growth simulators, steroid injections, and chemonucleolysis for specific pathologies. Endoscopic surgery results for a limited subset of patients with certain disease processes are good. Conclusions Back pain in adolescent athletes is common and may not lead to appropriate alterations in athletes' level of participation. Athletes with a higher body mass index should be counseled regarding the benefits of losing weight. Isokinetic testing and electromyographic data have the potential as diagnostic and screening tools. Strength deficits and postural control could be used to identify patients requiring early intervention and thus reduce the incidence. External bone growth simulators, steroid injections, and chemonucleolysis could potentially become conservative options in the future. When surgery is indicated, the endoscopic intervention has the potential to decrease operative time, decrease cost, and promote healing.
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Affiliation(s)
- Neeraj Vij
- University of Arizona College of Medicine - Phoenix
| | - Ian Naron
- Louisiana State University Health Shreveport School of Medicine
| | | | - Arthur Rezayev
- Louisiana State University Health Shreveport School of Medicine
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Shreveport
| | - Omar Viswanath
- Department of Anesthesiology, Louisiana State University Health Shreveport
| | - Ivan Urits
- Department of Anesthesiology, Louisiana State University Health Shreveport
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Astrup J, Gyntelberg F. Tension-type headache and low back pain reconsidered. Front Neurol 2022; 13:912348. [PMID: 35968274 PMCID: PMC9372361 DOI: 10.3389/fneur.2022.912348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
The natural history and clinical course of tension-type headache and non-specific low back pain are reconsidered. By closer examination, these two conditions appear to share several specific clinical features. Both are muscular pain conditions along the spine, they have a preponderance in women, they may occur spontaneously or follow a trivial traumatic incident, and they both have a high risk of chronicity. The affected muscles are tender with tender points. EMG indicates diffuse hyperactivity and abnormal activation pattern, and motor control of the affected muscles and adjacent muscle groups is discoordinated. These shared features suggest analogous pathophysiology involving the neuromotor control of affected and adjacent muscle groups in the cervical and lumbar regions, respectively. As recently suggested for the whiplash disease, we suggest the term spinal dyssynergia for this specific pattern of pathology. This suggestion provides a new perspective for the understanding of these diseases by placing their cause within the central nervous system and not in the spine or spinal musculature. This perspective warrants further clinical, neurophysiological, and neuropharmacological studies of this ‘family’ of common yet poorly understood clinical muscular pain conditions along the spine.
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Azevedo N, Ribeiro JC, Machado L. Balance and Posture in Children and Adolescents: A Cross-Sectional Study. SENSORS 2022; 22:s22134973. [PMID: 35808468 PMCID: PMC9269686 DOI: 10.3390/s22134973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 02/04/2023]
Abstract
Balance and posture are two topics that have been extensively studied, although with some conflicting findings. Therefore, the aim of this work is to analyze the relationship between the postural angles of the spine in the sagittal plane and the stable static balance. A cross-sectional study was conducted with children and adolescents from schools in northern Portugal in 2019. An online questionnaire was used to characterize the sample and analyze back pain. Spinal postural angle assessment (pelvic, lumbar, and thoracic) was performed using the Spinal Mouse®, while stabilometry assessment was performed using Namrol® Podoprint®. Statistical significance was set as α = 0.05. The results showed that girls have better balance variables. There is a weak correlation between the anthropometric variables with stabilometry variables and the postural angles. This correlation is mostly negative, except for the thoracic spine with anthropometric variables and the lumbar spine with BMI. The results showed that postural angles of the spine are poor predictors of the stabilometric variables. Concerning back pain, increasing the postural angle of the thoracic spine increases the odds ratio of manifestation of back pain by 3%.
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Affiliation(s)
- Nelson Azevedo
- CICS, ISAVE, Faculdade de Desporto da Universidade do Porto, 4200-450 Porto, Portugal;
| | - José Carlos Ribeiro
- CIAFEL, ITR, Faculdade de Desporto da Universidade do Porto, 4200-450 Porto, Portugal;
| | - Leandro Machado
- CIFI2D, LABIOMEP, Faculdade de Desporto da Universidade do Porto, 4200-450 Porto, Portugal
- Correspondence:
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Viseux FJF, Simoneau M, Billot M. A Comprehensive Review of Pain Interference on Postural Control: From Experimental to Chronic Pain. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060812. [PMID: 35744075 PMCID: PMC9230450 DOI: 10.3390/medicina58060812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022]
Abstract
Motor control, movement impairment, and postural control recovery targeted in rehabilitation could be affected by pain. The main objective of this comprehensive review is to provide a synthesis of the effect of experimental and chronic pain on postural control throughout the available literature. After presenting the neurophysiological pathways of pain, we demonstrated that pain, preferentially localized in the lower back or in the leg induced postural control alteration. Although proprioceptive and cortical excitability seem modified with pain, spinal modulation assessment might provide a new understanding of the pain phenomenon related to postural control. The literature highlights that the motor control of trunk muscles in patient presenting with lower back pain could be dichotomized in two populations, where the first over-activates the trunk muscles, and the second under-activates the trunk muscles; both generate an increase in tissue loading. Taking all these findings into account will help clinician to provide adapted treatment for managing both pain and postural control.
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Affiliation(s)
- Frédéric J. F. Viseux
- Centre d’Evaluation et de Traitement de la Douleur (CETD), Hôpital Jean Bernard, Centre Hospitalier de Valenciennes, F-59322 Valenciennes, France
- Département Sciences de l’Homme et du Vivant (SHV), Université Polytechnique Hauts-de-France (UPHF), LAMIH, CNRS, UMR 8201, F-59313 Valenciennes, France
- Correspondence:
| | - Martin Simoneau
- Département de Kinésiologie, Faculté de Médecine, Université Laval, Québec, QC G1V 0A6, Canada;
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS) du CIUSSS de la Capitale Nationale, Québec, QC G1M 2S8, Canada
| | - Maxime Billot
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, F-86000 Poitiers, France;
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Meinke A, Peters R, Knols RH, Swanenburg J, Karlen W. Feedback on Trunk Movements From an Electronic Game to Improve Postural Balance in People With Nonspecific Low Back Pain: Pilot Randomized Controlled Trial. JMIR Serious Games 2022; 10:e31685. [PMID: 35687390 PMCID: PMC9233263 DOI: 10.2196/31685] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/17/2022] [Accepted: 04/14/2022] [Indexed: 12/26/2022] Open
Abstract
Background Postural balance is compromised in people with low back pain, possibly by changes in motor control of the trunk. Augmenting exercising interventions with sensor-based feedback on trunk posture and movements might improve postural balance in people with low back pain. Objective We hypothesized that exercising with feedback on trunk movements reduces sway in anterior-posterior direction during quiet standing in people with low back pain. Secondary outcomes were lumbar spine and hip movement assessed during box lift and waiter bow tasks, as well as participant-reported outcomes. Adherence to the exercising intervention was also examined. Methods A randomized controlled trial was conducted with the intervention group receiving unsupervised home exercises with visual feedback using the Valedo Home, an exergame based on 2 inertial measurement units. The control group received no intervention. Outcomes were recorded by blinded staff during 4 visits (T1-T4) at University Hospital Zurich. The intervention group performed 9 sessions of 20 minutes in the 3 weeks between T2 and T3 and were instructed to exercise at their own convenience between T3 and T4. Postural balance was assessed on a force platform. Lumbar spine and hip angles were obtained from 3 inertial measurement units. The assessments included pain intensity, disability, quality of life, and fear of movement questionnaires. Results A total of 32 participants with nonspecific low back pain completed the first assessment T1, and 27 (84%) participants were randomized at T2 (n=14, 52% control and n=13, 48% intervention). Intention-to-treat analysis revealed no significant difference in change in anterior-posterior sway direction during the intervention period with a specified schedule (T2-T3) between the groups (W=99; P=.36; r=0.07). None of the outcomes showed significant change in accordance with our hypotheses. The intervention group completed a median of 61% (55/90; range 2%-99%) of the exercises in the predefined training program. Adherence was higher in the first intervention period with a specified schedule. Conclusions The intervention had no significant effect on postural balance or other outcomes, but the wide range of adherence and a limited sample size challenged the robustness of these conclusions. Future work should increase focus on improving adherence to digital interventions. Trial Registration ClinicalTrials.gov NCT04364243; https://clinicaltrials.gov/ct2/show/NCT04364243 International Registered Report Identifier (IRRID) RR2-10.2196/26982
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Affiliation(s)
- Anita Meinke
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Rick Peters
- Department of Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
| | - Ruud H Knols
- Department of Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland.,Directorate of Research and Education, Physiotherapy Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland.,Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Jaap Swanenburg
- Directorate of Research and Education, Physiotherapy Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland
| | - Walter Karlen
- Mobile Health Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Institute of Biomedical Engineering, University of Ulm, Ulm, Germany
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Dal Farra F, Arippa F, Arru M, Cocco M, Porcu E, Tramontano M, Monticone M. Effects of exercise on balance in patients with non-specific low back pain: a systematic review and meta-analysis. Eur J Phys Rehabil Med 2022; 58:423-434. [PMID: 34636528 PMCID: PMC9980551 DOI: 10.23736/s1973-9087.21.07293-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/12/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Non-specific low back pain (NS-LBP) is one of the most common musculoskeletal conditions related to medical expenses and disability. Evidence suggests that changes in motion patterns could induce trunk instability and impaired postural control. Therefore, this systematic review investigated the effects of exercise on balance in patients with NS-LBP. EVIDENCE ACQUISITION A systematic review and meta-analysis were conducted. Findings were reported following the 2020 PRISMA statement and the main databases were searched for RCTs. Studies were independently screened through a standardized form and their internal validity assessed by using the Cochrane risk of bias (RoB) tool. Pooled effects were calculated at post-treatment and quality of evidence was assessed through the GRADE framework. EVIDENCE SYNTHESIS Twelve articles were included in the review, eight in the meta-analysis. None of the studies were judged at low RoB. There is very low-quality evidence that exercise is effective in reducing Centre of Pressure (CoP) displacement (-16.99 [-27.29, -6.68]; P=0.001) and in improving single-leg stance test performance (-28.7 [-48.84, -8.67]; P=0.005) and dynamic balance (-4.74 [-8.02, -1.46]; P=0.005). Conversely, no significant results were observed in "ellipse area" and in "limits of stability" indexes. Other results were summarized in a qualitative synthesis. CONCLUSIONS Exercise could be effective in improving both static and dynamic balance in patients with NS-LBP over a short-term period. However, quality of evidence was estimated as very low, hence further double-blinded, high-quality RCTs are needed to address clinical practice and research.
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Affiliation(s)
- Fulvio Dal Farra
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federico Arippa
- Unit of Neurorehabilitation, Department of Neuroscience and Rehabilitation, ARNAS G. Brotzu, Cagliari, Italy -
| | - Mauro Arru
- Unit of Physical and Rehabilitation Medicine, Department of Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy
| | - Martina Cocco
- Unit of Physical and Rehabilitation Medicine, Department of Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy
| | - Elisa Porcu
- Unit of Physical and Rehabilitation Medicine, Department of Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy
| | - Marco Tramontano
- IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Movement, Human and Health Sciences, Interuniversity Center of Bioengineering of the Human Neuromusculoskeletal System, Foro Italico University of Rome, Rome, Italy
| | - Marco Monticone
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Neurorehabilitation, Department of Neuroscience and Rehabilitation, ARNAS G. Brotzu, Cagliari, Italy
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Alshehri MA, van den Hoorn W, Klyne DM, Hodges PW. Postural control of the trunk in individuals with and without low back pain during unstable sitting: A protocol for a systematic review with an individual participant data meta-analysis. PLoS One 2022; 17:e0268381. [PMID: 35551559 PMCID: PMC9098032 DOI: 10.1371/journal.pone.0268381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 04/28/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Postural control of the trunk is critical for performance of everyday activities and the health of spinal tissues. Although some studies report that individuals with low back pain (LBP) have poorer/compromised postural control than pain-free individuals when sitting on an unstable surface, others do not. Analyses commonly lack the statistical power to evaluate the relevance of features that could impact the performance of postural control, such as sex, age, anthropometrics, pain intensity or disability. This paper outlines a protocol for a systematic review with an individual participant data (IPD) meta-analysis that aims to synthesise the evidence and evaluate differences of postural control measures between individuals with and without LBP during unstable sitting. Methods and analysis A systematic review with IPD meta-analysis will be conducted according to PRISMA-IPD guidelines. To identify relevant studies, electronic databases and the reference lists of included articles will be screened. Unstable seat movements are derived from centre of pressure (CoP) data using a force plate or angle of the seat using motion systems/sensors. The comprehensiveness of reporting and methodological quality of included studies will be assessed. Analysis will involve a descriptive analysis to synthesise the findings of all included studies and a quantitative synthesis using two-stage IPD meta-analysis of studies that include both individuals with and without LBP for which IPD set can be obtained from authors. Analyses will include consideration of confounding variables. Ethics Exemption from ethical approval was obtained for this review (University of Queensland, ID: 2019003026). Systematic review registration PROSPERO ID: CRD42021124658.
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Affiliation(s)
- Mansour Abdullah Alshehri
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
- Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Wolbert van den Hoorn
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - David M. Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Paul W. Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
- * E-mail:
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Differences in Postural Balance, Pain Sensitivity and Depression between Individuals with Acute and Chronic Back Pain. J Clin Med 2022; 11:jcm11102700. [PMID: 35628827 PMCID: PMC9147726 DOI: 10.3390/jcm11102700] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022] Open
Abstract
To compare differences in postural balance, pain and depression in patients with chronic and acute low back pain, twenty patients with chronic and twenty patients with acute low back pain from the Edward Francis Small Hospital (Banjul, Gambia), as well as 20 age-matched healthy controls participated in the study. A modified Romberg test was used to assess postural balance during one minute with closed eyes. Body sway in the anteroposterior and mediolateral axes was video-recorded during test performance and further analyzed with an open source software for movement analyses (CvMob). Pain sensitivity was assessed by means of pressure pain thresholds and depression by a self-report questionnaire (PHQ-9). As results, patients with chronic low back pain displayed higher body sway in the anteroposterior and mediolateral axes, as well as faster body sway than patients with acute low back pain and healthy controls. Nevertheless, group differences disappeared when depression was introduced as a covariate, indicating a major role of depression in postural balance deficits of patients with pain disorders. As conclusions, the assessment of postural balance and depression should be implemented in the clinical routine for the design of tailored interventions in pain conditions.
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Early Notice Pointer, an IoT-like Platform for Point-of-Care Feet and Body Balance Screening. MICROMACHINES 2022; 13:mi13050682. [PMID: 35630149 PMCID: PMC9144081 DOI: 10.3390/mi13050682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 11/16/2022]
Abstract
Improper foot biomechanics associated with uneven bodyweight distribution contribute to impaired balance and fall risks. There is a need to complete the panel of commercially available devices for the self-measurement of BMI, fat, muscle, bone, weight, and hydration with one that measures weight-shifting at home as a pre-specialist assessment system. This paper reports the development of the Early Notice Pointer (ENP), a user-friendly screening device based on weighing scale technology. The ENP is designed to be used at home to provide a graphic indication and customised and evidence-based foot and posture triage. The device electronically detects and maps the bodyweight and distinct load distributions on the main areas of the feet: forefoot and rearfoot. The developed platform also presents features that assess the user's balance, and the results are displayed as a simple numerical report and map. The technology supports data display on mobile phones and accommodates multiple measurements for monitoring. Therefore, the evaluation could be done at non-specialist and professional levels. The system has been tested to validate its accuracy, precision, and consistency. A parallel study to describe the frequency of arch types and metatarsal pressure in young adults (1034 healthy subjects) was conducted to explain the importance of self-monitoring at home for better prevention of foot arch- and posture-related conditions. The results showed the potential of the newly created platform as a screening device ready to be wirelessly connected with mobile phones and the internet for remote and personalised identification and monitoring of foot- and body balance-related conditions. The real-time interpretation of the reported physiological parameters opens new avenues toward IoT-like on-body monitoring of human physiological signals through easy-to-use devices on flexible substrates for specific versatility.
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Proprioceptive manipulations in orthograde posture modulate postural control in low back pain patients: a pilot study. Sci Rep 2022; 12:6860. [PMID: 35478206 PMCID: PMC9046231 DOI: 10.1038/s41598-022-10701-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
As we stand upright, perceptual afferences are crucial to successfully help generating postural motor commands. Non-Specific Low Back Pain patients frequently demonstrate a lack of proprioceptive acuity, often translating into postural control deficiencies. For the first time, to our knowledge, we studied the postural effects of proprioceptive manipulations in orthograde posture on Non-Specific Low Back Pain patients. Using static posturography recordings, we computed sway speed, speed variance, and the main direction of sway. We also addressed the patient’s subjective feedbacks after being manipulated. Five minutes after the proprioceptive manipulations, our results revealed decreased speed and speed variance outcomes, but the main direction of sway was not modulated. Furthermore, after the proprioceptive manipulations, the patients also self-reported improved clinical outcomes. These findings provide new knowledge opening new fields of research as well as potential treatment strategies in Low Back Pain patients.
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