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Shahvarpour A, Gagnon D, Preuss R, Henry SM, Larivière C. Trunk postural balance and low back pain: Reliability and relationship with clinical changes following a lumbar stabilization exercise program. Gait Posture 2018; 61:375-381. [PMID: 29448220 DOI: 10.1016/j.gaitpost.2018.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/05/2018] [Accepted: 02/06/2018] [Indexed: 02/02/2023]
Abstract
Lumbar stabilization programs reduce pain and disability, but the mechanisms of action underlying this treatment are unknown. Trunk postural control during unstable sitting represents a surrogate measure of motor control mechanisms involved to maintain the dynamic stability of the spine. This exploratory study aimed to determine the reliability of trunk postural control measures over an 8-week interval, their sensitivity to low back pain status and treatment and their relationship with clinical outcomes. Trunk postural control measures were determined in patients with low back pain before and after an 8-week lumbar stabilization exercise program. Healthy controls were assessed over the same interval, but without any treatment, to determine the reliability of the measures and act as a control group at baseline. The kinematics of a wobble chair during unstable sitting was summarized using different linear and nonlinear measures quantifying the quantity and quality of movement, respectively. The reliability of the measures was moderate to excellent. The results showed significant reduction in pain and disability following the intervention. While no impairment at baseline scores was found, some linear and nonlinear measures changed over the intervention period among the patient group. However, for nonlinear measures only, significant correlations were detected with the change scores of pain and disability. The change of measures over the intervention period was likely due to learning rather than the intervention as similar alteration was detected in the healthy subjects. The results suggest that only the quality (not the quantity) of movement may have relationship with pain and disability.
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Affiliation(s)
- Ali Shahvarpour
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, 2900 Boul, Edouard-Montpetit, Montreal, Quebec , H3T 1J4 Canada; Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul, de Maisonneuve O. Montreal, Quebec, H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
| | - Dany Gagnon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, 2900 Boul, Edouard-Montpetit, Montreal, Quebec , H3T 1J4 Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
| | - Richard Preuss
- School of Physical and Occupational Therapy, McGill University, 3654 prom Sir-William-Osler, Montreal, Quebec, H3G 1Y5, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
| | - Sharon M Henry
- Department of Rehabilitation and Movement Science, The University of Vermont, 305 Rowell Building, Burlington, VT, United States.
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul, de Maisonneuve O. Montreal, Quebec, H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
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