Jesse V Jacobs1, Courtney A Lyman2, Juvena R Hitt3, Sharon M Henry4. 1. Department of Rehabilitation and Movement Science, University of Vermont, 305 Rowell Building, 106 Carrigan Dr., Burlington, VT 05405, USA; Center for Physical Ergonomics, Liberty Mutual Research Institute for Safety, 71 Frankland Rd., Hopkinton, MA 01748, USA. Electronic address: jesse.jacobs@med.uvm.edu. 2. Department of Rehabilitation and Movement Science, University of Vermont, 305 Rowell Building, 106 Carrigan Dr., Burlington, VT 05405, USA. Electronic address: c.amelialyman@gmail.com. 3. Department of Rehabilitation and Movement Science, University of Vermont, 305 Rowell Building, 106 Carrigan Dr., Burlington, VT 05405, USA. Electronic address: Juvena.Hitt@med.uvm.edu. 4. Department of Rehabilitation and Movement Science, University of Vermont, 305 Rowell Building, 106 Carrigan Dr., Burlington, VT 05405, USA; Department of Rehabilitation Therapy, University of Vermont Medical Center, 111 Colchester Ave., Burlington, VT 05401, USA. Electronic address: Sharon.Henry@uvmhealth.org.
Abstract
BACKGROUND: People with low back pain exhibit altered postural coordination that has been suggested as a target for treatment, but heterogeneous presentation has rendered it difficult to identify appropriate candidates and protocols for such treatments. This study evaluated the associations of task-related and person-related factors with the effect of low back pain on anticipatory postural adjustments. METHODS: Thirteen subjects with and 13 without low back pain performed seated, rapid arm flexion in self-initiated and cued conditions. Mixed-model ANOVA were used to evaluate group and condition effects on APA onset latencies of trunk muscles, arm-raise velocity, and pre-movement cortical potentials. These measures were evaluated for correlation with pain ratings, Fear Avoidance Beliefs Questionnaire scores, and Modified Oswestry Questionnaire scores. FINDINGS: Delayed postural adjustments of subjects with low back pain were greater in the cued condition than in the self-initiated condition. The group with low back pain exhibited larger-amplitude cortical potentials than the group without pain, but also significantly slower arm-raise velocities. With arm-raise velocity as a covariate, the effect of low back pain remained significant for the latencies of postural adjustments but not for cortical potentials. Latencies of the postural adjustments significantly correlated with Oswestry and Fear Avoidance Beliefs scores. INTERPRETATION: Delayed postural adjustments with low back pain appear to be influenced by cueing of movement, pain-related disability and fear of activity. These results highlight the importance of subject characteristics, task condition, and task performance when comparing across studies or when developing treatment of people with low back pain.
BACKGROUND:People with low back pain exhibit altered postural coordination that has been suggested as a target for treatment, but heterogeneous presentation has rendered it difficult to identify appropriate candidates and protocols for such treatments. This study evaluated the associations of task-related and person-related factors with the effect of low back pain on anticipatory postural adjustments. METHODS: Thirteen subjects with and 13 without low back pain performed seated, rapid arm flexion in self-initiated and cued conditions. Mixed-model ANOVA were used to evaluate group and condition effects on APA onset latencies of trunk muscles, arm-raise velocity, and pre-movement cortical potentials. These measures were evaluated for correlation with pain ratings, Fear Avoidance Beliefs Questionnaire scores, and Modified Oswestry Questionnaire scores. FINDINGS: Delayed postural adjustments of subjects with low back pain were greater in the cued condition than in the self-initiated condition. The group with low back pain exhibited larger-amplitude cortical potentials than the group without pain, but also significantly slower arm-raise velocities. With arm-raise velocity as a covariate, the effect of low back pain remained significant for the latencies of postural adjustments but not for cortical potentials. Latencies of the postural adjustments significantly correlated with Oswestry and Fear Avoidance Beliefs scores. INTERPRETATION: Delayed postural adjustments with low back pain appear to be influenced by cueing of movement, pain-related disability and fear of activity. These results highlight the importance of subject characteristics, task condition, and task performance when comparing across studies or when developing treatment of people with low back pain.
Authors: Deborah Gubler; Anne F Mannion; Peter Schenk; Mark Gorelick; Daniel Helbling; Hans Gerber; Valeriu Toma; Haiko Sprott Journal: Spine (Phila Pa 1976) Date: 2010-07-15 Impact factor: 3.468
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Authors: Bruno T Saragiotto; Christopher G Maher; Tiê P Yamato; Leonardo O P Costa; Luciola C Menezes Costa; Raymond W J G Ostelo; Luciana G Macedo Journal: Cochrane Database Syst Rev Date: 2016-01-08