Hip strategy for balance control in quiet standing is reduced in people with low back pain

Mok, N. W., Brauer, S. G. and Hodges, P. W. (2004) Hip strategy for balance control in quiet standing is reduced in people with low back pain. Spine, 29 6: E107-E112. doi:10.1097/01.BRS.0000115134.97854.C9

Author Mok, N. W.
Brauer, S. G.
Hodges, P. W.
Title Hip strategy for balance control in quiet standing is reduced in people with low back pain
Journal name Spine   Check publisher's open access policy
ISSN 0362-2436
Publication date 2004-01-01
Year available 2004
Sub-type Article (original research)
DOI 10.1097/01.BRS.0000115134.97854.C9
Open Access Status Not yet assessed
Volume 29
Issue 6
Start page E107
End page E112
Total pages 6
Editor J. Weinstein
Place of publication USA
Publisher Lippincott, Williams & Wilkins
Language eng
Subject C1
321024 Rehabilitation and Therapy - Occupational and Physical
730303 Occupational, speech and physiotherapy
Abstract Study Design. Quiet stance on supporting bases with different lengths and with different visual inputs were tested in 24 study participants with chronic low back pain (LBP) and 24 matched control subjects. Objectives. To evaluate postural adjustment strategies and visual dependence associated with LBP. Summary of Background Data. Various studies have identified balance impairments in patients with chronic LBP, with many possible causes suggested. Recent evidence indicates that study participants with LBP have impaired trunk muscle control, which may compromise the control of trunk and hip movement during postural adjustments ( e. g., hip strategy). As balance on a short base emphasizes the utilization of the hip strategy for balance control, we hypothesized that patients with LBP might have difficulties standing on short bases. Methods. Subjects stood on either flat surface or short base with different visual inputs. A task was counted as successful if balance was maintained for 70 seconds during bilateral stance and 30 seconds during unilateral stance. The number of successful tasks, horizontal shear force, and center-of-pressure motion were evaluated. Results. The hip strategy was reduced with increased visual dependence in study participants with LBP. The failure rate was more than 4 times that of the controls in the bilateral standing task on short base with eyes closed. Analysis of center-of-pressure motion also showed that they have inability to initiate and control a hip strategy. Conclusions. The inability to control a hip strategy indicates a deficit of postural control and is hypothesized to result from altered muscle control and proprioceptive impairment.
Keyword Orthopedics
Low Back Pain
Postural Control
Human Postural Responses
Axial Rotation Exertion
Lumbar Spine
Transversus Abdominis
Torque Output
Trunk Muscles
Clinical Neurology
Q-Index Code C1
Institutional Status UQ

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Created: Wed, 15 Aug 2007, 13:53:26 EST