Stability threshold during seated balancing is sensitive to low back pain and safe to assess.

Journal: Journal of biomechanics
Published Date: Jun 7, 2021

Abstract

Challenging trunk neuromuscular control maximally using a seated balancing task is useful for unmasking impairments that may go unnoticed with traditional postural sway measures and appears to be safe to assess in healthy individuals. This study investigates whether the stability threshold, reflecting the upper limits in trunk neuromuscular control, is sensitive to pain and disability and is safe to assess in low back pain (LBP) patients. Seventy-nine subjects with non-specific LBP balanced on a robotic seat while rotational stiffness was gradually reduced. The critical rotational stiffness, K, that marked the transition between stable and unstable balance was used to quantify the individual's stability threshold. The effects of current pain, 7-day average pain, and disability on K were assessed, while controlling for age, sex, height, and weight. Adverse events (AEs) recorded at the end of the testing session were used to assess safety. Current pain and 7-day average pain were strongly associated with K (current pain p < 0.001, 7-day pain p = 0.023), reflecting that people experiencing more pain have poorer trunk neuromuscular control. There was no evidence that disability was associated with K, although the limited range in disability scores in subjects may have impacted the analysis. AEs were reported in 13 out of 79 total sessions (AE Severity: 12 mild, 1 moderate; AE Relatedness: 1 possibly, 11 probably, 1 definitely-related to the study). Stability threshold is sensitive to pain and appears safe to assess in people with LBP, suggesting it could be useful for identifying trunk neuromuscular impairments and guiding rehabilitation.

Authors

  • N Peter Reeves
    Sumaq Life LLC, East Lansing, MI, USA; MSU Center for Orthopedic Research, Michigan State University, Lansing, MI, USA. Electronic address: reevesn@icloud.com.
  • Victor Giancarlo Sal Y Rosas Celi
    Sección de Matemáticas, Departamento de Ciencias, Pontificia Universidad Católica del Perú, Peru.
  • Ahmed Ramadan
    MSU Center for Orthopedic Research, Michigan State University, Lansing, MI, USA; Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA.
  • John M Popovich
    MSU Center for Orthopedic Research, Michigan State University, Lansing, MI, USA; Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.
  • Lawrence L Prokop
    MSU Center for Orthopedic Research, Michigan State University, East Lansing, MI, USA; Department of Physical Medicine & Rehabilitation, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA.
  • Mathew A Zatkin
    MSU Center for Orthopedic Research, Michigan State University, East Lansing, MI, USA; Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA.
  • Lisa A DeStefano
    MSU Center for Orthopedic Research, Michigan State University, East Lansing, MI, USA; Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA.
  • Timothy J Francisco
    MSU Center for Orthopedic Research, Michigan State University, East Lansing, MI, USA; Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA.
  • Jacob J Rowan
    MSU Center for Orthopedic Research, Michigan State University, East Lansing, MI, USA; Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA.
  • Clark J Radcliffe
    MSU Center for Orthopedic Research, Michigan State University, Lansing, MI, USA; Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA; Department of Mechanical Engineering, College of Engineering, Michigan State University, East Lansing, MI, USA.
  • Jongeun Choi
    MSU Center for Orthopedic Research, Michigan State University, Lansing, MI, USA; School of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea.
  • Nathan D Cowdin
    MSU Center for Orthopedic Research, Michigan State University, East Lansing, MI, USA.
  • Jacek Cholewicki
    MSU Center for Orthopedic Research, Michigan State University, Lansing, MI, USA; Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.

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