title: Functional contributors to poor movement and balance control in patients with low back pain: A descriptive analysis.
abstract: BACKGROUND
  Automatic and voluntary body position control is essential for postural stability; however, little is known about individual factors that impair the sensorimotor system associated with low back pain (LBP).
  
  
  OBJECTIVE
  To evaluate automatic and voluntary motor control impairments causing postural instability in patients with LBP.
  
  
  METHODS
  Motor control impairments associated with poor movement and balance control were analyzed prospectively in 32 patients with LBP. Numeric Rating Scale (NRS) for pain assessment, Oswestry Disability Index (ODI) for disability measurement, and computerized dynamic posturography (CDP) for analysis of postural responses were used to measure outcomes of all patients. Computerized dynamic posturography tests including Sensory organization test (SOT), limits of stability test (movement velocity, directional control, endpoint, and maximum excursion), rhythmic weight shift (rhythmic movement speed and directional control), and adaptation test (toes-up and toes-down tests) were performed and the results compared with NeuroCom normative data.
  
  
  RESULTS
  The mean age of the patients was 40.50 ± 12.28 years. Lower equilibrium scores were observed in SOT (p < 0.05). There was a significant increase in reaction time and decrease in movement velocity, directional control, and endpoint excursion (p < 0.05). Speed of rhythmic movement along the anteroposterior direction decreased, while speed increased along the lateral direction (p < 0.05). Poor directional control was recorded in the anteroposterior direction (p < 0.05). Toes-down test showed an increased COG sway in patients compared with that in the controls (p < 0.05).
  
  
  CONCLUSIONS
  LBP causes poor voluntary control of body positioning, a reduction in movement control, delays in movement initiation, and a difficulty to adapt to sudden surface changes.
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Ayhan
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
authors.forename: Sevil
authors.initials: S
authors.lastname: Bilgin
authors.affiliation: Department of Audiology, Voice and Speech Disorders, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
authors.forename: Songul
authors.initials: S
authors.lastname: Aksoy
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Yakut
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000503:physiopathology; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D011930:Reaction Time / Q000502:physiology; D055815:Young Adult
keywords: Low back pain; balance control; postural stability; posturography