title: Anticipatory and compensatory postural adjustments in people with low back pain: a protocol for a systematic review and meta-analysis.
abstract: BACKGROUND
  Anticipatory (APAs) and compensatory (CPAs) postural adjustments are organised by the central nervous system (CNS) and serve to control postural perturbations. Ineffective APAs and CPAs have been hypothesised to contribute to the persistence of symptoms and disability in people with low back pain (LBP). Despite two decades of research, there is no systematic review investigating APAs and CPAs in people with LBP. Thus, the aim of the current review is to determine if APA and CPA onset or amplitude, as measured by electromyography (EMG), centre of pressure (COP), and kinematics, are altered in people with LBP.
  
  
  METHODS
  A systematic review and meta-analysis will be conducted. Searches will be conducted in electronic databases for full-text articles published before January 2016 using pre-defined search strategies that utilise combinations of keywords and medical subject heading terms. Two independent reviewers will screen potentially relevant articles for inclusion, extract data, and assess risk of bias for individual studies. Any disagreements will be resolved by a third reviewer. Studies comparing APA onset and amplitude and CPA onset and amplitude measured by EMG, COP, or kinematics between people with LBP and healthy individuals will be included if all aspects of the eligibility criteria are met. Data will be synthesised if studies are homogeneous; otherwise, results will be reviewed narratively.
  
  
  CONCLUSIONS
  To our knowledge, this is the first systematic review to examine APAs and CPAs, as measured by EMG, COP, and kinematics in people with LBP. The findings of this review may aid in the identification of factors that play a role in the persistence of symptoms and disability and aid in the development of interventions to treat symptoms.
  
  
  BACKGROUND
  PROSPERO CRD42016032815.
authors.affiliation: School of Science and Health, Western Sydney University, Campbelltown Campus, Room 20.G.35, Locked bag 1797, Penrith, 2751, New South Wales, Australia. michael.knox@westernsydney.edu.au.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Knox
authors.affiliation: School of Science and Health, Western Sydney University, Campbelltown Campus, Room 20.G.35, Locked bag 1797, Penrith, 2751, New South Wales, Australia.
authors.forename: Lucy S
authors.initials: LS
authors.lastname: Chipchase
authors.affiliation: School of Science and Health, Western Sydney University, Campbelltown Campus, Room 20.G.35, Locked bag 1797, Penrith, 2751, New South Wales, Australia.
authors.forename: Siobhan M
authors.initials: SM
authors.lastname: Schabrun
authors.affiliation: School of Science and Health, Western Sydney University, Campbelltown Campus, Room 20.G.35, Locked bag 1797, Penrith, 2751, New South Wales, Australia.
authors.forename: Paul W M
authors.initials: PW
authors.lastname: Marshall
mesh_terms: D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D015201:Meta-Analysis as Topic; D059408:Pain Management / Q000379:methods*; D004856:Postural Balance; D012107:Research Design; D000078202:Systematic Reviews as Topic
keywords: Anticipatory; Compensatory; Low back pain; Postural adjustment; Postural control; Systematic review