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患有慢性下背痛的人在具有挑战性的任务中比对照组的平衡能力更差。

People with chronic low back pain have poorer balance than controls in challenging tasks.

作者信息

da Silva Rubens A, Vieira Edgar R, Fernandes Karen B P, Andraus Rodrigo A, Oliveira Marcio R, Sturion Leandro A, Calderon Mariane G

机构信息

a Center for Health Science Research, Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), Universidade Norte do Paraná (UNOPAR) , Londrina-PR , Brazil.

b Doctoral and Masters Program in Rehabilitation Sciences UEL/UNOPAR , Londrina-PR , Brazil.

出版信息

Disabil Rehabil. 2018 Jun;40(11):1294-1300. doi: 10.1080/09638288.2017.1294627. Epub 2017 Mar 10.

Abstract

PURPOSE

To compare the balance of individuals with and without chronic low back pain during five tasks.

METHOD

The participants were 20 volunteers, 10 with and 10 without nonspecific chronic low back pain, mean age 34 years, 50% females. The participants completed the following balance tasks on a force platform in random order: (1) two-legged stance with eyes open, (2) two-legged stance with eyes closed, (3) semi-tandem with eyes open, (4) semi-tandem with eyes closed and (5) one-legged stance with eyes open. The participants completed three 60-s trials of tasks 1-4, and three 30-s trials of task 5 with 30-s rests between trials. The center of pressure area, velocity and frequency in the antero-posterior and medio-lateral directions were computed during each task, and compared between groups and tasks.

RESULTS

Participants with chronic low back pain presented significantly larger center of pressure area and higher velocity than the healthy controls (p < 0.001). There were significant differences among tasks for all center of pressure variables (p < 0.001). Semi-tandem (tasks 3 and 4) and one-leg stance (task 5) were more sensitive to identify balance impairments in the chronic low back pain group than two-legged stance tasks 1 and 2 (effect size >1.37 vs. effect size <0.64). There were no significant interactions between groups and tasks.

CONCLUSIONS

Individuals with chronic low back pain presented poorer postural control using center of pressure measurements than the healthy controls, mainly during more challenging balance tasks such as semi-tandem and one-legged stance conditions. Implications for Rehabilitation People with chronic low back had poorer balance than those without it. Balance tasks need to be sensitive to capture impairments. Balance assessments during semi-tandem and one-legged stance were the most sensitive tasks to determine postural control deficit in people with chronic low back. Balance assessment should be included during rehabilitation programs for individuals with chronic low back pain for better clinical decision making related to balance re-training as necessary.

摘要

目的

比较患有和未患有慢性下腰痛的个体在五项任务中的平衡能力。

方法

参与者为20名志愿者,10名患有非特异性慢性下腰痛,10名无慢性下腰痛,平均年龄34岁,50%为女性。参与者在测力平台上按随机顺序完成以下平衡任务:(1)睁眼双脚站立,(2)闭眼双脚站立,(3)睁眼半串联站立,(4)闭眼半串联站立,(5)睁眼单腿站立。参与者对任务1 - 4完成三次60秒的试验,对任务5完成三次30秒的试验,试验之间休息30秒。在每个任务过程中计算前后方向和内外侧方向的压力中心面积、速度和频率,并在组间和任务间进行比较。

结果

慢性下腰痛患者的压力中心面积显著大于健康对照组,速度也更高(p < 0.001)。所有压力中心变量在任务间均存在显著差异(p < 0.001)。与双脚站立任务1和2相比,半串联站立(任务3和4)和单腿站立(任务5)对识别慢性下腰痛组的平衡障碍更敏感(效应大小>1.37 vs.效应大小<0.64)。组和任务之间没有显著的交互作用。

结论

与健康对照组相比,慢性下腰痛患者使用压力中心测量的姿势控制较差,主要是在更具挑战性的平衡任务中,如半串联和单腿站立条件下。康复意义慢性下腰痛患者的平衡能力比无慢性下腰痛的患者差。平衡任务需要灵敏以捕捉功能障碍。半串联和单腿站立时的平衡评估是确定慢性下腰痛患者姿势控制缺陷最敏感的任务。对于慢性下腰痛患者的康复计划,应包括平衡评估,以便在必要时更好地进行与平衡再训练相关的临床决策。

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