Sung Paul, Lee Dongchul
Indiana Wesleyan University, Marion, USA.
Neurostim Insight, Santa Clarita, CA, USA.
Eur Spine J. 2025 Jul 21. doi: 10.1007/s00586-025-09157-5.
Postural instability linked to fear of movement (FOM) is a frequent impairment among adults with chronic low back pain (LBP). However, progressive stability thresholds on sway control remain poorly characterized.
This study aimed to examine differences in sway excursion boundaries and circular stability thresholds during unilateral standing on the dominant and non-dominant limbs in adults with LBP.
Eighty adults (35 with LBP and 45 controls) participated in this study. Participants completed the Tampa Scale for Kinesiophobia (TSK) to assess fall-related fear. They performed three unilateral standing trials per limb on a force platform. Sway excursion boundaries were evaluated at 25%, 50%, and 75% circular thresholds within a 10 cm radius.
During dominant limb standing, there was a group interaction on trial and threshold (F = 6.80, p = 0.01). The LBP group showed greater sway excursions than the control group at 25% and 50% thresholds in the second trial and at 25%, 50%, and 75% thresholds in the third trial. During non-dominant limb standing, however, there was no group interaction on trial and threshold (F = 0.35, p = 0.56). There was no significant TSK interaction, regardless of limb dominance.
Adults with chronic LBP exhibit progressive postural instability under increasing balance demands, particularly during dominant limb standing. Although individuals with LBP demonstrated elevated FOM, it did not significantly influence postural sway outcomes. These findings underscore the importance of developing targeted, task-specific balance interventions to enhance dominant-limb stability in adults with chronic LBP.
与运动恐惧（FOM）相关的姿势不稳是慢性下腰痛（LBP）成年人中常见的损伤。然而，摇摆控制的渐进稳定性阈值仍未得到很好的表征。
本研究旨在探讨慢性下腰痛成年人在优势侧和非优势侧肢体单腿站立时，摇摆偏移边界和圆形稳定性阈值的差异。
80名成年人（35名慢性下腰痛患者和45名对照组）参与了本研究。参与者完成了坦帕运动恐惧量表（TSK）以评估与跌倒相关的恐惧。他们在测力平台上每条腿进行了三次单腿站立试验。在半径为10厘米的范围内，在25%、50%和75%的圆形阈值处评估摇摆偏移边界。
在优势侧肢体站立期间，试验和阈值存在组间交互作用（F = 6.80，p = 0.01）。在第二次试验的25%和50%阈值以及第三次试验的25%、50%和75%阈值处，慢性下腰痛组的摇摆偏移大于对照组。然而，在非优势侧肢体站立期间，试验和阈值没有组间交互作用（F = 0.35，p = 0.56）。无论肢体优势如何，TSK均无显著交互作用。
慢性下腰痛成年人在平衡需求增加时表现出渐进性姿势不稳，尤其是在优势侧肢体站立期间。虽然慢性下腰痛患者表现出较高的运动恐惧，但这并未显著影响姿势摇摆结果。这些发现强调了制定有针对性的、特定任务平衡干预措施以增强慢性下腰痛成年人优势侧肢体稳定性的重要性。
