Sung Paul, Lee Dongchul
Indiana Wesleyan University, Marion, United States.
Neurostim Insight, Santa Clarita, California, United States.
Eur Spine J. 2025 Jul 24. doi: 10.1007/s00586-025-09140-0.
Postural deficits are a common impairment in adults with chronic low back pain (LBP). However, the relationship between dynamic sway boundaries, visual reliance, and health-related quality of life (QOL) with LBP remains poorly understood.
This study investigated differences in sway excursion, circular stability thresholds, and QOL between adults with and without LBP during repeated unilateral stance tasks under eyes-open and eyes-closed conditions.
Eighty adults (45 with LBP, 35 controls) completed three unilateral stance trials on their dominant leg using a force platform. Participants performed three unilateral standing trials under the eyes-open condition and three trials under the eyes-closed condition on each limb. Sway excursion was quantified within 25%, 50%, and 75% circular thresholds inside a fixed 5 cm radius. Eight short form-36 QOL domains, including bodily pain, were used as covariates.
Significant main effects were observed for vision (F = 108.17, p < 0.001), trial repetition (F = 15.56, p < 0.001), and boundary threshold (F = 114.20, p < 0.001), along with a significant group interaction for vision × trial × boundary level (F = 4.01, p = 0.04). Post hoc analysis indicated reduced sway excursion in the LBP group, particularly at the 25% and 50% thresholds during trials 2 and 3. QOL-related analyses showed that boundary level was significantly associated with role limitations due to lower physical functioning scores (β = -0.34, p = 0.01).
Postural control during unilateral stance is modulated by visual input, task repetition, and spatial constraint. The LBP group demonstrated constrained sway excursion and reduced adaptability, which are reflected in diminished improvements in time-in-boundary across trials, particularly under eyes-closed conditions at wider sway thresholds. These limitations were relevant with lower physical functioning.
姿势缺陷是慢性下腰痛（LBP）成人患者常见的功能障碍。然而，动态摆动边界、视觉依赖与LBP患者健康相关生活质量（QOL）之间的关系仍未得到充分理解。
本研究调查了有和没有LBP的成年人在睁眼和闭眼条件下重复单侧站立任务期间的摆动偏移、圆形稳定性阈值和QOL的差异。
80名成年人（45名LBP患者，35名对照）使用测力平台对其优势腿完成三次单侧站立试验。参与者在每个肢体上进行三次睁眼条件下的单侧站立试验和三次闭眼条件下的试验。在固定半径5厘米内的25%、50%和75%圆形阈值内对摆动偏移进行量化。包括身体疼痛在内的8个简短形式-36 QOL领域用作协变量。
观察到视觉（F = 108.17，p < 0.001）、试验重复（F = 15.56，p < 0.001）和边界阈值（F = 114.20，p < 0.001）的显著主效应，以及视觉×试验×边界水平的显著组间交互作用（F = 4.01，p = 0.04）。事后分析表明，LBP组的摆动偏移减少，尤其是在试验2和3期间的25%和50%阈值处。与QOL相关的分析表明，边界水平与由于较低的身体功能得分导致的角色限制显著相关（β = -0.34，p = 0.01）。
单侧站立期间的姿势控制受视觉输入、任务重复和空间约束的调节。LBP组表现出受限的摆动偏移和适应性降低，这反映在试验期间边界内时间改善的减少，特别是在闭眼条件下更宽摆动阈值时。这些限制与较低的身体功能相关。
