Immediate Effects of Lumbosacral Orthosis on Postural Stability in Patients with Low Back Pain: A Preliminary Study

Fatemeh Azadinia, Ismail Ebrahimi-Takamjani, Mojtaba Kamyab, Morteza Asgari, Mohamad Parnianpour, Fatemeh Azadinia, Ismail Ebrahimi-Takamjani, Mojtaba Kamyab, Morteza Asgari, Mohamad Parnianpour

Abstract

Background: Lumbosacral orthosis (LSO) is commonly used for the treatment of back pain. The clinical and mechanical effectiveness of this device has been repeatedly investigated in several studies; however, its sensorimotor effectiveness has been rarely considered. Regarding this, the aim of the current study was to investigate the effect of a non-extensible LSO on postural stability (as a construct of sensorimotor function) in patients with nonspecific chronic low back pain (LBP).

Methods: This preliminary study was conducted on 17 patients with nonspecific chronic LBP using a single-group quasi-experimental design. Postural stability was measured while the participants were placed in a quiet standing position, under the combined conditions of base of support (rigid and foam surface), visual input (open eyes and closed eyes), and LSO (with and without orthosis).

Results: The findings demonstrated that wearing orthosis during the most challenging postural task (i.e., blindfolded while standing on a foam surface) significantly reduced postural sway parameters related to the position and displacement of the center of pressure (COP; the sway area and sway amplitude in the anteroposterior direction; P<0.001). However, the use of this device had no significant effect on COP velocity.

Conclusion: As the findings of the present study indicated, the use of a non-extensible LSO decreased the COP displacement; however, it did not affect the COP velocity. Therefore, our data could not utterly support the effectiveness of non-extensible LSO on postural stability as a construct of sensorimotor function. Postural control is an appropriate indicator for assessing the global functioning of the sensorimotor system due to its dependence upon the interaction between the neural and musculoskeletal systems. Consequently, further studies are needed to elucidate the positive effects of LSO on the aspects of sensorimotor function.

Keywords: LBP; Orthotic device; Postural balance.

Conflict of interest statement

The authors report no conflicts of interest concerning the materials or methods of this study or the findings specified in this paper.

References

    1. Jellema P, van Tulder MW, van Poppel MN, Nachemson AL, Bouter LM. Lumbar supports for prevention and treatment of low back pain: a systematic review within the framework of the Cochrane Back Review Group. Spine. 2001;26(4):377–86.
    1. Morrisette DC, Cholewicki J, Patenge WF, Logan S, Seif G, McGowan S. A randomized clinical trial comparing extensible and inextensible lumbosacral orthoses and standard care alone in the management of lower back pain. Spine. 2014;39(21):1733–42.
    1. Calmels P, Queneau P, Hamonet C, Le Pen C, Maurel F, Lerouvreur C, et al. Effectiveness of a lumbar belt in subacute low back pain: an open, multicentric, and randomized clinical study. Spine. 2009;34(3):215–20.
    1. Azadinia F, Ebrahimi-Takamjani I, Kamyab M, Parnianpour M, Asgari M. Comparing lumbosacral orthosis to routine physical therapy on postural stability in patients with chronic low back pain: A randomized trial. Med J Islam Repub Iran. 2017;31(1):26.
    1. van Poppel MN, de Looze MP, Koes BW, Smid T, Bouter LM. Mechanisms of action of lumbar supports: a systematic review. Spine. 2000;25(16):2103–13.
    1. Newcomer K, Laskowski ER, Yu B, Johnson JC, An KN. The effects of a lumbar support on repositioning error in subjects with low back pain. Arch Phys Med Rehabil. 2001;82(7):906–10.
    1. Cholewicki J, Reeves NP, Everding VQ, Morrisette DC. Lumbosacral orthoses reduce trunk muscle activity in a postural control task. J Biomech. 2007;40(8):1731–6.
    1. Cholewicki J, McGill KC, Shah KR, Lee AS. The effects of a three-week use of lumbosacral orthoses on trunk muscle activity and on the muscular response to trunk perturbations. BMC Musculoskelet Disord. 2010;11(1):154.
    1. Oleske DM, Lavender SA, Andersson GB, Kwasny MM. Are back supports plus education more effective than education alone in promoting recovery from low back pain?: Results from a randomized clinical trial. Spine. 2007;32(19):2050–7.
    1. van Poppel MN, Koes BW, van der Ploeg T, Smid T, Bouter LM. Lumbar supports and education for the prevention of low back pain in industry: a randomized controlled trial. JAMA. 1998;279(22):1789–94.
    1. Azadinia F, Ebrahimi Takamjani E, Kamyab M, Parnianpour M, Cholewicki J, Maroufi N. Can lumbosacral orthoses cause trunk muscle weakness? A systematic review of literature. Spine J. 2016;17(4):589–602.
    1. Leitner C, Mair P, Paul B, Wick F, Mittermaier C, Sycha T, et al. Reliability of posturographic measurements in the assessment of impaired sensorimotor function in chronic low back pain. J Electromyogr Kinesiol. 2009;19(3):380–90.
    1. Schelldorfer S, Ernst MJ, Rast FM, Bauer CM, Meichtry A, Kool J. Low back pain and postural control, effects of task difficulty on centre of pressure and spinal kinematics. Gait Posture. 2015;41(1):112–8.
    1. Yahia A, Jribi S, Ghroubi S, Elleuch M, Baklouti S, Elleuch MH. Evaluation of the posture and muscular strength of the trunk and inferior members of patients with chronic lumbar pain. Joint Bone Spine. 2011;78(3):291–7.
    1. Ruhe A, Fejer R, Walker B. Center of pressure excursion as a measure of balance performance in patients with non-specific low back pain compared to healthy controls: a systematic review of the literature. Eur Spine J. 2011;20(3):358–68.
    1. Karimi N, Ebrahimi I, Kahrizi S, Torkaman G. Evaluation of postural balance using the biodex balance system in subjects with and without low back pain. Pak J Med Sci. 2008;24(3):372–7.
    1. Shahabazi Seraj Moheb S, Sarrafzadeh J, Maroufi N, Ebrahimi Takamjani I, Ahmadi A, Negahban H. Comparison of postural balance between subgroups of nonspecific low-back pain patients based on o’sullivan classification system and normal subjects during lifting. Arch Bone Jt Surg. 2019;7(1):52–60.
    1. Mok NW, Brauer SG, Hodges PW. Changes in lumbar movement in people with low back pain are related to compromised balance. Spine. 2011;36(1):E45–52.
    1. Mok NW, Brauer SG, Hodges PW. Failure to use movement in postural strategies leads to increased spinal displacement in low back pain. Spine. 2007;32(19):E537–43.
    1. Mok NW, Brauer SG, Hodges PW. Postural recovery following voluntary arm movement is impaired in people with chronic low back pain. Gait Posture. 2011;34(1):97–102.
    1. Brumagne S, Janssens L, Knapen S, Claeys K, Suuden-Johanson E. Persons with recurrent low back pain exhibit a rigid postural control strategy. Eur Spine J. 2008;17(9):1177–84.
    1. Jones SL, Henry SM, Raasch CC, Hitt JR, Bunn JY. Individuals with non-specific low back pain use a trunk stiffening strategy to maintain upright posture. J Electromyogr Kinesiol. 2012;22(1):13–20.
    1. Van Daele U, Hagman F, Truijen S, Vorlat P, Van Gheluwe B, Vaes P. Differences in balance strategies between nonspecific chronic low back pain patients and healthy control subjects during unstable sitting. Spine. 2009;34(11):1233–8.
    1. O’Sullivan PB, Burnett A, Floyd AN, Gadsdon K, Logiudice J, Miller D, et al. Lumbar repositioning deficit in a specific low back pain population. Spine. 2003;28(10):1074–9.
    1. Reeves NP, Everding VQ, Cholewicki J, Morrisette DC. The effects of trunk stiffness on postural control during unstable seated balance. Exp Brain Res. 2006;174(4):694–700.
    1. Cholewicki J, Lee AS, Reeves NP, Morrisette DC. Comparison of trunk stiffness provided by different design characteristics of lumbosacral orthoses. Clin Biomech. 2010;25(2):110–4.
    1. Mazaheri M, Coenen P, Parnianpour M, Kiers H, van Dieën JH. Low back pain and postural sway during quiet standing with and without sensory manipulation: a systematic review. Gait Posture. 2013;37(1):12–22.
    1. Munoz F, Rouboa AI, Rougier PR. The balance control effects on sitting posture induced by lumbosacral orthosis wear vary depending on the level of stability. Appl Ergon. 2013;44(4):511–6.
    1. Munoz F, Salmochi JF, Faouen P, Rougier P. Low back pain sufferers: is standing postural balance facilitated by a lordotic lumbar brace? Orthop Traumatol Surg Res. 2010;96(4):362–6.
    1. Mok NW, Brauer SG, Hodges PW. Hip strategy for balance control in quiet standing is reduced in people with low back pain. Spine. 2004;29(6):E107–12.
    1. Corbeil P, Blouin JS, Teasdale N. Effects of intensity and locus of painful stimulation on postural stability. Pain. 2004;108(1):43–50.
    1. Reeves NP, Narendra KS, Cholewicki J. Spine stability: the six blind men and the elephant. Clin Biomech. 2007;22(3):266–74.
    1. Cenciarini M, Loughlin PJ, Sparto PJ, Redfern MS. Stiffness and damping in postural control increase with age. IEEE Trans Biomed Eng. 2010;57(2):267–75.
    1. Hodges P, van den Hoorn W, Dawson A, Cholewicki J. Changes in the mechanical properties of the trunk in low back pain may be associated with recurrence. J Biomech. 2009;42(1):61–6.
    1. Salavati M, Hadian MR, Mazaheri M, Negahban H, Ebrahimi I, Talebian S, et al. Test–retest reliabty of center of pressure measures of postural stability during quiet standing in a group with musculoskeletal disorders consisting of low back pain, anterior cruciate ligament injury and functional ankle instability. Gait Posture. 2009;29(3):460–4.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner