Altered postural control in anticipation of postural instability in persons with recurrent low back pain

Insight into the mechanisms of altered postural control in persons with low back pain (LBP) could lead to better interventions for patients with LBP. This study investigated (1) whether persons with recurrent LBP have an altered body inclination, and (2) whether anticipation of postural instability further alters body inclination. Thirty-three young healthy individuals and 56 young persons with recurrent LBP participated in this study. The upright standing posture was evaluated by means of two piezo-resistive electrogoniometers and a force platform for the conditions as follows: (1) quiet stance with and without vision, and (2) in anticipation of postural instability due to a ballistic arm movement or ankle muscle vibration. No differences in body inclination were observed when visual information was available between the two groups (P > 0.05). However, significant more forward inclination was seen in the persons with recurrent LBP when vision was occluded (+7.4%) and in anticipation of postural instability (+19%) (P < 0.05) compared to the healthy individuals. The results suggest that young persons with recurrent LBP have an altered body inclination that might be caused by anticipation of postural instability. The adopted forward inclined posture may potentially be a factor in the recurrence of LBP. (C) 2008 Elsevier B.V. All rights reserved.