Psychomotor speed and postural control in chronic low back pain patients - A controlled follow-up study

Study Design. Psychomotor speed (reaction time) and postural control (center point of force velocity) among healthy control volunteers and patients with chronic low back pain (LBP) were studied at the beginning of an active, functional, restoration back rehabilitation program and 6 months after the program. Objectives. To study cross-sectionally reaction times and center points of force velocity among control volunteers and patients with low back pain, and to evaluate the effects of the restoration on these measures of motor function in a follow-up examination. Summary of Background Data. Deficits of motor skills and of coordination have been reported in association with musculoskeletal disorders, but one can only speculate about an association between proprioceptive dysfunction and low back disorders on the basis of the currently available data. Methods. Sixty-one healthy control volunteers and 99 patients with low back pain-68 of these patients experienced moderate pain; 31 experienced severe pain-participated in the study. Reaction times for upper and lower limbs were tested with a system based on a microcomputer. Postural stability was measured with a vertical force platform. Results. A consistent trend was found in which patients with low back pain had reaction times slower than those of control volunteers. Men with severe low back pain had significantly longer hand reaction times than men in the control group (P = 0.03). Women with severe low back pain also had poorer postural control than women with moderate low back pain (P = 0.02) and women in the control group (P = 0.04). Functional restoration seemed to have an effect on reaction times. The restoration was considered successful if the condition of a patient with a disability that had resulted from low back pain improved during the follow-up examination and unsuccessful if the disability worsened. Patients who experienced these results were identified in groups called ''good'' and ''poor,'' respectively. Among men, the reaction times improved in the control group and ''good'' groups, but they became slower in the ''poor'' group. The difference between ''good'' and ''poor'' groups was significant (P = 0.008). Women in the ''good'' groups was significant (P = 0.008). Women in the ''good'' group achieved the most improved reaction times, and the difference between these women and the control women almost reached significance (P = 0.076). Conclusion. The results indicate that patients with chronic low back pain have impaired psychomotor speed and among women, impaired postural control. Psychomotor speed improved during an active, functional, restoration back rehabilitation program.