Balance reactions in middle-aged chronic low back pain patients

ABSTRACT

To measure the balance reactions with force-plate stabilometry in a group of subjects with back pain and those with healthy back to determine if there is difference between them and correlate balance stability indices with pain assessment parameters [pain duration and back pain disability score] in a group of patients with back pain Forty middle-age subjects complaining of chronic back pain of variable causes [lumber spondyolosis, old discotomy, chronic back strain and sacroiliac dysfunction] were included in this study [25 males and 15 females] with age between 20 and 42 years [mean32 +/- 7.16]. Also thirty subjects with healthy back were included in this study with age between 20-45 [mean 32.1 +/- 6.7]. All patients with back pain [not less than 6 months] were assessed through careful history and examination using Oswestery back pain disability questionnaire [ODS]. Balance responses [body sway] of each subject was evaluated by using computerized force-plate stabilometry [Biodex stability system] that provides dynamic multiaxial platform with variable degrees of eight instability levels ranging from least stability level to most stability level. The mean of anteroposterior [A-P] and mediolateral [M-L] stability indices for all dynamic positions in subjects with chronic LBP were greater than A-P and M-L stability indices in subjects with healthy back in the same positions with a statistic significant difference [p<0.05]. There was a significant positive correlation between both pain duration and ODS and A-P stability index and a non-significant negative correlation between them and M-L stability index. Dynamic balance is disturbed in patients with chronic back pain as compared to normal subjects in different dynamic balance positions especially in the A-P direction. The least stable position e.g. standing on one foot and with turning head and closed eye significantly increased the A-P stability index in patients with LBP than in normal subjects: