Proprioceptive change impairs balance control in older patients with low back pain

Abstract

[Purpose] This study aims to determine the specific proprioceptive control strategy used during postural balance in older patients with low back pain (LBP) and non-LBP (NLBP) and to assess whether this strategy is related to proprioceptive decline and LBP. [Subjects and Methods] Pressure displacement center was determined in 47 older persons with LBP and 64 older persons with NLBP during upright stance on a balance board without vision. Gastrocnemius (GS) and lumbar multifidus muscle (LM) vibratory stimulations of 60 and 240-Hz, respectively, were applied to evaluate the relative contributions of different proprioceptive signals (relative proprioceptive weighting ratio, RPW) used in postural control. Age, height, weight, back muscle strength, L1/2 and L4/5 lumbar multifidus cross section area ratio, skeletal muscle mass index, sagittal vertical axis, and Roland-Morris disability questionnaire (RDQ) were evaluated. [Results] Compared with older patients with NLBP, those with LBP showed a lower RPW 240-Hz, lower L4/5 lumbar multifidus cross-sectional area ratio, and a significantly higher age and RDQ. Logistic regression analysis showed that RPW 240-Hz and age were independently associated with LBP, after controlling for confounding factors. [Conclusion] Older patients with LBP decreased their reliance on GS (RPW 240-Hz) proprioceptive signals during balance control.