Issn Print: 0362-2436

Publication Date: 1998/10/01


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Point of View: One-Footed and Externally Disturbed Two-Footed Postural Control in Patients With Chronic Low Back Pain and Healthy Control Subjects: A Controlled Study With Follow-Up

Chris J. Snijders; Peter Hoogvliet; Gerrit Jan Kleinrensink; Rob Stoeckart

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Excerpt

For the readers of Spine it may be interesting to read that a relatively simple one-leg stance on a forceplate can help to discriminate between patients with severe low back pain (LBP), those with moderate LBP, and controls. As a second finding, Luoto et al show that for certain patients with moderate LBP, this one-footed postural control decreased after they had participated in an intensive rehabilitation program. The patients showing such a decrease in postural control were characterized by a poor outcome of the program (decreased Oswestry disability index). Although a proper control group (patients with moderate LBP not participating in a rehabilitation program) was lacking, it can be assumed that the decrease occurred as a result of the rehabilitation program.
The causes of both findings on decreased postural control may be multifactorial, including factors reported by the authors as well as several more specific factors.
Also of interest are the variables used to quantify postural control. Their statement "standardization is still inadequate" is reflected in the variables used in this study. In general, horizontal force measures are more sensitive than center of pressure measures in discriminating between changes in steadiness.1 However, the use of the center of pressure or its derivatives still can be justifiable, because of their strong relation with some specific aspects of postural control, especially during the one-leg stance.2 The results would have to be interpreted accordingly, of course.
Notwithstanding, the authors have drawn our attention to an important consequence of LBP. Even more importantly, they have shown us the method that must be used to measure LBP. The findings of this study can result in better, more thorough assessment of disabilities in patients with LBP. In addition, these findings can be used to improve current LBP rehabilitation programs.

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