Anticipatory and compensatory postural adjustments in people with low back pain: a systematic review and meta-analysis

Knox, Michael F.; Chipchase, Lucinda S; Schabrun, Siobhan M; Romero, Rick J; Marshall, P.W.

doi:10.1016/j.spinee.2018.06.008

Cited by 68 publications

(61 citation statements)

References 64 publications

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“…Chronic LBP patients demonstrate motor control deficits during standing and sitting (Della Volpe and others 2006; Lafond and others 2009), during challenging tasks such as one-legged standing (da Silva and others 2018) or during gait and functional tasks (Christe and others 2017; Hemming and others 2017). Furthermore, the systematic review by Knox and colleagues identified a delayed onset of muscle activity with anticipatory and compensatory postural responses to perturbations in patients with chronic LBP (Knox and others 2018). In sum, there is substantial evidence for behavioral motor control adaptations associated with LBP.…”

Section: Behavioral and Motor System Adaptions In Lbpmentioning

confidence: 99%

“…It has been suggested that these changes, if persistent, predispose individuals to recurrent and chronic LBP (van Dieën and others 2017). Indeed, compelling evidence indicates altered motor control in chronic LBP patients based on, for example, spine kinematics, EMG, and center of pressure analysis (reviewed in Knox and others 2018). Chronic LBP patients demonstrate motor control deficits during standing and sitting (Della Volpe and others 2006; Lafond and others 2009), during challenging tasks such as one-legged standing (da Silva and others 2018) or during gait and functional tasks (Christe and others 2017; Hemming and others 2017).…”

Section: Behavioral and Motor System Adaptions In Lbpmentioning

confidence: 99%

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Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

2018

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Motor control, which relies on constant communication between motor and sensory systems, is crucial for spine posture, stability and movement. Adaptions of motor control occur in low back pain (LBP) while different motor adaption strategies exist across individuals, probably to reduce LBP and risk of injury. However, in some individuals with LBP, adapted motor control strategies might have long-term consequences, such as increased spinal loading that has been linked with degeneration of intervertebral discs and other tissues, potentially maintaining recurrent or chronic LBP. Factors contributing to motor control adaptations in LBP have been extensively studied on the motor output side, but less attention has been paid to changes in sensory input, specifically proprioception. Furthermore, motor cortex reorganization has been linked with chronic and recurrent LBP, but underlying factors are poorly understood. Here, we review current research on behavioral and neural effects of motor control adaptions in LBP. We conclude that back pain-induced disrupted or reduced proprioceptive signaling likely plays a pivotal role in driving long-term changes in the top-down control of the motor system via motor and sensory cortical reorganization. In the outlook of this review, we explore whether motor control adaptations are also important for other (musculoskeletal) pain conditions.

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Section: Behavioral and Motor System Adaptions In Lbpmentioning

confidence: 99%

Section: Behavioral and Motor System Adaptions In Lbpmentioning

confidence: 99%

Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

2018

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“…In pain conditions, the functions of these muscles have been found to be impaired, decreasing and/or delaying compared with healthy individuals. During both expected and unexpected perturbations, persons with chronic LBP demonstrated delayed onset of the transversus abdominis and the deep lumbar multifidus muscles [5,13,14]. Similarly, the deep cervical flexor muscles also showed delayed onset in patients with chronic neck pain [15] and whiplash injury [16].…”

Section: Introductionmentioning

confidence: 99%

Abnormal performance of cervical stabilizer muscles in individuals with low back pain

Thongprasert

Kanlayanaphotporn

2018

Journal of Manual & Manipulative Therapy

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Objectives: To compare the performance of cervical stabilizer muscles using the craniocervical flexion test (CCFT) among individuals with subacute, chronic, and asymptomatic low back pain (LBP) conditions. Methods: Individuals with subacute (N = 23) and chronic LBP (N = 23) with their age-and gender-matched controls (N = 30) participated in this study. All recruited participants were required to perform the CCFT. The activation score (AS) and the performance index (PI) were recorded by an assessor who was blinded to the group of participants. Results: Approximately, 74% of subacute LBP participants and 60-65% of chronic LBP participants obtained abnormal AS and PI. AS was significantly lower in participants with subacute (P = 0.0002) and chronic LBP (P = 0.0009) than the control group. Likewise, the PI was significantly lower in participants with subacute (P = 0.0002) and chronic LBP (P = 0.0036) than the control group. Participants in the subacute LBP group showed significantly greater percentages of abnormal responses on the AS (P < 0.0001) and the PI (P = 0.0001) than the control. Discussion: Abnormal performance of cervical stabilizer muscles using the CCFT was demonstrated in a high proportion of participants with LBP. The findings highlight the plausible association in muscle control between cervical and lumbar stabilizers. Level of Evidence: 2b.

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“…These anticipatory postural adjustments (APAs) are also observed in trunk muscles during the transition from a double to a single‐leg stance 2 . Delayed APAs during dynamic stability tasks are associated with biophysical characteristics related to low back pain 3,4 . Therefore, normalizing the delayed trunk muscle activities in APAs is important to regain motor control for people with low back pain.…”

Section: Introductionmentioning

confidence: 99%

Immediate changes in anticipatory muscle activity after unexpected muscle contraction training

2020

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This study aimed to investigate the effects of unexpected trunk muscle contraction training for anticipatory muscle activity during a single‐leg lifting task. A total of 11 healthy adults performed 20 trials of rapid single‐leg lifts by flexing the hip joint of their dominant leg so that the thigh was 90° to the torso. As a training task, participants sat on a rocker board and a sudden movement was initiated to destabilize the trunk muscles. A force plate and 3D motion analysis system determined the motion time, which was from the weight shift onset to the center of mass shift onset. An electromyograph was used to determine the muscle activity onset time and amplitude from both sides of multifidus (MF), internal (IO), and external obliques (EO). The results showed that unexpected muscle contraction training was effective to hasten the stance side of IO muscle onset and decrease the stance side of MF and IO amplitude in a single‐leg lifting task. The stance side of MF and IO has an important role in counteracting the sacroiliac joint shear force in the single‐leg lifting task. Hence, our results indicated that the trunk muscle training improved anticipatory muscle contraction.

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Anticipatory and compensatory postural adjustments in people with low back pain: a systematic review and meta-analysis

Cited by 68 publications

References 64 publications

Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

Abnormal performance of cervical stabilizer muscles in individuals with low back pain

Immediate changes in anticipatory muscle activity after unexpected muscle contraction training

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