Is There a Relationship Between Lumbar Proprioception and Low Back Pain? A Systematic Review With Meta-Analysis

Tong, M.H.; Mousavi, Seyed Javad; Kiers, Henri; Ferreira, Paulo H.; Refshauge, Kathryn M.; Dieën, Jaap H. van

doi:10.1016/j.apmr.2016.05.016

Cited by 151 publications

(126 citation statements)

References 73 publications

(219 reference statements)

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“…When less reliable intrinsic feedback is available, the dependency on the extrinsic feedback may increase [ 7 ]. Overall, patients with CLBP have decreased lumbosacral proprioception compared to healthy persons [ 16 , 34 ], so it can be argued that removing the external feedback could influence the performance on the waiter’s bow more in patients with CLBP than in healthy participants. On the other hand, these proprioceptive impairments may be position specific (e.g.…”

Section: Discussionmentioning

confidence: 99%

Sensor-based postural feedback is more effective than conventional feedback to improve lumbopelvic movement control in patients with chronic low back pain: a randomised controlled trial

Matheve

Brumagne

Demoulin

et al. 2018

J NeuroEngineering Rehabil

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BackgroundImproving movement control can be an important treatment goal for patients with chronic low back pain (CLBP). Although external feedback is essential when learning new movement skills, many aspects of feedback provision in patients with CLBP remain currently unexplored. New rehabilitation technologies, such as movement sensors, are able to provide reliable and accurate feedback. As such, they might be more effective than conventional feedback for improving movement control. The aims of this study were (1) to assess whether sensor-based feedback is more effective to improve lumbopelvic movement control compared to feedback from a mirror or no feedback in patients with chronic low back pain (CLBP), and (2) to evaluate whether patients with CLBP are equally capable of improving lumbopelvic movement control compared to healthy persons.MethodsFifty-four healthy participants and 54 patients with chronic non-specific LBP were recruited. Both participant groups were randomised into three subgroups. During a single exercise session, subgroups practised a lumbopelvic movement control task while receiving a different type of feedback, i.e. feedback from movement sensors, from a mirror or no feedback (=control group). Kinematic measurements of the lumbar spine and hip were obtained at baseline, during and immediately after the intervention to evaluate the improvements in movement control on the practised task (assessment of performance) and on a transfer task (assessment of motor learning).ResultsSensor-based feedback was more effective than feedback from a mirror (p < 0.0001) and no feedback (p < 0.0001) to improve lumbopelvic movement control performance (Sensor vs. Mirror estimated difference 9.9° (95% CI 6.1°-13.7°), Sensor vs. Control estimated difference 10.6° (95% CI 6.8°-14.3°)) and motor learning (Sensor vs. Mirror estimated difference 7.2° (95% CI 3.8°-10.6°), Sensor vs. Control estimated difference 6.9° (95% CI 3.5°-10.2°)). Patients with CLBP were equally capable of improving lumbopelvic movement control compared to healthy persons.ConclusionsSensor-based feedback is an effective means to improve lumbopelvic movement control in patients with CLBP. Future research should focus on the long-term retention effects of sensor-based feedback.Trial registrationclinicaltrials.gov NCT02773160, (retrospectively registered on May 16th, 2016).Electronic supplementary materialThe online version of this article (10.1186/s12984-018-0423-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Sensor-based postural feedback is more effective than conventional feedback to improve lumbopelvic movement control in patients with chronic low back pain: a randomised controlled trial

Matheve

Brumagne

Demoulin

et al. 2018

J NeuroEngineering Rehabil

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“…To be comprehensive, in addition to pain mechanism, the diagnostic system requires evaluation of patients across multiple biological, psychological and social dimensions. These would include features relevant to motor control such as patterns of pain provocation and relief, 20-22, 62, 73 muscle atrophy and weakness, 55,56 proprioceptive impairment, 63,86 as well as differentiation of psychological features including pain beliefs and fear of pain or re-injury, 57,100 depression, catastrophising, self-efficacy, and social issues. 70 An important consideration is that domains are not independent.…”

Section: Are Subgroups Based On Motor Control Mutually Exclusive?mentioning

confidence: 99%

Analysis of Motor Control in Patients With Low Back Pain: A Key to Personalized Care?

Dieën¹,

Reeves²,

Kawchuk³

et al. 2019

Journal of Orthopaedic & Sports Physical Therapy

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Synopsis Motor control exercise has been shown to be effective in the management of low-back pain (LBP), but effect sizes are modest, possibly due to the fact that studies have used a one-size-fits-all approach, whereas literature suggests that patients may differ in presence or type of motor control issues. In this commentary, we address the question whether consideration of such variation in motor control issues might contribute to more personalized motor control exercise for patients with LBP. Such an approach is plausible, since motor control changes may play a role in persistence of pain through effects on tissue loading that may cause nociceptive afference in particular in case of peripheral sensitization. Subgrouping systems used in clinical practice which comprise motor control aspects allow reliable classification that is in part aligned with findings in studies on motor control in patients with LBP. Motor control issues may have heuristic value for treatment allocation, as the different presentations observed suggest different targets for motor control exercise, but this remains to be proven. Finally, clinical assessment of patients with LBP should take into account more aspects than motor control alone, including pain mechanisms, musculoskeletal health and psychosocial factors, and may need to be embedded in a stratification approach based on prognosis to avoid undue diagnostic procedures. J Orthop Sports Phys Ther, Epub 12 Jun 2018. doi:10.2519/jospt.2019.7916.

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“…We hypothesize that this may contribute to the changes in representations of the trunk in the somatosensory (37) cortex observed with LBP. In turn, these changes in the sensory cortex could contribute to the impaired proprioception (35) and the related imprecision in control of trunk movement in individuals with chronic LBP (50). Furthermore, conventional muscle recruitment patterns, with relative inhibition of deep muscle activity, are associated with changes in representations of trunk muscles on the motor cortex in individuals with LBP (5).…”

Section: Consequences Of Changes In Motor Behavior With Lbpmentioning

confidence: 99%

Low-Back Pain Patients Learn to Adapt Motor Behavior With Adverse Secondary Consequences

Dieën

Flor

Hodges

2017

Exercise and Sport Sciences Reviews

118

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We hypothesize that changes in motor behavior in individuals with low-back pain are adaptations aimed at minimizing the real or perceived risk of further pain. Through reinforcement learning, pain and subsequent adaptations result in less dynamic motor behavior, leading to increased loading and impoverished sensory feedback, which contribute to cortical reorganization and proprioceptive impairments that reduce the ability to control lumbar movement in a robust manner.

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Is There a Relationship Between Lumbar Proprioception and Low Back Pain? A Systematic Review With Meta-Analysis

Cited by 151 publications

References 73 publications

Sensor-based postural feedback is more effective than conventional feedback to improve lumbopelvic movement control in patients with chronic low back pain: a randomised controlled trial

Sensor-based postural feedback is more effective than conventional feedback to improve lumbopelvic movement control in patients with chronic low back pain: a randomised controlled trial

Analysis of Motor Control in Patients With Low Back Pain: A Key to Personalized Care?

Low-Back Pain Patients Learn to Adapt Motor Behavior With Adverse Secondary Consequences

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