Psychomotor Speed and Postural Control in Chronic Low Back Pain Patients

Luoto, Satu; Taimela, Simo; Hurri, Heikki; Aalto, Heikki; Pyykkö, Ilmari; Alaranta, Hannu

doi:10.1097/00007632-199611150-00012

Cited by 135 publications

(82 citation statements)

References 19 publications

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“…This can make patients uncertain and reluctant to return to normal activities. Combined with the deconditioned state many patients present with [1,16,23,25,33,39] this may explain the low improvements in function observed. This lack of post-operative advice has now been addressed in the form of a patient education booklet [28], the value of which is currently being explored in a randomised controlled study.…”

Section: Discussionmentioning

confidence: 99%

The outcome of spinal decompression surgery 5 years on

2007

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Decompression surgery is an increasingly common operation for the treatment of lumbar spinal stenosis. Although good relief from leg pain is expected after surgery, long term results of pain relief and function are more uncertain. This study prospectively followed a cohort of patients presenting with the signs and symptoms of spinal stenosis, who underwent decompression surgery to ascertain the long term outcome with respect to pain and function using visual analogue pain scores, the Oswestry Disability Index, and the Short Form 36, a general health questionnaire. From an initial pool of 84 recruited patients, 7 withdrew from surgical intervention; of the remaining 77, 51 (66%) returned for follow up assessments at 5 years. In these responders, a significant improvement was observed in back and leg pain, which was sustained for at least 1 year (P < 0.01). A significant improvement was also seen in physical function (P < 0.05) as assessed by Oswestry and SF-36. Although an initial improvement was noted in social function, this was not observed at 5 years. This study has demonstrated that decompression surgery is successful in relieving symptoms of lumbar spinal stenosis. Physical function, back and leg pain are significantly improved after 5 years but initial significant improvements in social function diminish over time.

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Section: Discussionmentioning

confidence: 99%

The outcome of spinal decompression surgery 5 years on

2007

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“…These changes in reflex response may influence stability control and risk of low-back pain. Patients with lowback pain demonstrate reduced and slowed reflexes compared to asymptomatic control subjects (Luoto et al, 1996;Radebold et al, 2000) but it remains unclear whether this is a compensatory consequence of low-back pain (Van Dieen et al, 2003) or a contributing cause. Nonetheless, it has been proposed that changes in paraspinal muscle response following flexed posture work may contribute to LBP risk (Holm et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Effects of static flexion–relaxation on paraspinal reflex behavior

Granata

Rogers

Moorhouse

2005

Clinical Biomechanics

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Background.-Static trunk flexion working postures and disturbed trunk muscle reflexes are related to increased risk of low-back pain. Animal studies conclude that these factors may be related; passive tissue strain in spinal ligaments causes subsequent short-term changes in reflex. Although studies have documented changes in the myoelectric onset angle of flexion-relaxation following prolonged static flexion and cyclic flexion we could find no published evidence related to the human reflex response of the trunk extensor muscles following a period of static flexion-relaxation loading.Methods.-Eighteen subjects maintained static lumbar flexion for 15 min. Paraspinal muscle reflexes were elicited both before and after the flexion-relaxation protocol using pseudorandom stochastic force disturbances while recording EMG. Reflex gain was computed from the peak value of the impulse response function relating input force perturbation to EMG response using timedomain deconvolution analyses.Findings.-Reflexes showed a trend toward increased gain after the period of flexion-relaxation (P < 0.055) and were increased with trunk extension exertion (P < 0.021). Significant gender differences in reflex gain were observed (P < 0.01).Interpretations.-Occupational activities requiring extended periods of trunk flexion contribute to changes in reflex behavior of the paraspinal muscles. Results suggest potential mechanisms by which flexed posture work may contribute to low-back pain. Significant gender differences indicate risk analyses should consider personal factors when considering neuromuscular behavior.

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“…Pain has been shown to impair attention and concentration (Weiner et al, 1006), and attention is a required component of sensory integration needed for postural control in older adults (Redfern et al, 2001). An association between back pain and impaired postural control has been demonstrated in laboratory studies of younger individuals (Luoto et al, 1996;Luoto et al, 1998;Nies and Sinnott, 1991), thus we examine the relationship between postural control (using functional reach) and pain in this study. Subjects were asked to reach forward beyond arms length while maintaining a fixed base of support in the standing position.…”

Section: Isodynamic Lifting Taskmentioning

confidence: 97%

The impact of chronic low back pain on older adults: A comparative study of patients and controls

Rudy

Weiner

Lieber

et al. 2007

Pain

214

179

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Chronic low back pain (CLBP) is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. Many older adults remain quite functional despite CLBP, and because age-related comorbidities often exist independently of pain (e.g., medical illnesses, sleep disturbance, mobility difficulty), the unique impact of CLBP is unknown. We conducted this research to identify the multidimensional factors that distinguish independent community dwelling older adults with CLBP from those that are pain-free. Three hundred twenty cognitively intact participants (162 with ≥ moderate pain for ≥ 3 months, and 158 pain-free) underwent comprehensive assessment of pain severity, medical comorbidity (illnesses, body mass index, medications), severity of degenerative disc and facet disease, lumbar flexion, psychological constructs (self-efficacy, mood, overall mental health), and self-reported as well as performance-based physical function. Significant differences were ascertained for all 22 measures. Discriminant function analysis revealed that eight measures uniquely maximized the separation between the two groups (self-reported function with the Functional Status Index and the SF-36, performance-based function with repetitive trunk rotation and functional reach, mood with the Geriatric Depression Scale, comorbidity with the Cumulative Illness Rating Scale and BMI, and severity of degenerative disc disease). These results should help to guide investigators that perform studies of CLBP in older adults and practitioners that want an easily adaptable battery for use in clinical settings.

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Psychomotor Speed and Postural Control in Chronic Low Back Pain Patients

Abstract: The results indicate that patients with chronic low back pain have impaired psychomotor speed and, among women, impaired postural control. Psychomotor speed improved during an active, functional, restoration back rehabilitation program.

Cited by 135 publications

References 19 publications

The outcome of spinal decompression surgery 5 years on

The outcome of spinal decompression surgery 5 years on

Effects of static flexion–relaxation on paraspinal reflex behavior

The impact of chronic low back pain on older adults: A comparative study of patients and controls

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