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Original article
Comparison of standing postural control and gait parameters in people with and without chronic low back pain: a cross-sectional case–control study
  1. Catharine Siân MacRae1,2,
  2. Duncan Critchley3,
  3. Jeremy S Lewis4,5,
  4. Adam Shortland6,7
  1. 1 College of Health and Life Sciences, Brunel University, Uxbridge, UK
  2. 2 Therapy Services, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  3. 3 Division of Health and Social Care Research, Academic Department of Physiotherapy, King’s College London, London, UK
  4. 4 Department of Allied Health Professions, University of Hertfordshire, Hatfield, UK
  5. 5 Musculoskeletal Services, Central London Community Healthcare NHS Foundation Trust, London, UK
  6. 6 One Small Step Gait Laboratory, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
  7. 7 Biomedical Engineering, King’s College London, London, UK
  1. Correspondence to Dr Catharine Siân MacRae; sian.macrae{at}Brunel.ac.uk

Abstract

Objective Differences in postural control and gait have been identified between people with and without chronic low back pain (CLBP); however, many previous studies present data from small samples, or have used methodologies with questionable reliability. This study, employing robust methodology, hypothesised that there would be a difference in postural control, and spatiotemporal parameters of gait in people with CLBP compared with asymptomatic individuals.

Methods This cross-sectional case–control study age-matched and gender-matched 16 CLBP and 16 asymptomatic participants. Participants were assessed barefoot (1) standing, over three 40 s trials, under four posture challenging conditions (2) during gait. Primary outcome was postural stability (assessed by root mean squared error of centre of pressure (CoP) displacement (CoPRMSEAP) and mean CoP velocity (CoPVELAP), both in the anteroposterior direction); gait outcomes were hip range of movement and peak moments, walking speed, cadence and stride length, assessed using force plates and a motion analysis system.

Results There were no differences between groups in CoPRMSEAP (P=0.26), or CoPVELAP (P=0.60) for any standing condition. During gait, no differences were observed between groups for spatiotemporal parameters, maximum, minimum and total ranges of hip movement, or peak hip flexor or extensor moments in the sagittal plane.

Conclusions In contrast to previous research, this study suggests that people with mild to moderate CLBP present with similar standing postural control, and parameters of gait to asymptomatic individuals. Treatments directed at influencing postural stability (eg, standing on a wobble board) or specific parameters of gait may be an unnecessary addition to a treatment programme.

  • lumbar spine
  • back injuries
  • exercise rehabilitation
  • gait analysis

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/bmjsem-2017-000286

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    Footnotes

    • Contributors CSM, the primary investigator, was involved in all aspects of the study, including methodology, data collection, analysis and interpretation of data, and was the primary author of the article. All authors contributed to methodology, data interpretation and editing of the manuscript for publication. All authors approved the final revision of the submitted manuscript. In addition, JSL received grant funding for the study, AS contributed to data collection. The corresponding author had full access to all data in the study and had final responsibility for the decision to submit for publication.

    • Funding The clinical study from which CLBP participants in the current study were recruited was funded by a Masai GB project grant. Masai GB had no role in the writing of the manuscript, data collection, analysis or interpretation; study design; patient recruitment; or the decision to submit for publication.

    • Competing interests None declared.

    • Ethics approval Ethical approval for the recruitment of symptomatic participants (Outer North London Research Ethics Committee (REC: 10/H0724/7)) and asymptomatic participants (King’s College London Research Ethics Subcommittee (BDM/10/11–7)) was gained.

    • Provenance and peer review Not commissioned; externally peer reviewed.