Low-Back Pain and Knee Position-Related Differences on Postural Control Measures During a One-Legged Stance in Athletes

J Sport Rehabil. 2020 Nov 25;30(4):631-637. doi: 10.1123/jsr.2020-0095.

Abstract

Context: Chronic low-back pain (CLBP) may be associated with changes in postural balance in athletes as poor postural control during sports practice.

Objective: To compare the postural control of athletes with and without CLBP during 2 one-legged stance tasks and identify the center of pressure (COP) cutoff values to determine the main differences. Designed: A cross-sectional study.

Setting: Laboratory of functional evaluation and human motor performance.

Participants: A total of 56 male athletes, 28 with and 28 without CLBP (mean age = 26 y).

Intervention: The one-legged stance with knee extension and with the knee at 30° flexion tasks were measured and analyzed on a force platform. The participants completed three 30-second trials (30 s of rest between each trial).

Main outcome measures: The COP parameters: the area of COP, mean COP sway velocity in both the anteroposterior and mediolateral directions, and total COP displacement were computed, and a receiver operating characteristics curve analysis was applied to determine the group differences.

Results: Athletes with CLBP had poorer postural control (P < .01) in both tasks. The 30° knee flexion reported more postural instability than the knee extension for all COP parameters (a large effect size d = 0.80).The knee extension cutoffs identified were >7.1 cm2 for the COP area, >2.6 cm/s for the COP sway velocity in the anterior-posterior direction, and >3.2 cm/s for the mediolateral direction. Whereas, the 30° knee flexion cutoffs were >10.9 cm2 for the COP area, >2.9 cm/s for the COP sway velocity in the anterior-posterior direction, and >4.1 cm/s for the mediolateral direction. Both measures showed enough sensitivity and specificity (ie, area under the curve = 0.88 in and 0.80, respectively) to discriminate both groups.

Conclusions: The athletes with CLBP had poorer postural control than the healthy athletes and obtained specific cutoff scores from the COP values.

Keywords: athletes; chronic low-back pain; postural balance; posture; spine.

MeSH terms

  • Adult
  • Athletes*
  • Case-Control Studies
  • Chronic Pain / physiopathology*
  • Cross-Sectional Studies
  • Humans
  • Knee Joint*
  • Low Back Pain / physiopathology*
  • Male
  • Pain Measurement
  • Postural Balance / physiology*
  • Posture / physiology*
  • Pressure
  • ROC Curve
  • Randomized Controlled Trials as Topic
  • Sensitivity and Specificity
  • Time Factors
  • Young Adult