Changes in coordination of postural control during dynamic stance in chronic low back pain patients
Changes in coordination of postural control during dynamic stance in chronic low back pain patients
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DOI：
10.1016/j.gaitpost.2005.10.009
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发表时间：
2006-11-01
期刊：
影响因子：
2.4
通讯作者：
Rossi, A.
中科院分区：
文献类型：
--
作者：
della Volpe, R.;Popa, T.;Rossi, A.
人体姿势系统的运作基于来自三个独立来源的综合信息：前庭、视觉和体感。可以想象，这些系统中的任何一个系统的错乱都会影响姿势系统的整体输出。慢性下腰痛(CLBP)患者的外周本体感觉系统或本体感觉信息的中央处理可能发生改变。因此，我们调查了CLBP患者在安静站立时是否表现出不同的姿势控制。对12例CLBP患者和12例年龄匹配的对照组进行动态姿势图检查。受试者的任务是在六种感官条件下安静地站在计算机控制的可移动平台上，这些条件改变了可用的视觉和本体感觉信息。虽然在稳定的支撑面条件下(1-3)，两组之间的平衡控制是相似的，但在平台摇摆参考条件下(4-6)，CLBP患者在前后方(AP)方向的摆动比对照组多得多。对照实验排除了摇摆增加是由于疼痛干扰所致。在CLBP患者中，在挑战性条件下，通过增加AP方向的摆动来维持体位的稳定性。体位策略的这种改变可能是外周本体感觉系统功能障碍或本体感觉信息中枢整合的基础。(C)2005 Elsevier B.V.保留所有权利。
The human postural system operates on the basis of integrated information from three independent sources: vestibular, visual and somatosensory. It is conceivable that a derangement of any of these systems will influence the overall output of the postural system. The peripheral proprioceptive system or the central processing of proprioceptive information may be altered in chronic low back pain (CLBP). We therefore investigated whether patients with CLBP exhibited an altered postural control during quiet standing. Dynamic posturography was performed by 12 CLBP patients and 12 age-matched controls. Subject's task was to stand quietly on a computer-controlled movable platform under six sensory conditions that altered the available visual and proprioceptive information. While the control of balance was comparable between the two groups across stabilized support surface conditions (1-3), CLBP patients oscillated much more than controls in the anterior-posterior (AP) direction in platform sway-referenced conditions (4-6). Control experiments ruled out that increased sway was due to pain interference. In CLBP patients, postural stability under challenging conditions is maintained by an increased sway in AP direction. This change in postural strategy may underlie a dysfunction of the peripheral proprioceptive system or the central integration of proprioceptive information. (C) 2005 Elsevier B.V. All rights reserved.