Poster Presentation 51st International Society for the Study of the Lumbar Spine Annual Meeting 2025

Introduction: Postural control, the ability to maintain balance and stability, is essential for functional independence and mobility. In individuals with chronic low back pain (LBP), impairments in postural control often led to greater postural sway, which reflects underlying deficits in sensory integration and motor response. These changes in sway are indicative of the adaptive, and sometimes maladaptive, strategies that individuals with LBP use to compensate for pain-related limitations in stability. This study investigated postural sway distance and velocity, utilizing the center of pressure (COP) and center of gravity (COG), between adults with and without LBP during repeated unilateral standing trials.

Methods: Twenty-six subjects with LBP and 39 control subjects participated in the study. Postural sway ranges, COP/COG sways, and sway velocities (computed by dividing path length by time in anteroposterior (AP) and mediolateral (ML) directions over 10 seconds) were analyzed across three unilateral standing trials (Figure 1).

Results: A significant group interaction in sway range difference was observed following repeated trials (F = 5.90, p = 0.02). For COG sway range, significant group interactions were demonstrated in both directions (F = 4.28, p = 0.04) and repeated trials (F = 5.79, p = 0.02). The LBP group demonstrated reduced ML sway velocities in the first (5.21 ± 2.43 for the control group, 4.16 ± 2.33 for the LBP group; t = 1.72, p = 0.04) and second (4.87 ± 2.62 for the control group, 3.79 ± 2.22 for the LBP group; t = 1.73, p = 0.04) trials (Figure 2).

Discussion: The LBP group demonstrated decreased ML sway velocities to enhance trunk stability in the initial two trials. The COG results emphasized the potential use of trunk strategies in augmenting postural stability and optimizing neuromuscular control during unilateral standing.