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

Impact of sleep quality on balance control in individuals with chronic low back pain: a cross-sectional study (#228)

Daniel KY Zheng 1 , Zhihan Sun 1 , Jeremy Chang 1 , Frank Fan Huang 1 , Yilin Liu 1 , Siying Yu 2 , Jinlong Wu 3 , Zimeng Wang 4 , Xueqiang Wang 5 , Arnold Wong 1
  1. The Hong Kong Polytechnic University, Hong Kong SAR, China
  2. Shanghai University of Sport, Shanghai, China
  3. Southwest University, Chongqing, China
  4. Capital Medical University, Beijing, China
  5. The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China

Introduction: Previous studies have identified a relationship between poor sleep quality and increased intensity of chronic low back pain (CLBP). Individuals suffering from CLBP or poor sleep quality (PSQ) frequently demonstrate compromised balance control and share similar physical and psychological issues (such as anxiety and depression) compared to asymptomatic individuals. However, the combined effects of CLBP and PSQ on balance control are not well understood. This study aims to explore how sleep quality and its related factors influence balance control in CLBP patients.

Methods: The study included 85 young adults (mean age 33.2 ± 12.5 years) diagnosed with CLBP. Pain intensity, along with physical and psychological well-being, was evaluated through various questionnaires. Sleep quality over the preceding month was measured using the Pittsburgh Sleep Quality Index (PSQI). Participants were classified into good sleep quality (GSQ) or PSQ groups based on their PSQI scores (≤ 5 for GSQ, > 5 for PSQ). Balance control was assessed through the one-leg stance test and the Y-balance test. Differences in balance control between groups were analyzed, and factors contributing to impaired balance were identified using forward stepwise regression analysis.

Results: The PSQ group consisted of 17 males and 31 females, while the GSQ group included 20 males and 17 females (p=0.086). The PSQ group was significantly older and reported higher levels of physical disability, anxiety, depression, and fear avoidance beliefs compared to the GSQ group. Even after controlling for these variables, individuals in the PSQ group exhibited significantly poorer performance in the one-leg stance test and lower normalized scores in the posteromedial, posterolateral, and composite scores of the Y-balance test. Sleep quality explained 16.9-24.9% of the variance in balance control, while age contributed an additional 5.2-13.2%. Furthermore, increased physical disability and anxiety levels were linked to worse balance control.

Discussion: Participants with both CLBP and PSQ displayed significantly poorer balance control than those with CLBP alone. Future research should examine whether PSQ has a more pronounced negative effect on balance control in older adults with CLBP, particularly among those at higher risk of falls.