• Megan M Sperry, Andrew T M Phillips, and Alison H McGregor.
• Department of Civil and Environmental Engineering, Structural Biomechanics, Imperial College London, Charing Cross Hospital, London, UK.
• J Back Musculoskelet Rehabil. 2019 Jan 1; 32 (1): 27-35.

BackgroundIt is hypothesized that inherent differences in movement strategies exist between control subjects and those with a history of lower back pain (LBP). Previous motion analysis studies focus primarily on tracking spinal movements, neglecting the connection between the lower limbs and spinal function. Lack of knowledge surrounding the functional implications of LBP may explain the diversity in success from general treatments currently offered to LBP patients.ObjectiveThis pilot study evaluated the response of healthy controls and individuals with a history of LBP (hLBP) to a postural disturbance.MethodsVolunteers (n= 26) were asked to maintain standing balance in response to repeated balance disturbances delivered via a perturbation platform while both kinematic and electromyographic data were recorded from the trunk, pelvis, and lower limb.ResultsThe healthy cohort utilized an upper body-focused strategy for balance control, with substantial activation of the external oblique muscles. The hLBP cohort implemented a lower limb-focused strategy, relying on activation of the semitendinosus and soleus muscles. No significant differences in joint range of motion were identified.ConclusionsThese findings suggest that particular reactive movement patterns may indicate muscular deficits in subjects with hLBP. Identification of these deficits may aid in developing specific rehabilitation programs to prevent future LBP recurrence.

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