Comparative analysis of diagnostic parameters of postural stability in patients with chronic lower back pain and healthy individuals
DOI:
https://doi.org/10.32782/2077-6594/2025.4/20Keywords:
proprioception, risk of falls, diagnostic indicators, motor control, rehabilitation, stabilometry, balance, chronic low back painAbstract
Chronic lower back pain remains one of the leading health problems, which has a significant impact on the working capacity and quality of life of the population. Impaired postural stability mechanisms in such patients can limit functional activity, contribute to the formation of compensatory movement strategies, and increase the risk of falls. At the same time, scientific research data on the relationship between pain syndrome and balance parameters remain contradictory. This necessitates a comprehensive study of diagnostic indicators of postural stability in individuals with chronic lower back pain. Purpose: The aim of the study was to conduct a comparative analysis of postural stability parameters and stability limits in patients with chronic radicular pain in the lower back and healthy individuals in the control group in order to identify differences and determine their possible clinical significance. Materials and methods. The study included 42 patients with chronic lower back pain lasting more than 3 months and 30 healthy individuals without complaints of back pain or musculoskeletal disorders. All participants provided written informed consent. Exclusion criteria included specific lower back pain, vestibular disorders, regular use of medications that affect balance, pregnancy, and spinal deformities. Pain intensity was assessed using a visual analog scale (VAS). The Biodex Balance System was used to analyze postural stability, which allowed recording PSI indices (total, anterior-posterior, and mediolateral) and stability limits (direction control — DC, task execution time — T). For statistical processing, we used the t-test, ANOVA with Bonferroni correction, and effect size calculation (Cohen’s d). Results. No statistically significant differences were found between the groups in terms of age, height, body weight, and body mass index (p > 0.05), confirming their comparability. Patients with chronic low back pain had significantly worse overall stability index (OASI) and anterior-posterior stability index (APSI) scores compared to healthy participants (p < 0.001). The values of the mediolateral stability index (MLSI) did not differ significantly (p = 0.34). Stability limits were also significantly altered: patients with back pain showed a decrease in directional control (DC) and an increase in task completion time (p = 0.001 and p = 0.01, respectively). The calculated effect size values (Cohen’s d > 0.9 for LOS and d > 2.8 for PSI) indicate the high clinical significance of the differences found. The results suggest that patients with chronic low back pain have pronounced impairments in motor control and proprioceptive regulation. Conclusions. Chronic lower back pain negatively affects diagnostic indicators of postural stability and its limits. The changes in postural stability parameters may be the result of motor control and proprioception disorders in patients with chronic low back pain. The results confirm the advisability of including the assessment of postural stability and its limits in the comprehensive examination of patients with chronic lower back pain.
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