Are Lumbar Repositioning Errors Larger Among Patients With Chronic Low Back Pain Compared With Asymptomatic Subjects?

Abstract 

Åsell M, Sjölander P, Kershbaumer H, Djupsjöbacka M. Are lumbar repositioning errors larger among patients with chronic low back pain compared with asymptomatic subjects?

Objective

To resolve the debate over whether lumbar repositioning acuity is reduced in patients with chronic low back pain (CLBP) by using a study design and methodology to minimize the effects of potential confounders.

Design

A single-blinded, controlled, multigroup comparative study.

Setting

Vocational rehabilitation center.

Participants

Ninety-two patients with CLBP, divided into subgroups based on severity of symptoms and diagnostic characteristics. An age- and sex-matched group (n=31) of healthy subjects were the control.

Interventions

Not applicable.

Main Outcome Measures

We measured repositioning errors (variable, constant) at 3 positions of the lumbar spine. Subjects were guided to a sitting target posture and asked to perform lumbar flexion before reproducing the target posture. Self-assessed pain, self-efficacy, and functional ability were addressed through questionnaires.

Results

There were no differences in repositioning errors between the patients with CLBP or the subgroups of patients and the control group. We found only weak correlations between the repositioning errors and the self-reported data on functional disability, self-efficacy, and pain.

Conclusions

We suggest that sensorimotor dysfunctions in CLBP should be evaluated with methods other than repositioning tests in order to generate data relevant to the development of rational diagnostic methods and rehabilitation programs.

Key Words:  Back pain , Low back pain , Lumbosacral region , Proprioception , Rehabilitation