Abstract
Objective
To systematically review the relationship between lumbar proprioception and low back
pain (LBP).
Data Sources
Four electronic databases (PubMed, EMBASE, CINAHL, SPORTDiscus) and reference lists
of relevant articles were searched from inception to March-April 2014.
Study Selection
Studies compared lumbar proprioception in patients with LBP with controls or prospectively
evaluated the relationship between proprioception and LBP. Two reviewers independently
screened articles and determined inclusion through consensus.
Data Extraction
Data extraction and methodologic quality assessment were independently performed using
standardized checklists.
Data Synthesis
Twenty-two studies (1203 participants) were included. Studies measured lumbar proprioception
via active or passive joint repositioning sense (JRS) or threshold to detection of
passive motion (TTDPM). Data from 17 studies were pooled for meta-analyses to compare
patients with controls. Otherwise, descriptive syntheses were performed. Data were
analyzed according to measurement method and LBP subgroup. Active JRS was worse in
patients compared with controls when measured in sitting (standard mean difference,
.97; 95% confidence interval [CI], .31–1.64). There were no differences between groups
measured via active JRS in standing (standard mean difference, .41; 95% CI, −.07 to
.89) or passive JRS in sitting (standard mean difference, .38; 95% CI, −.83 to 1.58).
Patients in the O'Sullivan flexion impairment subgroup had worse proprioception than
the total LBP cohort. The TTDPM was significantly worse in patients than controls.
One prospective study found no link between lumbar proprioception and LBP.
Conclusions
Patients with LBP have impaired lumbar proprioception compared with controls when
measured actively in sitting positions (particularly those in the O'Sullivan flexion
impairment subgroup) or via TTDPM. Clinicians should consider the relationship between
sitting and proprioception in LBP and subgroup patients to guide management. Further
studies focusing on subgroups, longitudinal assessment, and improving proprioception
measurement are needed.
Keywords
List of abbreviations:
AE (absolute error), CE (constant error), CI (confidence interval), DMP (directional motion perception), JRS (joint repositioning sense), LBP (low back pain), ROM (range of motion), TTDPM (threshold to detection of passive motion)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 15, 2016
Footnotes
Systematic Review Registration No.: CRD42015019761.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
