Abstract

Dynamic balance impairments are commonly observed in people with low back pain (LBP). People with LBP have reduced lumbopelvic stability and may exhibit spinal biomechanical and postural control changes during dynamic balance. A limited number of studies are available about the spinal kinematic and postural control changes during dynamic balance in people with nonspecific chronic low back pain (NSCLBP) subgroups. Therefore, the aim of this dissertation was to compare spinal kinematics and postural control between NSCLBP subgroups and healthy individuals during dynamic balance using a modified Star Excursion Balance Test (mSEBT). Eighteen NSCLBP subjects [9 active extension pattern (AEP), 9 flexion pattern (FP)], and 10 healthy controls were enrolled in this study. All subjects performed mSEBT on their dominant leg in the anterior (ANT), posterolateral (PL), and posteromedial (PM) reach directions. Normalized reach distance, balance parameters, including the center of pressure (COP) displacement and velocity as well as the pelvic, lumbar, and thoracic 3-dimensional kinematics were recorded. There were significant differences in mean reach distance in both PL and PM directions between AEP and healthy and between FP and healthy subjects. However, there was no significant difference among the three groups in the anterior reach direction. Kinematic results showed significant differences in both lumbar and thoracic spine regions between AEP and FP and between AEP and healthy in all reaching directions. However, there were no significant differences in spinal kinematics between FP and healthy subjects. In addition, the results showed a significant difference in mean COP velocity in PM direction between AEP and FP subjects, and between AEP and healthy subjects. The findings in this study highlight the heterogeneity of the individuals with NSCLBP and the importance of identifying the homogenous subgroups. Individuals with AEP and FP experience diminished dynamic balance compared to healthy controls. The thoracic and lumbar spine regions are very important to discriminate between AEP and FP, and between AEP and healthy during dynamic balance. In addition, the findings of this study support the concept of the Multidimensional Classification System (MDCS).

LLU Discipline

Physical Therapy

Department

Physical Therapy

School

School of Allied Health Sciences

First Advisor

Everett Lohman III

Second Advisor

Faris Alshammari

Third Advisor

Noha Daher

Fourth Advisor

Robert Dudley

Degree Name

Doctor of Philosophy (PhD)

Degree Level

Ph.D.

Year Degree Awarded

2020

Date (Title Page)

9-2019

Language

English

Library of Congress/MESH Subject Headings

Low Back Pain; Postural Balance; Biomechanical Phenomena

Type

Dissertation

Page Count

xiv, 105 p.

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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