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Lin JH1,2, Halaki M1, Rajan P1, Leaver A1
1University of Sydney, Faculty of Health Sciences, Sydney, Australia, 2Yangzhi Affiliated Rehabilitation Hospital of Tongji University, Department of Rehabilitation Therapy, Shanghai, China
Background: Low back pain is one of the most common health problems and it causes an enormous economic burden on society globally. Proprioception deficit has been identified in people with low back pain and it has been postulated to alter central sensory-motor control mechanisms placing the lumbar spine at higher risk of abnormal loading and nociceptive activation. There are studies showing that the proprioception deficits are correlated with pain and disability levels. However, other studies failed to demonstrate the significant correlations.
Purpose: To examine the relationship of pain and disability with proprioception in people with non-specific low back pain.
Methods: Systematic literature search was performed in MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, Scopus, SportDiscus, Web of Science Core Collection and Google scholar. Two independent reviewers assessed the articles and extracted data. The methodological quality of studies was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS tool). Meta-analyses of data from homogeneous studies were performed for each proprioception test method with subgroup analyses on each movement direction using Comprehensive Meta-Analysis 3.0 software.
Results: The literature search retrieved 3067 articles of which 14 studies were included for meta-analysis. Proprioception was measured by active joint repositioning sense, passive joint repositioning sense and threshold to detect passive motion. There is no significant correlation between any proprioception measures and pain or disability (p > 0.05). Subgroup analyses of movement direction revealed 2 little significant correlations: between absolute error of passive lumbar flexion and pain (r = 0.225, 95% CI 0.040 to 0.395, p = 0.017), and between absolute error of passive lumbar extension and disability (r = 0.196, 95% CI 0.010 to 0.369, p = 0.039).
Conclusion(s): The proprioception measured by active joint repositioning sense and threshold to detect passive motion are not correlated with pain and disability in people with non-specific low back pain while the absolute error of passive lumbar movement is correlated to a small degree with pain and disability. Therefore, the differences in proprioception observed between people with pain and asymptomatic subjects seem to be independent of the symptoms.
Implications: The findings of current study provide evidence for understanding the role of proprioception in management of low back pain. Clinicians may take the findings into consideration when designing treatment plan since the pain and disability level in people with low back pain may not change with the lumbar proprioception.
Keywords: Low back pain, proprioception, disability
Funding acknowledgements: The present study was supported by China Scholarship Council (201708200018).
Purpose: To examine the relationship of pain and disability with proprioception in people with non-specific low back pain.
Methods: Systematic literature search was performed in MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, Scopus, SportDiscus, Web of Science Core Collection and Google scholar. Two independent reviewers assessed the articles and extracted data. The methodological quality of studies was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS tool). Meta-analyses of data from homogeneous studies were performed for each proprioception test method with subgroup analyses on each movement direction using Comprehensive Meta-Analysis 3.0 software.
Results: The literature search retrieved 3067 articles of which 14 studies were included for meta-analysis. Proprioception was measured by active joint repositioning sense, passive joint repositioning sense and threshold to detect passive motion. There is no significant correlation between any proprioception measures and pain or disability (p > 0.05). Subgroup analyses of movement direction revealed 2 little significant correlations: between absolute error of passive lumbar flexion and pain (r = 0.225, 95% CI 0.040 to 0.395, p = 0.017), and between absolute error of passive lumbar extension and disability (r = 0.196, 95% CI 0.010 to 0.369, p = 0.039).
Conclusion(s): The proprioception measured by active joint repositioning sense and threshold to detect passive motion are not correlated with pain and disability in people with non-specific low back pain while the absolute error of passive lumbar movement is correlated to a small degree with pain and disability. Therefore, the differences in proprioception observed between people with pain and asymptomatic subjects seem to be independent of the symptoms.
Implications: The findings of current study provide evidence for understanding the role of proprioception in management of low back pain. Clinicians may take the findings into consideration when designing treatment plan since the pain and disability level in people with low back pain may not change with the lumbar proprioception.
Keywords: Low back pain, proprioception, disability
Funding acknowledgements: The present study was supported by China Scholarship Council (201708200018).
Topic: Musculoskeletal: spine; Pain & pain management
Ethics approval required: No
Institution: N/A
Ethics committee: N/A
Reason not required: This study is a systematic review with meta-analysis of published data.
All authors, affiliations and abstracts have been published as submitted.
