Research by Yuki Nishi, a visiting researcher at the Neurorehabilitation Research Center of Kio University, and Shu Morioka, a professor at the Center for Neurorehabilitation at Kio University, has shown that chronic low back pain sufferers develop dysfunction in anticipatory postural control due to kinesiophobia, and as a result, exercise and postural control are adversely affected. It became clear.
In people with chronic low back pain, pain-induced kinesiophobia may result in overprotection of the lower back during exercise and slowing of movement, referred to as ``freezing behavior''.On the other hand, in order to control exercise efficiently and accurately, it is important to adjust posture prior to exercise by “anticipatory postural adjustment (APA)” that considers the body sway accompanying exercise. However, it was not clear how APA functions in the lumbar movement of patients with chronic low back pain exhibiting "freezing behavior".
To elucidate this problem, this research group measured the APA and center of foot pressure (COP) during trunk flexion and extension exercise in 48 people with chronic low back pain and 22 healthy elderly people living in the community. checked the control.
As a result, chronic low back pain patients had longer APA time and switching between flexion and extension (motor control) than healthy elderly people.In addition, the position of the COP (posture control) in patients with chronic low back pain is a phenomenon in which after the position of the COP deviates forward due to flexion of the trunk, it remains in the forward position without deviating toward the midline even when the trunk is extended. was observed.This is thought to be caused by excessive freeze-like protection of motor control and postural control in chronic low back pain patients.
Furthermore, these mediation analyzes showed that flexion-extension switching time and anterior displacement of the COP were associated with APA and kinesiophobia.In other words, in chronic low back pain sufferers, kinesiophobia induces excessive protective strategies such as freezing behavior, resulting in a decline in the function of anticipatory postural control, which in turn adversely affects locomotion and postural control. be able to.
The results of this study are expected to contribute to further understanding of the pathology of chronic low back pain.
Paper information:[Scandinavian Journal of Pain]Anticipatory postural adjustments mediate the changes in fear-related behaviors in individuals with chronic low back pain
