Comparison of Postural Balance between Subgroups of Nonspecific Low-back Pain Patients Based on O’Sullivan Classification System and Normal Subjects during Lifting

Document Type : RESEARCH PAPER


1 Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

2 Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


Background: Balance disorder is one of the most-studied fields in low-back pain patients (LBP). However, there is
insufficient information regarding the effect of LBP subgrouping on postural control. The purpose of the present study
was to compare postural control between subgroups of chronic nonspecific LBP and healthy subjects during lifting.
Methods: A total of 35 men with chronic LBP (19 active extension pattern [AEP] and 16 flexion pattern [FP]) and 15
healthy controls were enrolled in this cross-sectional study. Pooled LBP was subdivided based on the O’Sullivan’s
classification system (OCS). The participants were asked to lift a box from the ground to the waist level and hold it for
20 seconds. The load was 10% of the subject’s weight. Force plate system was used to record balance parameters,
including standard deviations (SDs) of center of pressure (COP) amplitude and COP velocity in anterior-posterior and
medial-lateral directions and mean total velocity. The test was divided into two static and dynamic phases. Data were
analyzed using one-way analysis of variance and independent t-test.
Results: There were no significant differences between pooled LBP and control groups in any of the variables, except
for the SD of the anterior-posterior direction velocity in the X-plane in the static phase (P=0.017). After classifying LBP,
the results showed that the healthy and AEP groups were significantly different in SD of COP velocity in the frontal plane
(P=0.021), mean total velocity (P=0.010), and SD of COP velocity in the sagittal plane (P=0.039).
Conclusion: The present study showed that postural control was not different between the pooled LBP and normal
groups. After classifying pooled LBP based on OCS, we found that the AEP showed different postural control as
compared to healthy controls in the dynamic phase. The FP and AEP exhibited different postural control relative to the
healthy controls in the static phase, and COP velocity was lower in those groups compared to the control group. The
results of this study support the concept of LBP classification.


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Volume 7, Issue 1
January and February 2019
Pages 52-60
  • Receive Date: 31 July 2018
  • Accept Date: 26 August 2018
  • First Publish Date: 01 January 2019