The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

A Kinematic Analysis of Automatic Postural Responses during Predicted and Unpredicted Postural Perturbations in People with Low Back Pain

Document Type : RESEARCH PAPER

Authors
Abas Fatehi Peykani
Maryam Saadat
Shahla Zahednezhad
Shahin Goharpey
Saiedeh Monjezi
Department of physiotherapy, school of rehabilitation sciences, Ahvaz Jundishapur of Medical Sciences,Ahvaz,Iran -Rehabilitation Research center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
10.22038/abjs.2025.87584.3968
Abstract
Objectives: Limited evidence exists on alterations in postural response kinematics following external perturbations in individuals with chronic low back pain (LBP). Therefore, this study aimed to investigate differences in automatic postural responses between individuals with chronic LBP and asymptomatic controls during forward translation of the support surface.
Methods: A total of 21 participants with chronic non-specific low back pain (LBP) and 21 age- and sex-matched healthy adults participated in this study. Participants were exposed to both predicted and unpredicted perturbations through forward translation of the support surface, which were analyzed using a motion analysis system. Angular displacements of the trunk and lower limbs were measured across four predefined time intervals corresponding to anticipatory postural adjustments (APA) and compensatory postural adjustments (CPA).
Results: In the unpredicted condition, trunk angular displacement during the APA1 phase was significantly lower in the LBP group compared with the control group (P = 0.04). A significant main effect of group was observed for hip (P = 0.009, ηp² = 0.17), knee (P = 0.01, ηp² = 0.16), and ankle (P = 0.01, ηp² = 0.14) displacements during the CPA1 phase. Moreover, a significant group effect was found for knee (P = 0.01, ηp² = 0.20) and ankle (P = 0.04, ηp² = 0.09) displacements during the CPA2 phase. Participants with LBP exhibited greater lower-limb joint displacements than controls under predicted and unpredicted conditions.
Conclusion: Individuals with chronic low back pain (LBP) demonstrated altered kinematic strategies of the trunk and lower-limb joints in response to forward translation of the support surface. These findings suggest clinicians should consider evaluating and addressing automatic postural responses in this population.
        Level of evidence: III
Keywords
Case control studies
Kinematics
Low back pain
Lower extremity
Postural balance
Subjects
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The Archives of Bone and Joint Surgery
Volume 14, Issue 5
May 2026
Pages 349-355

  • Receive Date 26 April 2025
  • Revise Date 16 August 2025
  • Accept Date 19 October 2025