The effects of a lumbar support on repositioning error in subjects with low back pain.

OBJECTIVE To determine whether a lumbar support improves trunk repositioning error (RE), an aspect of proprioception. DESIGN RE was measured with and without a lumbar support. SETTING Outpatient clinic. PARTICIPANTS Twenty subjects with chronic low back pain (LBP) and 20 control subjects. INTERVENTIONS Subjects wore the lumbar support for 2 hours and then testing was repeated. MAIN OUTCOME MEASURES Standing with legs and pelvis immobilized, subjects moved to a predetermined target position and then attempted to replicate the position. The 3-dimensional position of the trunk was measured with a 3Space Tracker. RE was calculated as the absolute difference between the actual target position and the subject-perceived target position. Testing was performed with and without a lumbar support both before and after wearing the support for 2 hours. RESULTS In subjects with LBP, RE was significantly lower with a support in flexion, extension, and right lateral bending. In control subjects, RE was significantly lower when wearing the support in left bending only, and RE was significantly higher in control subjects after wearing the support for 2 hours. CONCLUSION A lumbar support improves trunk RE. In subjects with LBP, this result was significant in the sagittal plane and in right lateral bending, whereas in control subjects, it was significant only in left lateral bending.

[1]  T J Koh,et al.  Effect of an Ankle Orthosis and Ankle Ligament Anesthesia on Ankle Joint Proprioception , 1994, The American journal of sports medicine.

[2]  M. Baier,et al.  Ankle orthoses effect on single-limb standing balance in athletes with functional ankle instability. , 1998, Archives of physical medicine and rehabilitation.

[3]  R K Schwartz,et al.  The Influence of Prophylactic Orthoses on Abdominal Strength and Low Back Injury in the Workplace , 1990, American journal of physical medicine & rehabilitation.

[4]  T. Vischer,et al.  Role of physical therapy in the management of common low back pain. , 1992, Bailliere's clinical rheumatology.

[5]  S M McGill,et al.  Abdominal belts in industry: a position paper on their assets, liabilities and use. , 1993, American Industrial Hygiene Association Journal.

[6]  M J Pearcy,et al.  New method for the non-invasive three-dimensional measurement of human back movement. , 1989, Clinical biomechanics.

[7]  L M Bouter,et al.  Lumbar supports and education for the prevention of low back pain in industry: a randomized controlled trial. , 1998, JAMA.

[8]  R. Deyo.  Conservative therapy for low back pain. Distinguishing useful from useless therapy. , 1983, JAMA.

[9]  D. Magee.  Orthopedic Physical Assessment , 1986 .

[10]  L. Maffey-Ward,et al.  Toward a clinical test of lumbar spine kinesthesia. , 1996, The Journal of orthopaedic and sports physical therapy.

[11]  T. Getchell,et al.  Mechanisms of low back pain: a neurophysiologic and neuroanatomic study. , 1997, Clinical orthopaedics and related research.

[12]  P J McNair,et al.  Knee bracing: effects of proprioception. , 1996, Archives of physical medicine and rehabilitation.

[13]  Nachemson Al,et al.  Mechanical effectiveness studies of lumbar spine orthoses. , 1983 .

[14]  R. Deyo,et al.  The effectiveness of four interventions for the prevention of low back pain. , 1994, JAMA.

[15]  K. An,et al.  Repositioning Error in Low Back Pain: Comparing Trunk Repositioning Error in Subjects With Chronic Low Back Pain and Control Subjects , 2000, Spine.

[16]  K. H. Nilsen,et al.  Evaluation of low back pain and assessment of lumbar corsets with and without back supports. , 1981, Annals of the rheumatic diseases.

[17]  D S Barrett,et al.  Joint proprioception in normal, osteoarthritic and replaced knees. , 1991, The Journal of bone and joint surgery. British volume.

[18]  J J Congleton,et al.  An evaluation of a weightlifting belt and back injury prevention training class for airline baggage handlers. , 1992, Applied Ergonomics.

[19]  N D Grew,et al.  The physical effect of lumbar spinal supports , 1982, Prosthetics and orthotics international.

[20]  Gordon Fick,et al.  The Effect of Elastic Bandages on Human Knee Proprioception in the Uninjured Population , 1995, The American journal of sports medicine.

[21]  K. Ragnarsson,et al.  Low-Back Orthoses , 1992 .

[22]  H. Alaranta,et al.  Compliance and subjective relief by corset treatment in chronic low back pain. , 1988, Scandinavian journal of rehabilitation medicine.

[23]  N. Davey,et al.  Controlled trial of a back support ('Lumbotrain') in patients with non-specific low back pain. , 1992, Current medical research and opinion.

[24]  K. An,et al.  Differences in Repositioning Error Among Patients With Low Back Pain Compared With Control Subjects , 2000, Spine.

[25]  K N An,et al.  Application of a magnetic tracking device to kinesiologic studies. , 1988, Journal of biomechanics.

[26]  P. Calmels,et al.  An update on orthotic devices for the lumbar spine based on a review of the literature. , 1996, Revue du rhumatisme.