Chronic non-specific low back pain and ankle proprioceptive acuity in community-dwelling older adults

Fangxin Xiao; Huub Maas; Jaap H van Dieën; Adrian Pranata; Roger Adams; Jia Han

doi:10.1016/j.neulet.2022.136806

Chronic non-specific low back pain and ankle proprioceptive acuity in community-dwelling older adults

Neurosci Lett. 2022 Aug 24:786:136806. doi: 10.1016/j.neulet.2022.136806. Epub 2022 Jul 16.

Authors

Fangxin Xiao¹, Huub Maas², Jaap H van Dieën², Adrian Pranata³, Roger Adams⁴, Jia Han⁵

Affiliations

¹ School of Kinesiology, Shanghai University of Sport, Shanghai, China; Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Science, Amsterdam, the Netherlands.
² Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Science, Amsterdam, the Netherlands.
³ School of Kinesiology, Shanghai University of Sport, Shanghai, China; Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, Australia.
⁴ Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia.
⁵ School of Kinesiology, Shanghai University of Sport, Shanghai, China; College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China; Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia; Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, Australia. Electronic address: jia.han@canberra.edu.au.

PMID: 35850319
DOI: 10.1016/j.neulet.2022.136806

Abstract

Background: For people above 65 years old, low-back pain (LBP) is associated with balance problems and falls. Down-weighting of proprioception due to ageing and LBP may cause such balance problems. While lumbar proprioceptive deficits have been shown in LBP and indications for more generalized deficits have been found, ankle proprioception, which is crucial for balance control, has not been studied in people with LBP.

Research question: Is there any difference in ankle proprioceptive acuity between community-dwelling older adults with and without LBP? We hypothesized that ankle proprioception was impaired in community-dwelling older adults with LBP compared to those without LBP.

Methods: Thirty participants over 65 years old volunteered. Fifteen had LBP (M/F = 2/13, age = 72.0 (4.6) years), fifteen were healthy controls without back pain (control group) (M/F = 2/13, age = 72.1 (4.8) years). Ankle proprioception was measured in normal weight-bearing conditions, using the Active Movement Extent Discrimination Apparatus (AMEDA). Accuracy on the ankle proprioceptive test was expressed as absolute error (AE), constant error (CE) and variable error (VE).

Results: AE was significantly larger (P = 0.029, 95 % CI = [0.00, 0.90]) in the LBP group, CE was also significantly larger (P = 0.046, 95 % CI = [-0.91, -0.01]), indicating an underestimation of ankle inversion in participants with LBP compared to controls. VE was not different between the two groups (P = 0.520, 95 % CI = [-0.20, 0.59]). No significant correlation was found between pain intensity and AE, CE or VE (P > 0.05).

Conclusion: Ankle proprioception decreased in older people with LBP compared to healthy peers, suggesting impaired central proprioceptive processing. Older people with LBP underestimate the extent of ankle inversion, which may increase fall risk. Thus, evaluation and training of ankle proprioception may be useful in older people with LBP.

Keywords: Ankle proprioception; Chronic non-specific low back pain; Elderly; Postural control; Stability.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Ankle
Ankle Joint
Humans
Independent Living
Low Back Pain* / etiology
Proprioception