Low Back Pain, Weak Balance, Weak Posture and Sensori-motor errors

The StrongPosture® thesis is that sensory-motor errors in how the body is Balancing, Aligning and Moving (BAM) are a significant factor in chronic low back pain, a concept supported by a number of recent studies looking at low back pain (LBP), proprioception and balance.

Experimental Brain Research published a study that looked at proprioceptive dysfunctions in the peripheral and central processing of information. They found that when compared to people without pain, subjects with LBP functionally adapt and develop decreased postural control due to impaired processing of sensory information. [1] We would call this a sensory error, one that can contribute to postural control impairment in those with LBP, as well as to changes in the self-perception of body image secondary to pain.

Furthermore, a 2014 European Spine Journal study [2] demonstrated a linear correlation between pain intensity and postural sway in patients with LBP. “Postural control, as evidenced by increased oscillation of COP, is impaired in individuals with cLBP relative to controls. Differences are magnified by visual deprivation and unstable surface conditions.” When central modulation of information from neuromuscular spindles is dysfunctional, with prolonged latency from presumable reduced spindle feedback, that is an error.

In other words, patients with non-specific LBP exhibit greater postural instability than healthy controls. The feedback loop of sensori-motor errors creates both mechanical and neurologic adaptation…what we call weak posture.

The solution: retraining control by systematically correlating focused motion with external input and cues to correct sensorimotor errors.

We call that system the StrongPosture® protocols.

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1  Popa T, Bonifazi M, Della Volpe R, Rossi A, Mazzocchio R (Mar 2007).  Adaptive changes in postural strategy selection in chronic low back pain.  Exp Brain Res, 177(3), 411-418.  http://www.ncbi.nlm.nih.gov/pubmed/16977448
2  Caffaro R, Franca FJ, Burk T, Magalhaes M, Ramos L, Marques A (Apr 2014).  Postural control in individuals with and without non-specific chronic low back pain: a preliminary case-control study.  Eur Spine J, 4, 807-13.  http://www.ncbi.nlm.nih.gov/pubmed/24570125