Balance Ability in Low Back Pain Patients With Lumbosacral Radiculopathy Evaluated With Tetrax: A Matched Case-Control Study
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective To compare postural balance ability in patients with low back pain between groups with and without lumbosacral radiculopathy. Methods Patients who were referred for electromyography because of low back pain during the period from April 2017 through June 2018 were chosen as subjects. They were divided into groups with and without lumbosacral radiculopathy based on the results of electromyography. We used Tetrax (Sunlight Medical Ltd., Ramat Gan, Israel) to objectively evaluate postural balance ability, and to measure the fall risk, stability index, weight distribution index, and Fourier index. Results Patients in the lumbosacral radiculopathy group showed significantly higher fall risk (73.25 vs. 38.00; p<0.05), weight distribution index (8.57 vs. 5.00; p<0.05), and stability index (21.19 vs. 13.16; p<0.05) than those in the group without lumbosacral radiculopathy. The Fourier index at high-medium frequency was significantly increased in the lumbosacral radiculopathy group (8.27 vs. 5.56; p<0.05), whereas weight-bearing on the side of radiculopathy was significantly decreased. Conclusion Patients with lumbosacral radiculopathy have decreased postural balance compared with patients without this condition. Somatosensory disturbances in lumbosacral radiculopathy might cause postural balance impairment. Assessment and treatment plan not only for pain reduction but also for postural balance improvement should be considered in the management of patients with lumbosacral radiculopathy.
Abstract
Objective To compare postural balance ability in patients with low back pain between groups with and without lumbosacral radiculopathy. Methods Patients who were referred for electromyography because of low back pain during the period from April 2017 through June 2018 were chosen as subjects. They were divided into groups with and without lumbosacral radiculopathy based on the results of electromyography. We used Tetrax (Sunlight Medical Ltd., Ramat Gan, Israel) to objectively evaluate postural balance ability, and to measure the fall risk, stability index, weight distribution index, and Fourier index. Results Patients in the lumbosacral radiculopathy group showed significantly higher fall risk (73.25 vs. 38.00; p<0.05), weight distribution index (8.57 vs. 5.00; p<0.05), and stability index (21.19 vs. 13.16; p<0.05) than those in the group without lumbosacral radiculopathy. The Fourier index at high-medium frequency was significantly increased in the lumbosacral radiculopathy group (8.27 vs. 5.56; p<0.05), whereas weight-bearing on the side of radiculopathy was significantly decreased. Conclusion Patients with lumbosacral radiculopathy have decreased postural balance compared with patients without this condition. Somatosensory disturbances in lumbosacral radiculopathy might cause postural balance impairment. Assessment and treatment plan not only for pain reduction but also for postural balance improvement should be considered in the management of patients with lumbosacral radiculopathy.
참고문헌 (38)
- Andersson GB, "Epidemiological features of chronic low-back pain", Lancet, 354, pp.581~585 (1999)
- Kovacs FM, "Correlation between pain, disability, and quality of life in patients with common low back pain", Spine(Phila Pa 1976), 29, pp.206~210 (2004)
- Konstantinou K, "Sciatica: review of epidemiological studies and prevalence estimates", Spine(Phila Pa 1976), 33, pp.2464~2472 (2008)
- Aminoff MJ, "Electrophysiologic evaluation of lumbosacral radiculopathies : electromyography, late responses, and somatosensory evoked potentials", Neurology, 35, pp.1514~1518 (1985)
- Coster S, "Diagnostic value of history, physical examination and needle electromyography in diagnosing lumbosacral radiculopathy", J Neurol, 257, pp.332~337 (2010)
- Prieto TE, "Measures of postural steadiness : differences between healthy young and elderly adults", IEEE Trans Biomed Eng, 43, pp.956~966 (1996)
- Brandt T, "Clinical disorders of balance, posture and gait", pp.146~162 (2004), Arnold
- Schieppati M, "Free and supported stance in Parkinson’s disease: the effect of posture and ‘postural set’ on leg muscle responses to perturbation, and its relation to the severity of the disease", Brain, 114(Pt 3), pp.1227~1244 (1991)
- Fernie GR, "The relationship of postural sway in standing to the incidence of falls in geriatric subjects", Age Ageing, 11, pp.11~16 (1982)
- Tyson SF, "Balance disability after stroke", Phys Ther, 86, pp.30~38 (2006)
- 김희상, "Balance Control and Knee Osteoarthritis Severity", Annals of Rehabilitation Medicine, 35(5), pp.701~709 (2011), 대한재활의학회
- Radebold A, "Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain", Spine(Phila Pa 1976), 26, pp.724~730 (2001)
- Dvir Z, "The effect of frontal loading on static and dynamic balance reactions in patients with chronic low back dysfunction", Basic Appl Myol, 7, pp.91~96 (1997)
- Alexander KM, "Differences in static balance and weight distribution between normal subjects and subjects with chronic unilateral low back pain", J Orthop Sports Phys Ther, 28, pp.378~383 (1998)
- Mientjes MI, "Balance in chronic low back pain patients compared to healthy people under various conditions in upright standing", Clin Biomech(Bristol, Avon), 14, pp.710~716 (1999)
- Frost LR, "Deficits in foot skin sensation are related to alterations in balance control in chronic low back patients experiencing clinical signs of lumbar nerve root impingement", Gait Posture, 41, pp.923~928 (2015)
- Frost LR, "Muscle activation timing and balance response in chronic lower back pain patients with associated radiculopathy", Clin Biomech(Bristol, Avon), 32, pp.124~130 (2016)
- Lin SI, "Sensorimotor and balance function in older adults with lumbar nerve root compression", Clin Orthop Relat Res, (394), pp.146~153 (2002)
- 이재준, "뇌졸중 환자에서 보행관련 활동평가척도로서의 한글판 버그균형검사", Annals of Rehabilitation Medicine, 31(4), pp.400~403 (2007), 대한재활의학회
- Zhang JG, "Postural stability and physical performance in social dancers", Gait Posture, 27, pp.697~701 (2008)
- Steinberg N, "The effect of a weight management program on postural balance in obese children", Eur J Pediatr, 172, pp.1619~1626 (2013)
- Akkaya N, "TEST-retest reliability of TETRAX static posturography system in young adults with low physical activity level", Int J Sports Phys Ther, 10, pp.893~900 (2015)
- Zhang L, "Test-retest reliability of Tetrax posturographic balance assessment system in elderly", Chin J Rehabil Theory Pract, 17, pp.637~639 (2011)
- Christensen IK, "Validation of posturographic measurements in adolescents", Otol Neurotol, 39, pp.e568~e574 (2018)
- Nardin RA, "Electromyography and magnetic resonance imaging in the evaluation of radiculopathy", Muscle Nerve, 22, pp.151~155 (1999)
- Nykvist F, "Severe sciatica : a 13-year follow-up of 342 patients", Eur Spine J, 4, pp.335~338 (1995)
- Selim AJ, "The importance of radiating leg pain in assessing health outcomes among patients with low back pain. Results from the Veterans Health Study", Spine(Phila Pa 1976), 23, pp.470~474 (1998)
- Boskovic K, "The quality of life of lumbar radiculopathy patients under conservative treatment", Vojnosanit Pregl, 66, pp.807~812 (2009)
- Bronfort G, "Efficacy of spinal manipulation and mobilization for low back pain and neck pain : a systematic review and best evidence synthesis", Spine J, 4, pp.335~356 (2004)
- Rubinstein SM, "Spinal manipulative therapy for chronic low-back pain: an update of a Cochrane review", Spine(Phila Pa 1976), 36, pp.E825~E846 (2011)
- Saldana MT, "Patient-reported-outcomes in subjects with painful lumbar or cervical radiculopathy treated with pregabalin : evidence from medical practice in primary care settings", Rheumatol Int, 30, pp.1005~1015 (2010)
- Boswell MV, "Interventional techniques : evidence-based practice guidelines in the management of chronic spinal pain", Pain Physician, 10, pp.7~111 (2007)
- Gibson JN, "The Cochrane review of surgery for lumbar disc prolapse and degenerative lumbar spondylosis", Spine(Phila Pa 1976), 24, pp.1820~1832 (1999)
- Abdi S, "Epidural steroids in the management of chronic spinal pain : a systematic review", Pain Physician, 10, pp.185~212 (2007)
- Shumway-Cook A, "Motor control:theory and practical applications" (2001), Lippincott Williams & Wilkins
- Nygaard OP, "The function of sensory nerve fibers in lumbar radiculopathy: use of quantitative sensory testing in the exploration of different populations of nerve fibers and dermatomes", Spine(Phila Pa 1976), 23, pp.348~353 (1998)
- Yamashita T, "A quantitative analysis of sensory function in lumbar radiculopathy using current perception threshold testing", Spine(Phila Pa 1976), 27, pp.1567~1570 (2002)
- Priplata AA, "Vibrating insoles and balance control in elderly people", Lancet, 362, pp.1123~1124 (2003)