Comparison of limb dominance and visual condition on dynamic postural stability

in subjects with and without recurrent low back pain

Jeff King and Riley Ballard

Advisor: Paul Sung
Doctoral Program in Physical Therapy, Central Michigan University
Background Results
• Low back pain (LBP) is the most common
musculoskeletal condition affecting postural
stability
• Postural stability is influenced by lower limb
dominance and visual input

• Lower limb dominance and visual input are directly

related to postural deficits in subjects with low
back pain

• There is lack of understanding of center of

pressure excursion and dynamic postural stability
while considering visual conditions

• Center of pressure is the sum of all forces acting

between the foot and the ground • The excursions were analyzed by limb
dominance and visual conditions between
subjects with and without LBP

Purpose • There were no significant differences among

participants within the same group for all
Methods conditions
• To compare the COP excursion measurements and • No differences were found in COP between the
the dynamic postural stability index (DPSI) based two groups for all conditions
on limb dominance and visual input between
subjects with and without recurrent LBP The groups did demonstrate a significant interaction
• All subjects were determined right side dominant by preference of kicking ball with right foot.
• Subjects completed random trials of dominant and non-dominant limbs in standing and eyes-closed or eyes-open with on vision and limb dominance for the DPSI (F =
weight evenly distributed and requirement of 90 degrees of contralateral limb hip flexion and arms at side upon request 4.17, p = 0.04) during the following condition:
• Non-dominant limb standing with eyes
• DPSI analysis assessed fluctuations from zero along the axes of the AMTI force plate w closed
Experimental Design

• Cross-sectional design Discussion

• Subjects recruited from Central Michigan University
community through advertisement • The LBP group demonstrated enhanced postural
• Participants: 26 subjects with recurrent LBP and 29 stability during dominant limb standing in the eyes
without closed condition compared to their non-dominant limb
• Required absence of sensory, motor, or
psychological conditions • COP may not be a true record of body sway, but
• Absence of any condition preventing single-leg rather a measure of the activity of the motor system
stance when moving for a postural reaction

• Instead, the DPSI should be utilized to compare

postural integration while considering visual input and
limb dominance in individuals with LBP

• The DPSI indicated a sensitive outcome assessment

for dynamic standing balance strategies, postural
stability, and injury prevention in subjects with LBP