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The slow and fast components of postural sway in chronic neck pain disorders

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Abstract [2609]

Abstract Number: RR-PO-204-19-Wed

ASSESSMENT OF THE SLOW AND FAST COMPONENTS OF POSTURAL SWAY IN CHRONIC NECK PAIN

Röijezon U.1, Rudolfsson T.2, Björklund M.3, Djupsjöbacka M.2

1Luleå University of Technology, Department of Health Sciences, Luleå, Sweden, 2University of Gävle, Centre of

Musculoskeletal Research, Umeå, Sweden, 3University of Gävle, Centre of Musculoskeletal Research, Gävle, Sweden

Purpose: The main aim was to extend the knowledge of postural control alterations in neck pain disorders by investigating the slow and fast components of body sway. Secondary aims were to evaluate associations between the postural sway components and self-rated characteristics, and the impact of anthropometrics and concurrent low back pain on the magnitude of the sway components.

Relevance: Previous research has revealed altered postural sway related to neck pain disorders, but little has been mentioned about the mechanisms attributed to the various outcome variables. Several researchers have, however, concluded that postural sway in quiet stance includes a slow and a fast component. The magnitude of the slow component has been attributed to noise in sensory information and central processing when estimating the location of centre of mass (CoM), while the fast component has been ascribed to restoring forces controlling CoM location. Investigation of the slow and fast components of postural sway in neck pain disorders can expand our understanding of postural control alterations and provide directions for rehabilitation.

Participants: Two data collections were included: Sample 1: Subjects with chronic non-specific neck pain (NS, n=24), whiplash associated disorders (WAD, n=21) and healthy controls (CON, n=21). Sample 2: Women only, 98 NS and 32 CON.

Methods: The subjects stood quietly on a force platform with eyes closed (30 and 180 seconds in sample 1 and 2, respectively). The magnitudes of the slow and fast centre of pressure (CoP) components were calculated and group differences were analysed. Anthropometrics and age were included as covariates in the analysis if correlated with the sway variables. Association between postural sway and self-ratings of symptoms, functioning and kinesiophobia was evaluated.

Analysis: ANOVA, or ANCOVA, was used to explore group differences of the CoP-derived variables. Unpaired t-tests were used in sample 2 to analyse effect of concurrent low back pain. A multivariate regression method (O-PLS) was used to identify anthropometric factors to be included as covariates in the ANCOVAs, as well as to analyze

associations between CoP variables and self-rated characteristics.

Results: Increased magnitude of the slow sway component was found for both NS and WAD. Age and weight were positively associated with increased magnitude of the fast component only. For WAD, the magnitude of the slow component was associated mainly with physical functioning and sensory symptoms. For NS, concurrent low back pain was associated with increased magnitude of the slow component.

Conclusions: Altered postural control was present only for the slow sway component, which implies aberration in sensory feedback or processing. Associations between postural sway and self-rated characteristics in WAD support the clinical validity of postural control assessment in this group. Increased postural sway found in NS with concurrent low back pain suggests an important role of generalized spinal pain on postural control alterations.

Implications: Assessment and rehabilitation of postural control should be considered in WAD, and NS with concurrent low back pain. The increased magnitude of the slow component in the neck pain groups suggests rehabilitation regimes targeting improvement of sensory feedback and processing.

Key-words: 1. Neck pain, 2. postural control, 3. slow and fast sway components

Funding acknowledgements: Alfta Research Foundation, the Swedish Council for Working Life and Social Research (2006-1162) and Länsförsäkringar Forskning och Framtid (51-1010/06).

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