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The effect of dual-task conditions on postural control in adults with low back pain: a systematic review and meta-analysis: a systematic review and meta-analysis

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Title: The effect of dual-task conditions on postural control in adults with low back pain: a systematic review and meta-analysis: a systematic review and meta-analysis
Authors: Pourahmadi, Mohammadreza, Negahban, Hossein, Koes, Bart Willem, Fernández-de-Las-Peñas, César, Ebrahimi Takamjani, Ismail, Bahramian, Mehrdad
Source: J Orthop Surg Res
Journal of Orthopaedic Surgery and Research, Vol 18, Iss 1, Pp 1-18 (2023)
Publisher Information: Springer Science and Business Media LLC, 2023.
Publication Year: 2023
Subject Terms: Orthopedic surgery, Adult, Male, Low Back Pain/psychology, Diseases of the musculoskeletal system, Review, Dual task, 3. Good health, Center of pressure, RC925-935, Postural balance, Systematic review, Humans, Low back pain, Female, 10. No inequality, Low Back Pain, Postural Balance, RD701-811
Description: Background Dual-task conditions, which involve performing two tasks simultaneously, may exacerbate pain and further impair daily functioning in individuals with low back pain (LBP). Understanding the effects of dual-task conditions on postural control in patients with LBP is crucial for the development of effective rehabilitation programs. Our objective was to investigate the impact of dual-task conditions on postural control in individuals with LBP compared to those without LBP. Methods We conducted a comprehensive search of Medline via PubMed, Scopus, the Cochrane Central Register of Controlled Trials, Web of Science, and EMBASE databases, with no language restrictions, from inception to January 1, 2023. The primary outcome measures of the study were velocity, area, amplitude, phase plane portrait, and path/sway length of the center of pressure (CoP). Standardized mean difference (SMD) effect sizes were calculated, and the quality of the studies was assessed using the Newcastle–Ottawa Scale (NOS). Results From 196 studies, five involving 242 adults (≥ 18 years) met the inclusion criteria. Three studies were rated as high quality, while two were deemed moderate. In the included studies, 140 participants had non-specific LBP, while 102 participants did not report any symptoms, with mean ages of 36.68 (± 14.21) and 36.35 (± 15.39) years, respectively. Three studies had both genders, one exclusively included females, and one did not specify gender. Meta-analyses of primary outcomes revealed no significant differences in postural control between patients with LBP and pain-free controls during both easy and difficult postural tasks and cognitive load for velocity (easy: SMD − 0.09, 95% CI − 0.91 to 0.74; difficult: SMD 0.12, 95% CI − 0.67 to 0.91), area (easy: SMD 0.82, 95% CI − 2.99 to 4.62; difficult: SMD 0.14, 95% CI − 2.62 to 2.89), phase plane (easy: SMD − 0.59, 95% CI − 1.19 to 0.02; difficult: SMD − 0.18, 95% CI − 0.77 to 0.42), path/sway length (easy: SMD − 0.18, 95% CI − 0.77 to 0.42; difficult: SMD − 0.14, 95% CI − 0.84 to 0.55), and amplitude (easy: SMD 0.89, 95% CI − 1.62 to 3.39; difficult: SMD 1.31, 95% CI − 1.48 to 4.10). Conclusions The current evidence suggests that there are no significant differences in postural control parameters during dual-task conditions between individuals with non-specific LBP and pain-free subjects. However, due to the limited number of available studies, significant publication bias, and considerable statistical heterogeneity, definitive conclusions cannot be drawn. Therefore, further research comprising high-quality studies with larger sample sizes is necessary to obtain conclusive results. Trial registration PROSPERO CRD42022359263.
Document Type: Article
Other literature type
Language: English
ISSN: 1749-799X
DOI: 10.1186/s13018-023-04035-6
Access URL: https://pubmed.ncbi.nlm.nih.gov/37528400
https://doaj.org/article/c1c40dca946045fe81ecf0daac150b2c
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (http://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Accession Number: edsair.doi.dedup.....2bc7471465d065b66baf2f26409d0d75
Database: OpenAIRE
Description
Abstract:Background Dual-task conditions, which involve performing two tasks simultaneously, may exacerbate pain and further impair daily functioning in individuals with low back pain (LBP). Understanding the effects of dual-task conditions on postural control in patients with LBP is crucial for the development of effective rehabilitation programs. Our objective was to investigate the impact of dual-task conditions on postural control in individuals with LBP compared to those without LBP. Methods We conducted a comprehensive search of Medline via PubMed, Scopus, the Cochrane Central Register of Controlled Trials, Web of Science, and EMBASE databases, with no language restrictions, from inception to January 1, 2023. The primary outcome measures of the study were velocity, area, amplitude, phase plane portrait, and path/sway length of the center of pressure (CoP). Standardized mean difference (SMD) effect sizes were calculated, and the quality of the studies was assessed using the Newcastle–Ottawa Scale (NOS). Results From 196 studies, five involving 242 adults (≥ 18 years) met the inclusion criteria. Three studies were rated as high quality, while two were deemed moderate. In the included studies, 140 participants had non-specific LBP, while 102 participants did not report any symptoms, with mean ages of 36.68 (± 14.21) and 36.35 (± 15.39) years, respectively. Three studies had both genders, one exclusively included females, and one did not specify gender. Meta-analyses of primary outcomes revealed no significant differences in postural control between patients with LBP and pain-free controls during both easy and difficult postural tasks and cognitive load for velocity (easy: SMD − 0.09, 95% CI − 0.91 to 0.74; difficult: SMD 0.12, 95% CI − 0.67 to 0.91), area (easy: SMD 0.82, 95% CI − 2.99 to 4.62; difficult: SMD 0.14, 95% CI − 2.62 to 2.89), phase plane (easy: SMD − 0.59, 95% CI − 1.19 to 0.02; difficult: SMD − 0.18, 95% CI − 0.77 to 0.42), path/sway length (easy: SMD − 0.18, 95% CI − 0.77 to 0.42; difficult: SMD − 0.14, 95% CI − 0.84 to 0.55), and amplitude (easy: SMD 0.89, 95% CI − 1.62 to 3.39; difficult: SMD 1.31, 95% CI − 1.48 to 4.10). Conclusions The current evidence suggests that there are no significant differences in postural control parameters during dual-task conditions between individuals with non-specific LBP and pain-free subjects. However, due to the limited number of available studies, significant publication bias, and considerable statistical heterogeneity, definitive conclusions cannot be drawn. Therefore, further research comprising high-quality studies with larger sample sizes is necessary to obtain conclusive results. Trial registration PROSPERO CRD42022359263.
ISSN:1749799X
DOI:10.1186/s13018-023-04035-6