Dynamic Balance as Measured by the Y-Balance Test Is Reduced in Individuals with Low Back Pain: A Cross-Sectional Comparative Study
Hooper, Troy L., C. Roger James, Jean-Michel Brismée, Toby J. Rogers, Kerry K. Gilbert, Kevin L. Browne, and Phillip S. Sizer. Physical Therapy in Sport. 2016 22:.29–34.
Take Home Message: Patients who suffer from current or previous symptoms of lower back pain demonstrated lower reach distances in the posterior directions of the Y-Balance Test compared to healthy individuals.
Many patients suffering from low back pain (LBP) have postural control deficits, and patients who suffer from one episode of LBP are also more likely to suffer recurrent episodes. However, little is known if there are postural control deficits in patients who are in remission from LBP. Therefore, Hooper et al evaluated 42 participants (separated into 3, 14 patient groups; 8 males and 6 females per group) to compare patients with current LBP, those with a history of LBP, and healthy controls to their performance on the Y-Balance Test to establish relationships between Y-Balance Test performance, demographic, behavior, and disability measures. Each participant completed the Y-Balance Test by standing on their dominate leg with toes on the marked line, and hands on hips. Then, the patients completed the Y-Balance test by reaching as far as they could in 3 randomized directions (Anterior, Posteromedial, Posterolateral). The researchers found no difference between the 3 groups and their performance in the anterior direction of Y-Balance Test. However, participants with a history or current LBP displayed lower reach distances compared to the healthy control group in Posteromedial and Posterolateral directions of Y-Balance Test.
This was an interesting study because it demonstrated balance deficits using the Y-Balance Test in patients who are currently or have previously suffered with LBP compared to healthy participants. However, there were no reach distance differences found in anterior reach direction of the Y-Balance Test between groups. It is likely that patients with current or a history of LBP patients were relying on their vision to maintain balance during the anterior reach; therefore, they were not visually compromised as they were in the posterior directions. The authors present valuable insights regarding balance deficits in patients with LBP using an easy and affordable clinical tool to implement. These findings suggest that clinicians should assess balance deficits within patients either currently or those with a history suffering from lower back pain so that appropriate balance training strategies can be incorporated in the rehabilitation of lower back pain patients.
Questions for Discussion: What kind of balance training protocol would suggest for the patients who are in remission and are pain free but have history of low back pain? Do you think those that have previously suffered LBP lost range of motion and proprioception?
Written by: Abbis Haider Jaffri
Reviewed by: Jane McDevitt