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Journal of Orthopaedic Surgery and Research
Article . 2023 . Peer-reviewed
License: CC BY
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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
Authors: Pourahmadi, Mohammadreza; Negahban, Hossein; Koes, Bart Willem; Fernández-de-Las-Peñas, César; Ebrahimi Takamjani, Ismail; Bahramian, Mehrdad;

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

Abstract

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.

Keywords

Orthopedic surgery, Adult, Male, Low Back Pain/psychology, Diseases of the musculoskeletal system, Review, Dual task, Center of pressure, RC925-935, Postural balance, Systematic review, Humans, Low back pain, Female, Low Back Pain, Postural Balance, RD701-811

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
8
Top 10%
Average
Top 10%
Green
gold