Lumbosacral orthosis can improve postural control in older adults with chronic low back pain

Older adults with chronic low back pain may report poor postural control and increased fall risks. Possible key mechanisms are altered lumbar spine proprioception, stiffness and mobility, which could be enhanced through lumbar stabilization approaches. The purpose of this study was thus to evaluate the immediate effects of two lumbar stabilization approaches on postural control measures, namely a lumbosacral orthosis and the abdominal drawing-in maneuver. 57 older adults (> 65 yrs): 22 with chronic low back pain and 35 healthy controls performed two trials (30 s) of a semi-tandem balance task on a force platform, while three experimental conditions were randomly assessed: (1) control (without lumbar stabilization), (2) lumbosacral orthosis, and (3) the abdominal drawing-in maneuver. Linear variables derived from the platform center of pressure were computed (mean amplitude, ellipse area, sway velocity, and frequency) as outcomes. No group × condition interactions were significant. However, chronic low back pain individuals showed significantly (p ≤ 0.03) poorer postural control than healthy controls for 3/7 center of pressure parameters. Significant experimental condition effects (p<0.01) were also observed. The lumbosacral orthosis reduced center of pressure sway as compared to control (13%) and the abdominal drawing-in maneuver (15%) mainly for sway center of pressure velocity, while the abdominal drawing-in maneuver deteriorated postural control (23 to 39%) comparatively to the other two conditions. Lumbosacral orthosis improved postural control across some center of pressure parameters, while the abdominal drawing-in maneuver degraded performance. These results have implications for clinical decision-making to promote fall prevention and sustainable health for older adults with and without chronic low back pain.