Received 21 January 2004; received in revised form 8 April 2004; accepted 8 May 2004
Abstract
The purpose of this study was to examine whether postural instability observed in persons with spinal pain and in elderly persons is due to
changes in proprioception and postural control strategy. The upright posture of 20 young and 20 elderly persons, with and without spinal pain,
was challenged by vibrating ankle muscles (i.e. tibialis anterior, triceps surae) or paraspinal muscles. Center of pressure displacement was
recorded using a force plate. Persons with spinal pain were more sensitive to triceps surae vibration and less sensitive to paraspinal vibration
than persons without spinal pain. Elderly persons were more sensitive to tibialis anterior vibration than young healthy persons. These results
suggest that spinal pain and aging may lead to changes in postural control by refocusing proprioceptive sensitivity from the trunk to the ankles.
© 2004 Elsevier Ireland Ltd. All rights reserved.
Keywords: Postural control; Proprioception; Vibration; Low back pain; Aging; Inverted pendulum; Somatosensory integration
Postural stability is achieved, in part, through input from ity [1], suggesting that sensory deficits from either location
the proprioceptive, visual, and vestibular systems, which might result in instability. Postural instability has been ob-
the central nervous system (CNS) must weight relative to served in patients with low back pain [11] as well as in
one another depending on the immediate conditions. An im- elderly persons [12]. Patients with low back pain have also
portant property of the postural control system is its ability been attributed reduced lumbosacral proprioception [3],
to gate sensory input in accordance with the internal repre- which might be a causative factor in their instability.
sentation of the current posture, so as to avoid undesirable The study described in this paper investigated whether
responses triggered by external or internal perturbations [8]. the weighting of proprioceptive input in the back and an-
In some circumstances, it might be advantageous for the kles changes in persons with low back pain and persons
CNS to be able to reweight sensory input based on location who are elderly. Tendon and muscle vibration was used as
of origin, rather than modality. For example, if the quality an experimental probe to quantify the weighting of propri-
of input from a particular body location decreases due to oceptive input from the areas of the lumbar back and the
injury, disease, or normal aging, the CNS might increase ankles, at least as far as it influences stability during quiet
the weighting of input from other locations that provide in- standing. Vibration is a potent stimulus for muscle spindle
formation useful for maintaining a stable posture. Without Ia afferents [2], and applied to the leg muscles during quiet
spatial reweighting of sensory input, reliance on impover- standing, it can induce postural instability, sometimes to
ished input from a particular body location might lead to the point of falling (e.g., [5]). Mechanical vibrations were
loss of balance and falling. applied, during quiet standing, to the triceps surae, tibialis
Proprioceptive input from the muscles of the legs and anterior, or lumbar paraspinal muscles in young and elderly
trunk plays an important role in maintaining postural stabil- persons with low back pain (LBP) and age-matched healthy
persons during quiet standing.
Twenty young adults (10 healthy, 10 LBP; mean age
∗ Corresponding author. Tel.: +32 16 329121; fax: +32 16 329197. = 25 years) and 20 elderly persons (10 healthy, 10 LBP;
E-mail address: simon.brumagne@flok.kuleuven.ac.be (S. Brumagne). mean age = 63 years) participated in this study. The patients
0304-3940/$ – see front matter © 2004 Elsevier Ireland Ltd. All rights reserved.
doi:10.1016/j.neulet.2004.05.013
64 S. Brumagne et al. / Neuroscience Letters 366 (2004) 63–66
more equally to all body segments in stiff persons. Postural [3] S. Brumagne, P. Cordo, R. Lysens, S. Swinnen, S. Verschueren, The
chain mobility seems to be necessary for postural stability, role of paraspinal muscle spindles in lumbosacral position sense in
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in particular, in the pelvic and lumbar spine regions [7,10]. 994.
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This work was partially supported by grants PDM/99/121 165.
(Research Council K.U. Leuven) and 1.5.104.03 (Fund for [14] S.M.P. Verschueren, S. Brumagne, S.P. Swinnen, P.J. Cordo, The
Scientific Research—Flanders). effect of aging on dynamic position sense at the ankle, Behav. Brain
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