The effect of visual cues at different heights on sit-to-stand movements in people with and without low back pain

Background

Investigating movement strategies that can be utilized to avoid pain-provocation could enhance the management of low back pain episodes.

Objective

To assess the effect of visual cues at different heights on the kinematics of sit-to-stand movements, as well as perceived difficulty and pain levels.

Design

Cross-over design comparing individuals with low back pain to healthy controls.

Methods

26 asymptomatic controls and 15 individuals with chronic, recurrent low back pain performed 5 sets of 5 sit-to-stand movements. High, middle, and low visual cues were used during sets 2–4. Spinal sagittal plane range of motion, peak spinal flexion and extension angles, and trunk centre of mass velocity were obtained from kinematic data.

Results

The low cue led to significantly more head and lumbar spine flexion, while the high cue led to significantly more head and thoracic spine extension and increased thoracic spine range of motion. The low back pain group demonstrated a significantly lower vertical trunk centre of mass velocity than the control group during the high cue trials. There was a significant association between higher perceived difficulty scores and lower trunk centre of mass velocity for the low back pain group. Pain scores were not significantly different between cue conditions.

Conclusion

Visual cues can be used to temporarily change the spinal kinematics of sit-to-stand movements in people with and without low back pain. This could be helpful in clinical practice to encourage more, or less, movement in specific spinal regions, and avoid pain provocation to facilitate functional rehabilitation.