Falls efficacy and directional postural sway responses during the sensory organization test in adults with nonspecific chronic low back pain.

Background: Nonspecific chronic low back pain (CLBP) is frequently associated with impaired postural regulation and increased reliance on visual input for balance. However, little is known about how individuals with CLBP adapt to progressively challenging conditions.

Purpose: This study examined the effects of visual input and task repetition on postural stability during bipedal stance in older adults with and without CLBP.

Methods: Seventy-two participants (CLBP group: 68.48 ± 8.15 years old: n = 31; control group 66.63 ± 7.65 years old: n = 41) completed three trials of the Sensory Organization Test, which manipulated visual and somatosensory cues. Postural stability was assessed via center of pressure excursions in both anteroposterior (AP) and mediolateral (ML) directions while considering the modified Falls Efficacy Scale (FES).

Results: Significant effects of sensory condition were observed across trials (Trial 2: F = 18.51, p = 0.001; Trial 3: F = 13.25, p = 0.001), with the most significant instability occurring under vestibular-reliant and multisensory conflict conditions. Condition × FES interactions indicated that adults with lower falls efficacy scores demonstrated larger sway excursions, particularly in Trials 2 and 3 (p = 0.001). Within the CLBP group, ML sway was significantly greater than AP sway (p < 0.01).

Conclusion: Although sway excursion decreased slightly across repeated trials, postural deficits in the CLBP group were exacerbated under multisensory conflicts, particularly in the ML direction. These findings highlight the need for balance strategies that address both sensory integration and psychological factors, such as fear of falling, to improve postural stability.