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Published in: BMC Geriatrics 1/2021

Open Access 01-12-2021 | Back Pain | Research article

How cognitive loads modulate the postural control of older women with low back pain?

Authors: Le Ge, Qiuhua Yu, Chuhuai Wang, Huanjie Huang, Xin Li, Shanshan Zhang, Siyun Zhang

Published in: BMC Geriatrics | Issue 1/2021

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Abstract

Background

The capacity of postural control is a key factor related to falling in older people, particularly in older women with low back pain (LBP). Cognitive involvement in postural control increases with age. However, most scholars have not considered different difficulty levels of cognitive loads when exploring the effects of cognition on postural control in older patients with LBP. The present study is to investigate how different levels of cognitive loads modulate postural control in older women with LBP.

Methods

This was a cross-sectional study. Twenty older women with LBP were recruited into the LBP group, and 20 healthy older women without the history of LBP were recruited into the healthy control group. Balance parameters were computed to quantify postural control. All participants underwent the balance test, which required the participant to maintain stability during standing on a force platform with or without a concurrent cognitive task. The balance test included three levels of difficulties of posture tasks (eyes-open vs. eyes-closed vs. one-leg stance) and three cognitive tasks (without cognitive task vs. auditory arithmetic task vs. serial-7 s arithmetic task).

Results

A repeated-measure analysis of variance (3 postural tasks × 3 congnitive tasks× 2 groups) testing the effects of the different congnitive task levels on the performance in different postural conditions. Older women with LBP had worse postural control (as reflected by larger center of pressure (COP) parameters) than control group regardless of postural or cognitive difficulties. Compared with the single task, the COP parameters of participants with LBP were larger during dual tasks, even though the difficulty level of the cognitive task was low. Larger COP parameters were shown only if the difficulty level of the cognitive task was high in control group. Correlations between sway area/sway length and the number of falls were significant in dual tasks.

Conclusion

Our findings shed light on how cognitive loads modulate postural control for older women with LBP. Compared with control group, cognitive loads showed more disturbing effects on postural control in older women with LBP, which was associated with falling.
Literature
12.
go back to reference Huxhold O, Li SC, Schmiedek F. Ulman. Dual-tasking postural control: aging and the effects of cognitive demand in conjunction with focus of attention. Brain Res Bull. 2006;69(3):294–305.CrossRef Huxhold O, Li SC, Schmiedek F. Ulman. Dual-tasking postural control: aging and the effects of cognitive demand in conjunction with focus of attention. Brain Res Bull. 2006;69(3):294–305.CrossRef
13.
go back to reference Bernard-Demanze L, Dumitrescu M, Jimeno P, Borel L, Lacour M. Age-related changes in posture control are differentially affected by postural and cognitive task complexity. Curr Aging Sci. 2009;2(2):139–49 PMID: 20021408.CrossRef Bernard-Demanze L, Dumitrescu M, Jimeno P, Borel L, Lacour M. Age-related changes in posture control are differentially affected by postural and cognitive task complexity. Curr Aging Sci. 2009;2(2):139–49 PMID: 20021408.CrossRef
14.
go back to reference Kitayuguchi J, Kamada M, Inoue S, Kamioka H, Abe T, Okada S, Mutoh Y. Association of low back and knee pain with falls in Japanese community-dwelling older adults: a 3-year prospective cohort study. Geriatr Gerontol Int. 2017;17(6):875–84. https://doi.org/10.1111/ggi.12799 Epub 2016 May 20. PMID: 27198168.CrossRefPubMed Kitayuguchi J, Kamada M, Inoue S, Kamioka H, Abe T, Okada S, Mutoh Y. Association of low back and knee pain with falls in Japanese community-dwelling older adults: a 3-year prospective cohort study. Geriatr Gerontol Int. 2017;17(6):875–84. https://​doi.​org/​10.​1111/​ggi.​12799 Epub 2016 May 20. PMID: 27198168.CrossRefPubMed
15.
go back to reference Palacios-Ceña D, Alonso-Blanco C, Hernández-Barrera V, Carrasco-Garrido P, Jiménez-García R, Fernández-de-las-Peñas C. Prevalence of neck and low back pain in community-dwelling adults in Spain: an updated population-based national study (2009/10-2011/12). Eur Spine J. 2015;24(3):482–92. https://doi.org/10.1007/s00586-014-3567-5 Epub 2014 Sep 11. PMID: 25208501.CrossRefPubMed Palacios-Ceña D, Alonso-Blanco C, Hernández-Barrera V, Carrasco-Garrido P, Jiménez-García R, Fernández-de-las-Peñas C. Prevalence of neck and low back pain in community-dwelling adults in Spain: an updated population-based national study (2009/10-2011/12). Eur Spine J. 2015;24(3):482–92. https://​doi.​org/​10.​1007/​s00586-014-3567-5 Epub 2014 Sep 11. PMID: 25208501.CrossRefPubMed
16.
go back to reference Muraki S, Akune T, Oka H, En-Yo Y, Yoshida M, Nakamura K, Kawaguchi H, Yoshimura N. Prevalence of falls and the association with knee osteoarthritis and lumbar spondylosis as well as knee and lower back pain in Japanese men and women. Arthritis Care Res (Hoboken). 2011;63(10):1425–31. https://doi.org/10.1002/acr.20562 PMID: 21793231.CrossRef Muraki S, Akune T, Oka H, En-Yo Y, Yoshida M, Nakamura K, Kawaguchi H, Yoshimura N. Prevalence of falls and the association with knee osteoarthritis and lumbar spondylosis as well as knee and lower back pain in Japanese men and women. Arthritis Care Res (Hoboken). 2011;63(10):1425–31. https://​doi.​org/​10.​1002/​acr.​20562 PMID: 21793231.CrossRef
30.
go back to reference Sherafat S, Salavati M, Takamjani IE, et al. Effect of dual-tasking on dynamic postural control in individuals with and without non-specific low back pain. J Manip Physiol Ther. 2014;37(3):170–9.CrossRef Sherafat S, Salavati M, Takamjani IE, et al. Effect of dual-tasking on dynamic postural control in individuals with and without non-specific low back pain. J Manip Physiol Ther. 2014;37(3):170–9.CrossRef
35.
go back to reference Marchese R, Bove M, Abbruzzese G. Effect of cognitive and motor tasks on postural stability in Parkinson’s disease: a posturographic study. Mov Disord. 2003;18(6):652–8.CrossRef Marchese R, Bove M, Abbruzzese G. Effect of cognitive and motor tasks on postural stability in Parkinson’s disease: a posturographic study. Mov Disord. 2003;18(6):652–8.CrossRef
36.
go back to reference Mak L, Yeh TT, Boulet J, et al. Interaction between delayed visual feedback and secondary cognitive tasks on postural control in older adults. Mov Sport Sci Sci Motricité. 2011;74:81–8. Mak L, Yeh TT, Boulet J, et al. Interaction between delayed visual feedback and secondary cognitive tasks on postural control in older adults. Mov Sport Sci Sci Motricité. 2011;74:81–8.
37.
go back to reference Riley MA, Baker AA, Schmit JM. Inverse relation between postural variability and difficulty of a concurrent short-term memory task. Brain Res Bull. 2003;62:191–5.CrossRef Riley MA, Baker AA, Schmit JM. Inverse relation between postural variability and difficulty of a concurrent short-term memory task. Brain Res Bull. 2003;62:191–5.CrossRef
38.
go back to reference Wulf G, Mercer J, McNevin N, Guadagnoli MA. Reciprocal influences of attentional focus on postural and suprapostural task performance. J Mot Behav. 2004;36(2):189–99.CrossRef Wulf G, Mercer J, McNevin N, Guadagnoli MA. Reciprocal influences of attentional focus on postural and suprapostural task performance. J Mot Behav. 2004;36(2):189–99.CrossRef
39.
go back to reference Mazaheri M, Heidari E, Mostamand J, et al. Competing effects of pain and fear of pain on postural control in low back pain? Spine (Phila Pa 1976). 2014;39(25):1518–23.CrossRef Mazaheri M, Heidari E, Mostamand J, et al. Competing effects of pain and fear of pain on postural control in low back pain? Spine (Phila Pa 1976). 2014;39(25):1518–23.CrossRef
40.
go back to reference Horak FB, Shupert CL, Mirka A. Components of postural dyscontrol in the elderly: a review. Neurobiol Aging. 1989;10:727–38.CrossRef Horak FB, Shupert CL, Mirka A. Components of postural dyscontrol in the elderly: a review. Neurobiol Aging. 1989;10:727–38.CrossRef
41.
go back to reference Jette AM, Branch LG, Berlin J. Musculoskeletal impairments and physical disablement among the aged. J Gerontol Med Sci. 1990;45:M203–8.CrossRef Jette AM, Branch LG, Berlin J. Musculoskeletal impairments and physical disablement among the aged. J Gerontol Med Sci. 1990;45:M203–8.CrossRef
Metadata
Title
How cognitive loads modulate the postural control of older women with low back pain?
Authors
Le Ge
Qiuhua Yu
Chuhuai Wang
Huanjie Huang
Xin Li
Shanshan Zhang
Siyun Zhang
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-021-02025-z

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