Perturbation-based Balance Training in Adults Aged Above 55 Years with Chronic Low Back Pain: A Comparison of Effects of Water versus Land Medium - A Preliminary Randomized Trial


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Abstract

Background:‘Rapid balance reaction’ or ‘perturbation’ training is an emerging paradigm in elderly back pain rehabilitation due to its connection to postural stability.

Objective:This study aimed to inform the feasibility and practicality of perturbation-based balance training (PBT) using a stratification approach and to determine the effectiveness of land versus water-based PBT in elderly individuals with chronic low back pain (CLBP)

Methods:Elderly CLBP participants (n=24) received exercise interventions as per treatmentbased classification (TBC) and were randomly allotted into water-based perturbation exercises (WBPE, Mean age=63.0±2.6years, n=12) and land-based perturbation exercise group (LBPE, 62.3±2.6 years, n=12). Pain intensity, disability, scores of fear-avoidance beliefs, fall efficacy, and rate of perceived exertion (RPE) were assessed before and at the end of 6 weeks.

Results:WBPE group reported a significant reduction in pain score (median difference(MD)):2, p(<0.03), fear avoidance behaviour for work (MD:9, p(<0.01) and fear avoidance behaviour for physical activity (MD:10, P< 0.05), improved straight leg raise right (SLR) (MD:37.5°, p(<0.05), and improved modified fall efficacy scores (MFES, MD:25, p(<0.05) compared to the LBPE group at post-intervention. Within-group analysis in both groups revealed significant improvement in clinical outcomes except for fear-avoidance beliefs related to physical activity in the LBPE group. Subgroup analysis revealed that the high BMI elderly CLBP group of LBPE had significant improvements similar to the WBPE group except for scores of FABQ physical activity scores and SLR.

Conclusion:Possible key factors for future research are discussed in the realms of perturbation exercise in the elderly with CLBP.

About the authors

Ramprasad Muthukrishan

Department of Physiotherapy, Gulf Medical University

Author for correspondence.
Email: info@benthamscience.net

Fatima Badr Ul Islam

Department of Physiotherapy, Gulf Medical University

Email: info@benthamscience.net

Sukumar Shanmugam

Department of Physiotherapy, Gulf Medical University

Email: info@benthamscience.net

Watson Arulsingh

Department of Physiotherapy, Gulf Medical University

Email: info@benthamscience.net

Kumaraguruparan Gopal

Department of Physiotherapy, Gulf Medical University

Email: info@benthamscience.net

Praveen Kandakurti

Department of Physiotherapy, Gulf Medical University

Email: info@benthamscience.net

Sannasi Rajasekar

, Srinivas College of Physiotherapy and Research Centre

Email: info@benthamscience.net

Gulshan Malik

, Thumbay Physical Therapy and Rehabilitation Hospital

Email: info@benthamscience.net

Geovinson S.G.

, Thumbay Physical Therapy and Rehabilitation Hospital

Email: info@benthamscience.net

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