Dynamic sensory integration and visual reliance modulation during postural control in older adults with chronic low back pain.

BACKGROUND

Chronic low back pain (LBP) has been reported with altered postural control, yet the trial-specific sensory adaptations underlying this disruption remain unclear.

PURPOSE: This study was conducted to compare differences in equilibrium indices, sensory integration, and center of gravity (COG) sway regulation between individuals with and without LBP during repeated Sensory Organization Test (SOT) trials.

METHODS

Thirty-four adults with LBP and 42 control participants completed three trials across six SOT conditions. The study employed a comparative repeated-measures design to examine differences in equilibrium indices, sensory integration scores, and COG sway between older adults with and without LBP across repeated trials. Disability level was assessed using the Oswestry Disability Index, and pain intensity was measured with the Visual Analogue Scale.

RESULTS

A significant main effect of trial (F = 24.99, p = 0.001) and condition (F = 371.44, p = 0.001) confirmed sensorimotor adaptation and condition-specific balance demands. The LBP group exhibited significantly lower equilibrium scores in the most challenging condition (Condition 6, Trial 3; t = 1.68, p = 0.04). Sensory analysis revealed a significant sensory type × group interaction (F = 5.06, p = 0.03), with reduced visual reliance in the LBP group during the initial trial (t = 1.88, p = 0.03). For COG sway, significant trial × sway interactions indicated direction-specific adaptation across repeated exposures, while condition × sway interactions reflected sensory-specific effects.

CONCLUSION

Our results demonstrate dynamic within-session sensory reweighting and altered postural strategies. Reduced visual reliance and subtle deficits under high-challenge conditions identify potential rehabilitation targets to improve balance and mitigate fall risk.