University of Vermont COBRE (P20 RR016435)
"Center for Neuroscience Excellence"
Pilot Project 2: "The Neurophysiology of Postural Coordination With Low Back Pain"
Investigator: Jesse Jacobs, Ph.D.
The goal of this work is to understand the relationship between impaired neuromotor control and chronic, recurrent low back pain (LBP) during tasks that require postural stabilization in order to direct effective rehabilitation strategies. In the United States, up to 80% of people experience LBP, representing the 5th leading diagnosis identified for office visits to a physician. Impairments of the spine have been identified as the most frequent cause of limited activity in people under the age of 45, and the third most frequent cause of limitation in people between 45 and 65 years of age. With such prevalence, yearly expenses due to LBP are estimated to total 100 billion dollars in the United States. In addition, as many as 85% of people who experience LBP also experience recurring symptoms. Clearly, LBP represents a significant public health concern, and the ineffectiveness of treatment to prevent recurring or chronic symptoms suggests a limited understanding of what causes LBP.
Although there are several differential diagnoses of LBP, a pathoanatomical basis is rarely identified, instead being characterized as idiopathic or nonspecific in nature. Abnormal neuromuscular coordination during voluntary and reactive postural stabilization may represent a contributing factor to nonspecific chronic LBP. Therefore, the proposed studies will quantify measures of altered central and muscular neurophysiology in people with and without LBP as they perform two distinct postural tasks that represent different mechanisms of neural control: anticipatory postural adjustments (APA) that precede voluntary limb movement and automatic postural responses (APRs) to an induced loss of balance. By identifying relationships between impaired neuromotor control and chronic, recurrent LBP, the proposed studies will inform more effective classification and rehabilitation strategies for people with LBP in order to improve health outcomes.