Back Pain Affects Amputees’ Trunk Control

Individuals with unilateral lower-limb loss are at an increased risk for developing chronic low back pain. Atypical trunk and pelvis motor behavior secondary to lower limb loss could alter trunk posture control and increase demands on the trunk muscles for stability. However, it is unclear whether trunk postural control is associated with the presence of chronic low back in amputees.

A study published in Science-Direct determined the potential role of impaired trunk postural control among people with lower-limb loss and chronic low back pain.  Two groups of men with unilateral lower-limb loss, 18 with chronic low back pain and 13 without pain, performed an unstable sitting task. Trunk postural control was characterized using traditional and non-linear measures derived from center-of-pressure time series, as well as trunk kinematics and the ratio of lumbar to thoracic erector spinae muscle activations.

Traditional and non-linear center-of-pressure measures and trunk muscle activation ratios were similar between groups, while participants with chronic low back pain demonstrated greater trunk motion and reduced dynamic stability.

Researchers found individuals with both lower-limb amputations and chronic low back pain exhibit impaired trunk postural control compared to those with amputation but without pain. Atypical trunk motor behavior may be a response to altered functional requirements of walking with a prosthesis. An inability to control the trunk could lead to spinal instability and pain in the presence of repetitive exposure to aberrant motor behavior of these proximal structures during everyday activities, the study found.

What You Can Do:

Chronic back issues can sometimes be helped by strengthening your core. There are many core exercises that can be done daily right from your wheelchair. If you are experiencing chronic pain, try one of the exercises below.

  1.  Seated Twist – Sit tall in a chair with your feet flat on the ground. Grab a medicine ball, extend your arms to eye level with your arms slightly bent, and gently twist your body to the right as far as comfortably possible, pause, return to center, and repeat to the left.
  2. Side Bend – Sit tall in a chair with your feet flat on the floor. Let your arms hang down on both sides of your body. From here, gently bend to the right at your waist, extending your right hand as far toward the floor as comfortable. Return to the starting position. Repeat on the opposite side.
  3. Modified Reverse Crunch – While sitting in your chair, lean back slightly and bring your legs up to crunch from the bottom. This exercise can be done with or without a prosthesis.

Source: The O&P Almanac