Are changes in pain intensity related to changes in balance control in individuals with chronic non-specific low back pain? A systematic review and meta-analysis
Purpose: The aim of this study was to summarize the evidence regarding whether pain reduction in individuals with chronic non-specific low back pain (CNSLBP) following conservative interventions is related to corresponding improvements in balance control. Methods: Randomized controlled trials were i...
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Elsevier
2025-12-01
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| Series: | Journal of Sport and Health Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2095254624001455 |
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| author | Daniel K.Y. Zheng Jae Q.J. Liu Jeremy R. Chang Jeffrey C.Y. Ng Zhixing Zhou Jinlong Wu Chelsia K.C. Cheung Frank F. Huang Sabina M. Pinto Dino Samartzis Manuela L. Ferreira Kanchana Ekanayake Stephen Lord Xueqiang Wang Arnold Y.L. Wong |
| author_facet | Daniel K.Y. Zheng Jae Q.J. Liu Jeremy R. Chang Jeffrey C.Y. Ng Zhixing Zhou Jinlong Wu Chelsia K.C. Cheung Frank F. Huang Sabina M. Pinto Dino Samartzis Manuela L. Ferreira Kanchana Ekanayake Stephen Lord Xueqiang Wang Arnold Y.L. Wong |
| author_sort | Daniel K.Y. Zheng |
| collection | DOAJ |
| description | Purpose: The aim of this study was to summarize the evidence regarding whether pain reduction in individuals with chronic non-specific low back pain (CNSLBP) following conservative interventions is related to corresponding improvements in balance control. Methods: Randomized controlled trials were identified from 5 databases (MEDLINE, Cochrane Library, Embase, Web of Science, and PsycINFO). Two reviewers independently screened and identified relevant studies that investigated the effects of non-surgical or non-pharmacological CNSLBP treatments on both pain intensity and balance control. Meta-regression analyses were performed to establish the associations between post-treatment changes in these 2 variables. Results: Thirty one studies involving 1280 participants with CNSLBP were included. Moderate-quality evidence suggested that pain reduction was associated with and explained 34%–45% of decreases in body sway, as measured by center-of-pressure (CoP) area and CoP velocity with eyes open. However, no significant association was observed between pain reduction and CoP area or velocity in anteroposterior/mediolateral directions. Similarly, there was no significant association between pain reduction and CoP distance or radius. Low-quality evidence indicated that pain relief explained a 15% improvement in one-leg stance with eyes open but not in the eyes-closed condition. Additionally, very low-quality evidence suggested that pain relief explained a 44% decrease in the static anteroposterior stability index with eyes closed but not in the eyes-open, mediolateral, or overall conditions. Furthermore, low-quality evidence indicated that reduced pain was associated with and accounted for 25%–43% of the improved composite and posteromedial scores of the star-excursion balance test, rather than the anterior and posterolateral scores. Conclusion: Depending on the type of balance assessment, pain relief following conservative interventions may slightly to moderately enhance balance control in individuals with CNSLBP. Clinicians should pay close attention to the balance control in patients with CNSLBP, particularly among older adults. |
| format | Article |
| id | doaj-art-be97a9110bbf4c41aa8d904118a83027 |
| institution | Kabale University |
| issn | 2095-2546 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Sport and Health Science |
| spelling | doaj-art-be97a9110bbf4c41aa8d904118a830272025-01-24T04:44:57ZengElsevierJournal of Sport and Health Science2095-25462025-12-0114100989Are changes in pain intensity related to changes in balance control in individuals with chronic non-specific low back pain? A systematic review and meta-analysisDaniel K.Y. Zheng0Jae Q.J. Liu1Jeremy R. Chang2Jeffrey C.Y. Ng3Zhixing Zhou4Jinlong Wu5Chelsia K.C. Cheung6Frank F. Huang7Sabina M. Pinto8Dino Samartzis9Manuela L. Ferreira10Kanchana Ekanayake11Stephen Lord12Xueqiang Wang13Arnold Y.L. Wong14Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, ChinaDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, ChinaDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, ChinaDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, ChinaDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, ChinaCollege of Physical Education, Southwest University, Chongqing 400715, ChinaDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, ChinaDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, ChinaDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, ChinaDepartment of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USAFaculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, AustraliaUniversity Library, The University of Sydney, Sydney, NSW 2006, AustraliaNeuroscience Research Australia, University of New South Wales, Sydney, NSW 2052, AustraliaDepartment of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou 325035, ChinaDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China; Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong 999077, China; Corresponding author.Purpose: The aim of this study was to summarize the evidence regarding whether pain reduction in individuals with chronic non-specific low back pain (CNSLBP) following conservative interventions is related to corresponding improvements in balance control. Methods: Randomized controlled trials were identified from 5 databases (MEDLINE, Cochrane Library, Embase, Web of Science, and PsycINFO). Two reviewers independently screened and identified relevant studies that investigated the effects of non-surgical or non-pharmacological CNSLBP treatments on both pain intensity and balance control. Meta-regression analyses were performed to establish the associations between post-treatment changes in these 2 variables. Results: Thirty one studies involving 1280 participants with CNSLBP were included. Moderate-quality evidence suggested that pain reduction was associated with and explained 34%–45% of decreases in body sway, as measured by center-of-pressure (CoP) area and CoP velocity with eyes open. However, no significant association was observed between pain reduction and CoP area or velocity in anteroposterior/mediolateral directions. Similarly, there was no significant association between pain reduction and CoP distance or radius. Low-quality evidence indicated that pain relief explained a 15% improvement in one-leg stance with eyes open but not in the eyes-closed condition. Additionally, very low-quality evidence suggested that pain relief explained a 44% decrease in the static anteroposterior stability index with eyes closed but not in the eyes-open, mediolateral, or overall conditions. Furthermore, low-quality evidence indicated that reduced pain was associated with and accounted for 25%–43% of the improved composite and posteromedial scores of the star-excursion balance test, rather than the anterior and posterolateral scores. Conclusion: Depending on the type of balance assessment, pain relief following conservative interventions may slightly to moderately enhance balance control in individuals with CNSLBP. Clinicians should pay close attention to the balance control in patients with CNSLBP, particularly among older adults.http://www.sciencedirect.com/science/article/pii/S2095254624001455Conservative interventionsBalance controlLow back painMeta-regressionPain relief |
| spellingShingle | Daniel K.Y. Zheng Jae Q.J. Liu Jeremy R. Chang Jeffrey C.Y. Ng Zhixing Zhou Jinlong Wu Chelsia K.C. Cheung Frank F. Huang Sabina M. Pinto Dino Samartzis Manuela L. Ferreira Kanchana Ekanayake Stephen Lord Xueqiang Wang Arnold Y.L. Wong Are changes in pain intensity related to changes in balance control in individuals with chronic non-specific low back pain? A systematic review and meta-analysis Journal of Sport and Health Science Conservative interventions Balance control Low back pain Meta-regression Pain relief |
| title | Are changes in pain intensity related to changes in balance control in individuals with chronic non-specific low back pain? A systematic review and meta-analysis |
| title_full | Are changes in pain intensity related to changes in balance control in individuals with chronic non-specific low back pain? A systematic review and meta-analysis |
| title_fullStr | Are changes in pain intensity related to changes in balance control in individuals with chronic non-specific low back pain? A systematic review and meta-analysis |
| title_full_unstemmed | Are changes in pain intensity related to changes in balance control in individuals with chronic non-specific low back pain? A systematic review and meta-analysis |
| title_short | Are changes in pain intensity related to changes in balance control in individuals with chronic non-specific low back pain? A systematic review and meta-analysis |
| title_sort | are changes in pain intensity related to changes in balance control in individuals with chronic non specific low back pain a systematic review and meta analysis |
| topic | Conservative interventions Balance control Low back pain Meta-regression Pain relief |
| url | http://www.sciencedirect.com/science/article/pii/S2095254624001455 |
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