Is dynamic balance impaired in people with non-specific low back pain when compared to healthy people? A systematic review

INTRODUCTION: Low back pain (LBP) represents a frequent health issue in most of the countries; in recent years, there was a growing interest concerning the role of balance and postural stability in individuals with non-specific LBP (NS-LBP). The aim of this systematic review is to provide a synthesis of the evidence on the association between NS-LBP and an impaired dynamic balance. EVIDENCE ACQUISITION: The reporting of this study followed the 2020 PRISMA statement. Analytical observational studies, investigating the dynamic balance performance via functional or motor-tasks tests in LBP in comparison to healthy people, were searched in PubMed, Embase and Scopus up to December 2023. Their characteristics were reported in a standardized form, and their methodological quality was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist for cross-sectional studies. EVIDENCE SYNTHESIS: A qualitative synthesis of the study findings and a discussion of the results are provided. 19 cross-sectional studies were included in this review, with an overall sample size of 894. A meta-analysis was not possible due to high levels of heterogeneity across the studies. None of the included studies were deemed to be of a good methodological quality. Overall, most studies reported differences between NS-LBP and healthy people in terms of dynamic balance, showing worst performances in NS-LBP, both at motor-task tests and at the posturography. CONCLUSIONS: Impaired dynamic balance seems to be correlated to NS-LBP. However, due to the presence of methodological issues in the included studies, further confirmations are needed. Clinicians should take into consideration the importance of a balance assessment in NS-LBP, by implementing proper functional tests. High-quality observational research is recommended, to assess dynamic balance with standardized and uniform modalities, in relation to specific stages of the condition.