Abstract
Background
The purpose of this study was to evaluate how acute pain changes the postural control
and stability during quiet standing and after unexpected perturbations.
Methods
Nine subjects stood as quiet as possible on a movable force platform that recorded
the centre of pressure position and provided unexpected floor perturbations, before,
during and after experimental calf muscle pain. Bilateral surface electromyography
from the tibialis anterior and medial gastrocnemius muscles was recorded. The foot
pressure distributions were measured using pressure insoles. Intramuscular injections
of hypertonic saline were administrated (right leg) to induce acute pain in the tibialis
anterior and/or medial gastrocnemius muscles, and an isotonic injection was used as
control.
Findings
Simultaneous pain in tibialis anterior and medial gastrocnemius altered the postural
control. During quiet standing: higher medial-lateral centre of pressure speed and
increased total sway displacement (P<0.05), weight moved to the non-painful side, (P<0.05) and plantar centre of pressure of the left foot was shifted towards the heel’s
direction (P<0.05). During forward perturbation: higher mean displacement in the medial-lateral
direction (P<0.05). After the perturbation: larger sway area (P<0.05). Pain only in the medial gastrocnemius muscle increased medial-lateral centre
of pressure speed (P<0.05) during the quiet standing. Pain only in the tibialis anterior muscle increased
peak pressure on the contralateral foot (P<0.05).
Interpretation
These findings suggest that large acute painful areas on the calf muscles impair the
postural control and potentially increase the risk factors for falls. Further strategies
aiming to reduce pain in patients may lead to improvement in balance.
Keywords
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Article info
Publication history
Published online: August 09, 2010
Accepted:
June 2,
2010
Received:
September 24,
2009
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
