Effect of Dual-Tasking on Dynamic Postural Control in Individuals With and Without Nonspecific Low Back Pain

Abstract Objective The purpose of this study was to compare the effect of dual tasking on postural and cognitive performance between participants with and without nonspecific chronic low back pain. Methods In this 3-factor mixed-design study, dynamic postural stability was assessed in 15 patients with chronic nonspecific low back pain and 15 age-, sex-, and size-matched asymptomatic participants. Bilateral stance on a Biodex Balance System was investigated at 3 levels of postural task difficulty (different platform stabilities levels with eyes open and closed) and 2 levels of cognitive task difficulty (with or without auditory Stroop test). We measured anterior-posterior, medial-lateral, and overall indices for postural performance. Average reaction time and error ratio of a modified auditory Stroop test were calculated as measures of the cognitive task performance. Results Mixed-design 3-way analyses of variance revealed significant interactions. Post hoc 2-way analyses of variance showed significant group by cognitive task difficulty for anterior-posterior ( P P = .003), and overall stability indices ( P P P = .02), and overall stability indices ( P P = .002), whereas matched asymptomatic individuals increased their reaction time ( P Conclusion Postural task performance is attenuated by cognitive loading at a moderate level of postural task difficulty. Therefore, to observe the effect of attentional demands of postural control, task difficulty should be considered.