The Association of Acute Stress and Single Leg Balance

Abstract

Chronic low back pain is a widespread and expensive societal burden that is routinely near the top of the list of reasons people live with a disability. There is an undeniable connection between low back pain and psychological stress, and it has long been accepted that stress comes as a consequence of the burden of pain. Our group sought to determine if the inverse of this paradigm might be true: that stress may actually play a role in the etiology of low back pain through its influence on neuromuscular control and strategies for balance stability. In this dissertation, we include a brief review of the literature regarding the complex interplay of stress physiology, low back pain, and neuromuscular trunk control. In Chapters 2 and 3 we have included two manuscripts, the first of which is a published protocol for the Feigned Annoyance and Frustration Test—a novel modality that we have determined to be valid for inducing stress in a lab setting. The second manuscript includes our analysis of the neuromuscular impact of stress on a single leg balance task. In brief: individuals demonstrated decreased activation of key trunk muscles after exposure to stress and individuals with low back pain exhibited a greater number of differences in muscle activation compared to healthy controls. The final chapter includes a summary of suggestions for future research based on the components in our dataset that have yet to be explored