Investigation of the effects of external focus dynamic balance education on pain functionality and balance in individuals with chronic lack pain

Balance, physical performance and functional parameters are adversely affected in individuals with chronic low back pain (CLBP). While the effects of focus of attention exercises were investigated in various populations in terms of balance and performance, there was no study examining the effects of attention focus instructions on balance and performance in individuals with low back pain. Our aim is to investigate the effects of dynamic balance exercises applied with external attention focus instructions on balance, physical performance and functional status in individuals with CLBP.48 volunteers participated in this study. After completing the study period, 4 people left the study. 44 participants were divided into two groups as randomized external focus (EF) group (n=22) and control group (CG). Traditional physiotherapy methods and dynamic balance exercises were applied to both groups by a researcher for 3 sessions a week for 8 weeks. The EF group was given EF instructions during dynamic balance exercises. In CG, internal focus (IF) instructions were given during the same dynamic balance exercises. Participants before and after treatment pain (Visual Analog Scale), range of motion, functional level (Oswestry Disability Index), sleep quality (Pittsburgh Sleep Quality Index), kinesiophobia (Tampa Kinesiophobia Scale), balance (Biodex Balance System), physical performance (Physical Performance Test Battery (FPTB), postur (Spinal Mouse Device), proprioception (repositioning test) parameters were evaluated. Significant improvements were observed in both groups in intragroup comparisons in all parameters except proprioception (p<0.05). When the post-treatment values were compared, the EF group was found to be superior to CG in dynamic overall, dynamic a-p, physical performance tests, 50 steps walking, 5 min walking, 10 repetitions of flexion, weight forward reaching test, posture, spinal mobility and postural competence values. (p<0.05). The results of the study show that externally focused balance exercises are effective on dynamic balance, limit of stability, fall risk physical performance posture, spinal mobilit and posture competence in individuals with CLBP.