Usefulness of static posturography with reference to established subjective clinical examination

The study group will be consisted of randomly selected patients of both sexes, undergoing treatment for lumbosacral discogenic pain syndrome due to degenerative spondyloarthropathy, with no history of hip or knee osteoarthritis, as the latter could manifest with pain radiating to the lumbosacral segment of the spine. The diagnosis will be established based on medical history, physical examination, and radiographic assessments (anteroposterior and lateral X-ray films, magnetic resonance imaging, or computed tomography). All study subjects will be underwent static posturography, rated their pain severity based on a visual analog scale (VAS), and had their physical functioning will be evaluated with a modified WOMAC questionnaire. These assessments will be conducted in the morning on the first and final days of the rehabilitation course, before the rehabilitation treatments scheduled for those days, and after approximately three months (± 2 weeks) after rehabilitation course completion. The study group will be underwent a 15-day course of physiotherapy, including: relaxation-promoting positioning- reducing load on the lumbosacral spine by a system of slings with knees and hips bending to angle of 90 degrees (about 30 min. once daily,the duration of administration, 3 weeks) , magnetotherapy (frequency with f=2-50Hz, field intensity of 2.5-5 mT and duration of 15 minutes, once daily,the duration of administration, 3 weeks), hydrocortisone iontophoresis at the trigger point in the lumbosacral region(2% hydrocortisonum, once daily,the duration of administration, 3 weeks) , interferential current (f=1–100 Hz) , special exercises for strengthening core and lower extremity muscles, intended for patients with spondyloarthropathies, isometric exercises, general fitness exercises, proprioception exercises for the lower extremities and spine, water exercises-about 30 min. once daily,the duration of administration, 3 weeks and patient education on preventing low back overload - guidance on prevention of low back pain for example in work, sitting position, activities of daily living etc. Education will be provided in whole 15-day course of physiotherapy on each session. It will be provided by certificated physiotherapist with PhD or MSc degree. Participants with osteoarthritis of the lumbosacral spine will be patients of the Department of Rehabilitation of the Independent Public Central Clinical Hospital in Warsaw. Pedobarographic measurements will be collected using a WIN-POD Pel 38 electronic podometer and WIN-POD 3.81 software at a frequency (f) of 100 Hz per 30 seconds. To ensure uniform data collection and reliable results, examiners will be asked to adhere to a strict study protocol that included asking participants a series of questions prior to the test about conditions that could adversely affect postural stability. The questions will be designed to assess overall well-being, medication intake, number of hours of sleep, alcohol consumption, history of excessive physical exercise, and current pain or discomfort. The examination will be consisted of four, 30-second tests with 60-second intermissions in the sitting position. The first two pedobarographic tests will be performed with eyes open (EO) in freestanding posture, whereas the third and fourth tests will be performed with eyes closed (EC). The participants will be asked to remove their shoes and stand upright on the forceplate with the head erect and their arms hanging loosely by their sides. Also they will be asked to stand (barefoot) on a floor-based foot pressure measurement device as pedobarographic balance measurements of deviation length, area and velocity from center of gravity will be recorded. All tests will be conducted in a quiet room with normal temperature and the same illumination. WIN-POD electronic podometer will be calibrated prior to the recordings and further underwent an automatic calibration check before each trial.