Effects of Walking with Internal and External Attention on the Balance and Plantar Pressure Pattern in Patients with Low Back Pain

Plantar pressure variables and their measurement and comparison can be considered as a useful tool for assessing the effectiveness of motion, especially in patients with low back pain. The aim of the present study was to investigate the effects of walking with internal and external attention on the balance and foot pressure patterns in patients with low back pain.
The sample of the present trial study included 15 women (Age: 22.86±1.15 years, Height: 162.53±1.54 cm, Weight: 61.06±2.42 kg) with low back pain. Plantar pressure values were recorded during normal walking, internal, and external attention walking using a foot scan system with 300 Hz sample rate. All analyses were performed using SPSS, version 22. A repeated measures ANOVA was used for statistical analysis.
The results showed an increase in the time to peak of ground reaction force values during heel-contact, mid-stance, and push-off phases in the internal attention walking compared to normal walking conditions and increased walking with internal attention compared to walking with external attention conditions. The ground reaction force and the plantar pressure peak values on the Metatarsal 2 region increased in normal walking compared to walking with internal attention conditions and increased in walking with external attention as compared to walking with internal attention conditions. The ground reaction force peak values on the lateral heel region increased in normal walking compared to internal attention walking conditions and increased in external attention walking compared to internal attention walking conditions.
Internal and external attention walking conditions do not have significant effects on stance time. Also, the loading rate of ground reaction force values decreased in internal attention walking as compared to external attention walking conditions.