Anticipatory and compensatory postural adjustments in people with low back pain: A protocol for a systematic review and meta-analysis

Michael F. Knox, Lucy S. Chipchase, Siobhan M. Schabrun, Paul W.M. Marshall

Research output: Contribution to journalReview articlepeer-review

4 Citations (Scopus)
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Background: Anticipatory (APAs) and compensatory (CPAs) postural adjustments are organised by the central nervous system (CNS) and serve to control postural perturbations. Ineffective APAs and CPAs have been hypothesised to contribute to the persistence of symptoms and disability in people with low back pain (LBP). Despite two decades of research, there is no systematic review investigating APAs and CPAs in people with LBP. Thus, the aim of the current review is to determine if APA and CPA onset or amplitude, as measured by electromyography (EMG), centre of pressure (COP), and kinematics, are altered in people with LBP. Methods/design: A systematic review and meta-analysis will be conducted. Searches will be conducted in electronic databases for full-text articles published before January 2016 using pre-defined search strategies that utilise combinations of keywords and medical subject heading terms. Two independent reviewers will screen potentially relevant articles for inclusion, extract data, and assess risk of bias for individual studies. Any disagreements will be resolved by a third reviewer. Studies comparing APA onset and amplitude and CPA onset and amplitude measured by EMG, COP, or kinematics between people with LBP and healthy individuals will be included if all aspects of the eligibility criteria are met. Data will be synthesised if studies are homogeneous; otherwise, results will be reviewed narratively. Discussion: To our knowledge, this is the first systematic review to examine APAs and CPAs, as measured by EMG, COP, and kinematics in people with LBP. The findings of this review may aid in the identification of factors that play a role in the persistence of symptoms and disability and aid in the development of interventions to treat symptoms.

Original languageEnglish
Article number62
Number of pages5
JournalSystematic Reviews
Publication statusPublished - 16 Apr 2016
Externally publishedYes

Bibliographical note

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver( applies to the data made available in this article, unless otherwise stated.


  • Anticipatory
  • Compensatory
  • Low back pain
  • Postural adjustment
  • Postural control
  • Systematic review


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