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The Effectiveness of an Unstable Sandal on Low Back Pain and Golf Performance

Nigg, Benno M, Dr.h.c; Davis, Elysia BSc (Hons); Lindsay, David BHMS, BPhty, MSc, CAT(C); Emery, Carolyn BSc(PT), PhD

Clinical Journal of Sport Medicine: November 2009 - Volume 19 - Issue 6 - p 464-470
doi: 10.1097/JSM.0b013e3181c0a96f
Original Research

Objective: The objectives of this study were to assess the effect of unstable sandals on (1) low back pain (LBP) in golfers with undiagnosed moderate LBP, (2) static and dynamic balance, and (3) golf performance.

Design: This was a 6-week prospective study where subjects were randomized to a control group and an intervention group.

Setting: Baseline measurements were recorded in the Human Performance Laboratory.

Participants: Forty male golfers with nonspecific moderate LBP.

Intervention: The intervention group wore unstable shoes for 6 weeks, and the control group wore their regular golf shoes.

Main Outcome Measures: Low back pain, timed balance, and golf performance were assessed at baseline and at 6 weeks. Changes were compared through independent samples t tests.

Results: (1) There was a significant difference between groups in the change of perceived LBP scores in the laboratory (test group: −17.5/100 mm, control: −3.6/100 mm) and in the comparison of the first week entries to the last week entries recorded in logbooks (test group: −10.7/100 mm, control group: +2.6/100 mm). (2) There was no significant change in the static or dynamic balance times. (3) There was no significant change in golf performance between the intervention and control groups.

Conclusion: The results indicate that unstable sandals can be used to reduce moderate lower back pain in this population of golfers without negatively affecting performance.

From the *Human Performance Laboratory; and †Sport Medicine Centre, Roger Jackson Center for Health and Wellness Research, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.

Submitted for publication December 16, 2008; accepted September 7, 2009.

The authors state that they have no financial interest in the products mentioned within this article.

Reprints: Benno M. Nigg,, Dr.h.c., Human Performance Laboratory, Roger Jackson Centre for Health and Wellness Research, Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada (e-mail:

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