Increased and early lumbopelvic motion during trunk and limb movements is thought to contribute to low back pain (LBP). Therefore, reducing lumbopelvic motion could be an important component of physical therapy treatment. Our purpose was to examine the effects of classification-specific physical therapy treatment (Specific) based on the Movement System Impairment (MSI) model and non-specific treatment (Non-Specific) on lumbopelvic movement patterns during hip rotation in people with chronic LBP. We hypothesized that following treatment people in the Specific group would display decreased lumbopelvic rotation and achieve more hip rotation before lumbopelvic rotation began. We hypothesized that people in the Non-Specific group would display no change in these variables. Kinematic data collected before and after treatment for hip lateral and medial rotation in prone were analyzed. The Specific group (N=16) demonstrated significantly decreased lumbopelvic rotation and achieved greater hip rotation before the onset of lumbopelvic rotation after treatment with both hip lateral and medial rotation. The Non-Specific group (N=16) demonstrated significantly increased lumbopelvic rotation and no change in hip rotation achieved before the onset of lumbopelvic rotation. People who received treatment specific to their MSI LBP classification displayed decreased and later lumbopelvic motion with hip rotation, whereas people who received generalized non-specific treatment did not.
Objective
To examine sex differences in lumbopelvic motion and symptom behavior during hip medial rotation in people with low back pain (LBP). We hypothesized that men would demonstrate greater and earlier lumbopelvic motion and would be more likely to report increased symptoms compared to women.
Design
Cross-sectional observational study.
Setting
University musculoskeletal analysis laboratory.
Participants
Thirty men and 29 women with chronic LBP were recruited from the community and a university-based physical therapy clinic.
Interventions
Not applicable.
Main Outcome Measures
Lumbopelvic rotation range of motion, amount of hip rotation completed prior to the start of lumbopelvic motion, and provocation of LBP symptoms during the test of prone hip medial rotation were measured.
Results
Men demonstrated significantly more lumbopelvic rotation (men: 10.0° ± 5.1°, women: 4.5° ± 3.9°; P<0.001) and completed less hip rotation prior to the start of lumbopelvic motion (men: 5.4° ± 3.8°, women: 16.0° ± 13.2°; P<0.001) compared to women. Additionally, a significantly greater percentage of men (60.0%) than women (34.5%; P=0.050) reported increased symptoms with hip medial rotation.
Conclusions
Men could be at greater risk than women for experiencing LBP symptoms related to hip medial rotation as a result of greater and earlier lumbopelvic motion.
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