Hip Abductor To Hip Adductor Strength Ratio Measurements In Patients With Non-Specific Low Back Pain

Abstract

Background:The hip musculature is globally known to support the pelvis, which aids in reducing the occurrence of low back pain (LBP). The hip abductors have an important role in stabilizing the pelvis while walking, but previous research has shown a decrease in strength of the hip abductors in patients with LBP. Due to the ability to activate and assist with hip and leg motions, the adductor muscles may have an effect on controlling hip motion to reduce LBP and sacroiliac dysfunction to compensate for weak hip abductors. The hip adductors stabilize the femur during low extremity injuries. However, it is unknown if the hip adductors respond in a similar fashion when pertaining to those with LBP. Objective: To calculate the hip abductor to hip adductor strength ratio in people with and without LBP. Participants: Participants were allocated into either control (n=15, 179.9cm + 8.3, 75.6kg + 16.0, age 21.9 + 1.8) or LBP (n=15, 169.3cm + 9.3, 76.2kg + 18.5, age 21.9 + 4.3) groups based on the inclusion criteria. The participants in the control group could not have LBP pain as determined with a 0% on the Oswestry Disability Index (ODI) and 0 on the Visual Analogue Scale (VAS) and were between the age of 18-40. Participants included in the LBP group rated pain as > 3cm on the VAS, 20-40% on the ODI, met 3 out of 4 of the clinical predictor rules for LBP, and be between the age of 18-40. Those with previous surgeries from the low back and/or lower extremity, a specific diagnosis for LBP (e.g., herniated disc, spondylolysis), or current pregnancy, were excluded from the study. Methods: Participants performed a side lying straight leg raise (SLR) for hip adduction and hip abduction of both legs. Participants isometrically contracted at maximal force into a mobilization belt for 5 seconds. The desired range of motion for the SLR was, 10° of hip adduction and 30° of hip abduction. A mobilization belt was properly tightened to each participant's degree of motion. Data was recorded using a hand-held dynamometer connected to the mobilization belt to enforce an immoveable object. The highest value of 3 trails was recorded and used in the data analysis. A strength ratio was calculated by dividing hip adductor strength from hip abductor strength for each leg. A ratio greater than 1 indicated stronger hip abductors.A one-way ANOVA was used to assess hip strength ratio differences for each leg between groups. Results: There was no significant difference between LBP and control groups for hip strength ratios on the right (p=0.785) and left limbs (p=0.237). Conclusion: The results of this study did not display any observable or significant difference between the two groups or corresponding ratio measurements. It is still inconclusive what the role the hip adductors play in patients with LBP.