Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending

Abstract

Study DesignCross-sectional study.PurposeTo verify the association of hamstring tightness and range of motion in anterior pelvic tilt (PT), lumbar motion (LM), and trunk flexion (TF) during forward bending.Overview of LiteratureIncreased hamstring stiffness could be a possible contributing factor to low back injuries. Clinical observations have suggested that hamstring tightness influences lumbar pelvic rhythm. Movement restrictions or postural asymmetry likely lead to compensatory movement patterns of the lumbar spine, and subsequently to increased stress on the spinal soft tissues and an increased risk of low back pain (LBP).MethodsHamstring muscle tightness was measured using the self-monitored active knee extension (AKE) test. A bubble inclinometer was used to determine the range of motion of PT, LM, and TF during forward bending. Statistical analysis included descriptive statistics, comparisons between groups and a correlation between hamstring tightness (AKE) and anterior PT, TF, and regional LM with p≤0.05.ResultsThe LBP group was composed of 36 participants, and the asymptomatic group consisted of 32 participants. The mean for PT in the control group was 66.7°, 64.5° for LM and 104.6° for TF. Respective values in the symptomatic group were 57.0°, 79.8°, and 82.2°.ConclusionsParticipants with LBP showed restriction in the pelvis and TF range of motion, but had higher amplitudes in the lumbar spine during forward bending.

Is there evidence to use kinematic/kinetic measures clinically in low back pain patients? A systematic review

“…The highest score recorded was 78% in 4 studies ( Burnett et al, 2004 ; Jayaraman et al, 1994 ; Song et al, 2012 ; Sung et al, 2012 ). Based on Ratcliffe et al's ( Ratcliffe et al, 2014 ) rating score, 27 articles [10, 19–43] were of high, and the remaining 35 articles ( Akinpelu and Adeyemi, 1989 ; Al-Eisa et al, 2006a ; Al-Eisa et al, 2006b ; Aluko et al, 2011 ; Barrett et al, 1999 ; Boline et al, 1992 ; Crosbie et al, 2013a ; Crosbie et al, 2013b ; Cyteval et al, 1996 ; Fenety and Kumar, 1992 ; Freddolini et al, 2014a ; Freddolini et al, 2014b ; Gioftsos and Grieve, 1996 ; Henchoz et al, 2013 ; Jandre Reis and Macedo, 2015 ; Kim et al, 2013 ; Lamoth et al, 2002 ; Lamoth et al, 2006b ; Lee et al, 2011b ; McClure et al, 1997 ; McGregor et al, 1997 ; Morlock et al, 2000 ; Muller et al, 2015 ; Newman et al, 1996 ; Ng et al, 2002 ; Porter and Wilkinson, 1997 ; Shum et al, 2005a ; Shum et al, 2005b ; Shum et al, 2007b ; Vaisy et al, 2015 ; van Wingerden et al, 2008 ; Vismara et al, 2010 ; Vogt et al, 2001 ; Vogt et al, 2003 ; Wong and Lee, 2004 ) were of medium quality. Table 1 shows a quality assessment summary of all included studies indicating potential sources of bias.…”

“…Studies included in the review were published between 1989 and 2015, with the majority published in the last 15 years (49/62) ( Al-Eisa et al, 2006a ; Al-Eisa et al, 2006b ; Aluko et al, 2011 ; Burnett et al, 2004 ; Crosbie et al, 2013a ; Crosbie et al, 2013b ; Dankaerts et al, 2009 ; Dunk and Callaghan, 2010 ; Freddolini et al, 2014a ; Freddolini et al, 2014b ; Gombatto et al, 2015 ; Henchoz et al, 2013 ; Jandre Reis and Macedo, 2015 ; Kim et al, 2013 ; Kim et al, 2014 ; Kim and Yoo, 2015 ; Lamoth et al, 2002 ; Lamoth et al, 2006a ; Lamoth et al, 2006b ; Larivière et al, 2011 ; Lee et al, 2011a ; Lee et al, 2011b ; Mitchell et al, 2008 ; Morlock et al, 2000 ; Muller et al, 2015 ; Ng et al, 2002 ; Park et al, 2012 ; Sanchez-Zuriaga et al, 2011 ; Seay et al, 2011 ; Shum et al, 2005a ; Shum et al, 2005b ; Shum et al, 2007a ; Shum et al, 2007b ; Song et al, 2012 ; Sung, 2013 ; Sung et al, 2012 ; Taylor et al, 2003 ; Taylor et al, 2004 ; Vaisy et al, 2015 ; van den Hoorn et al, 2012 ; Van Hoof et al, 2012 ; van Wingerden et al, 2008 ; Vismara et al, 2010 ; Vogt et al, 2001 ; Vogt et al, 2003 ; Wong and Lee, 2004 ). Most of the studies (34/62) ( Boline et al, 1992 ; Crosbie et al, 2013a ; Crosbie et al, 2013b ; Cyteval et al, 1996 ; Dunk and Callaghan, 2010 ; Esola et al, 1996 ...…”

“…Chronic LBP patients were recruited in 37 studies ( Akinpelu and Adeyemi, 1989 ; Boline et al, 1992 ; Burnett et al, 2004 ; Crosbie et al, 2013a ; Crosbie et al, 2013b ; Cyteval et al, 1996 ; Dankaerts et al, 2009 ; Gioftsos and Grieve, 1996 ; Henchoz et al, 2013 ; Jandre Reis and Macedo, 2015 ; Jayaraman et al, 1994 ; Kim et al, 2014 ; Lamoth et al, 2002 ; Lamoth et al, 2006a ; Lamoth et al, 2006b ; Lariviere et al, 2000 ; Larivière et al, 2002 ; Larivière et al, 2011 ; Lee et al, 2011a ; Lee et al, 2011b ; McClure et al, 1997 ; Muller et al, 2015 ; Newcomer et al, 2000 ; Ng et al, 2002 ; Park et al, 2012 ; Porter and Wilkinson, 1997 ; Sanchez-Zuriaga et al, 2011 ; Seay et al, 2011 ; Sung, 2013 ; Vaisy et al, 2015 ; van den Hoorn et al, 2012 ; Van Hoof et al, 2012 ; van Wingerden et al, 2008 ; Vismara et al, 2010 ; Vogt et al, 2001 ; Vogt et al, 2003 ; Wong and Lee, 2004 ), 9 studies ( Aluko et al, 2011 ; Freddolini et al, 2014a ; Freddolini et al, 2014b ; Shum et al, 2005a ; Shum et al, 2005b ; Shum et al, 2007a ; Shum et al, 2007b ; Taylor et al, 2003 ; Taylor et al, 2004 ) recruited acute LBP patients and 5 studies had a mix of chronic and acute LBP patients ( Dunk and Callaghan, 2010 ; Esola et al, 1996 ; Gombatto et al, 2015 ; Song et al, 2012 ; Sung et al, 2012 ). In 11 articles the type of LBP (e.g.…”

Examining and comparing the health and performance indices of university undergraduate students according to year of study and gender

“…This could reflect that BP does not serve as a predisposing agent for increase or decline in LBHF. Although LBHF is a function of muscular movement along the trunk where the heart is anatomically located, LBHF is mostly associated with hamstring muscles: semimembranous, semitendinous, and biceps femoris, located in the back of the thigh with a connection to the lower pelvis of the lower leg ( Jandre Reis and Macedo, 2015 ). This could imply that range of motion at the trunk region of the body may not be majorly required during cardiovascular mechanism for moderate aerobic to high intensity activities of healthy living.…”

A physical therapist’s role in pain management: A biopsychosocial perspective

“…Oftentimes, a physical test that determines a range of motion is performed, which is then compared to accepted normal values matched to the patient's age, gender, and current activity level. Some pain has been associated with reduced range of motion, such as LBP being associated with reduced knee extension angles, trunk flexion, and pelvic tilt range of motion (Reis & Macedo, 2015). For this reason, tests often include measuring both active and passive ranges of motion (Petersen & Hayes, 2000).…”