Three-Dimensional Kinetics of the Lumbar Spine and Hips in Low Back Pain Patients During Sit-to-Stand and Stand-to-Sit

Shum, Gary L.; Crosbie, Jack; Lee, Raymond Y.W.

doi:10.1097/01.brs.0000259204.05598.10

Cited by 99 publications

(77 citation statements)

References 41 publications

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“…Several studies have focused on the interaction between the lumbar spine and pelvis during diverse active movements such as stand-to-sit or gait and how it is altered in subjects with LBP [30,31]. These results suggest that the pelvic segment demonstrates increased axial trunk rotation during the tasks, which is consistent with our results.…”

Section: Discussionsupporting

confidence: 91%

A kinematic analysis of relative stability of the lower extremities between subjects with and without chronic low back pain

Song²,

Lee³

et al. 2011

Eur Spine J

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Even though a number of studies have evaluated postural adjustments based on kinematic changes in subjects with low back pain (LBP), kinematic stability has not been examined for abnormal postural responses during the one leg standing test. The purpose of this study was to evaluate the relative kinematic stability of the lower extremities and standing duration in subjects with and without chronic LBP. In total, 54 subjects enrolled in the study, including 28 subjects without LBP and 26 subjects with LBP. The average age of the subjects was 37.8 ± 12.6 years and ranged from 19 to 63 years. The outcome measures included normalized holding duration and relative kinematic stability. All participants were asked to maintain the test position without visual input (standing on one leg with his/her eyes closed and with the contra lateral hip flexed 90°) for 25 s. The age variable was used as a covariate to control confounding effects for the data analyses. The control group demonstrated significantly longer holding duration times (T = -2.78, p = 0.007) than the LBP group (24.6 ± 4.2 s vs. 20.5 ± 6.7 s). For the relative kinematic stability, there was a difference in dominance side (F = 9.91, p = 0.003). There was a group interaction between side and lower extremities (F = 11.79, p = 0.001) as well as an interaction between age and dominance side (F = 7.91, p = 0.007). The relative kinematic stability had a moderate negative relationship with age (r = -0.60, p = 0.007) in subjects without LBP. Clinicians need to understand the effects of age and relative stability, which decreased significantly in the single leg holding test, in subjects with LBP in order to develop effective rehabilitation strategies.

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Section: Discussionsupporting

confidence: 91%

A kinematic analysis of relative stability of the lower extremities between subjects with and without chronic low back pain

Song²,

Lee³

et al. 2011

Eur Spine J

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“…Subjects with recurrent LBP were able to complete a task by increasing lumbar and hip movements in the frontal and horizontal planes of motion while limiting movements in the sagittal plane [33,34]. This uncoordinated axial rotation of the trunk might be a risk factor in connection with spinal injuries during twisting activities.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting shoulder–pelvic integration during axial trunk rotation in subjects with recurrent low back pain

et al. 2012

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Introduction Shoulder-pelvic integration could play a central role in the control of dynamic posture and movement. However, kinematic coordination during axial trunk rotation has not been carefully investigated in subjects with recurrent low back pain (LBP). The purpose of this study was to compare the maximum rotational angles of the shoulders and pelvis in the transverse plane between subjects with and without recurrent LBP. Materials and methods A total of 38 age-matched subjects (19 control subjects: 69.00 ± 5.75 years old and 19 subjects with LBP: 68.79 ± 5.40 years old) participated in the study. The axial trunk rotation test was conducted in the upright position with bilateral hips and knees fully extended and both feet shoulder width apart. Results The results of this study indicated that there was a difference in pelvic girdle rotation between groups (100.79 ± 26.46 in the control group, 82.12 ± 23.16 in the LBP group; t = 2.31, p = 0.02); however, there was no difference for the shoulder girdle (177.63 ± 36.98 in the control group, 156.42 ± 30.09 in the LBP group; t = 1.91, p = 0.06). There were interactions with age (F = 9.27, p = 0.004) and BMI (F = 7.50, p = 0.01) with the rotational angles of the shoulder and pelvis. Conclusion These results indicated a different pattern of trunk rotation movement with the age and BMI serving as important factors to consider for recurrent LBP. The results of our study also indicated a different pattern of shoulder and pelvic coordination with age and gender. Clinicians need to consider the consequences of limited shoulderpelvic rotational angles, especially limited rotational angle on the pelvis during trunk axial rotation. Further studies are required to determine the causes of the underlying problems for clinical decision-making and altered shoulderpelvic rotation in subjects with recurrent LBP.

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“…The majority of the population experience non-specific low-back pain (LBP) at least once in a lifetime [1,2]. Non-specific LBP comprises a large proportion of LBP cases, and the cost of treating LBP is high [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Since the hip joint and lumbar spine are both adjacent to the pelvis, the hip joint moves in cooperation with the lumbar spine to provide functional movement [20][21][22]. However, limited hip flexion range can be a risk factor contributing to musculoskeletal pain syndromes, changing mechanical forces, and potentially leading to excessive stress in the lumbopelvic region [1,2,23,24]. In previous studies, it has been demonstrated that insufficient hip mobility contributes to excessive lumbar motion during forward bending, resulting in LBP [24].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, hip flexion motion in sitting is frequently used for strengthening and manual muscle testing of the hip flexor muscle. Although the association between LBP and hip flexibility is considered important, effects on the lumbopelvic region have not been assessed sufficiently during seated hip flexion in patients with LBP [1,2,23,24]. Thus, clinicians and researchers must focus on examining hip motion to consider the effects of limited hip flexion in sitting in terms of kinematic changes in lumbopelvic motion.…”

Section: Introductionmentioning

confidence: 99%

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Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion

Kim

Cynn

et al. 2013

Eur Spine J

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Purpose Limited hip flexion may lead to a poor lumbopelvic motion during seated active hip flexion in people with low-back pain (LBP). The purpose of this study was to compare lumbopelvic motion during seated hip flexion between subjects with and without LBP accompanying limited hip flexion. Methods Fifteen patients with LBP accompanying limited hip flexion and 16 healthy subjects were recruited. The subjects performed seated hip flexion with the dominant leg three times. A three-dimensional motion-analysis system was used to measure lumbopelvic motion during seated hip flexion. Results During seated active hip flexion, the angle of hip flexion was significantly lower in patients with LBP accompanying limited hip flexion (17.4 ± 4.4 in the LBP group, 20.8 ± 2.6 in the healthy group; t = 2.63, p = 0.014). The angle of the lumbar flexion (4.8 ± 2.2 in the LBP group, 2.6 ± 2.0 in the healthy group; t = -2.96, p = 0.006) and posterior pelvic tilting (5.0 ± 2.6 in the LBP group, 2.9 ± 2.0 in the healthy group; t = 2.48 p = 0.019), however, were significantly greater in patients with this condition. Conclusions The results of this study suggest that limited hip flexion in LBP can contribute to excessive lumbar flexion and posterior pelvic tilting during hip flexion in the sitting position. Further studies are required to confirm whether improving the hip flexion range of motion can reduce excessive lumbar flexion in patients with LBP accompanying limited hip flexion.

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Three-Dimensional Kinetics of the Lumbar Spine and Hips in Low Back Pain Patients During Sit-to-Stand and Stand-to-Sit

Abstract: Back pain subjects exhibit compensatory movements and altered load sharing strategies during the sit-to-stand and stand-to-sit activities. Exercise therapy should take account of these changes so that the normal kinematic and kinetic characteristics of the spine and hips can be restored.

Cited by 99 publications

References 41 publications

A kinematic analysis of relative stability of the lower extremities between subjects with and without chronic low back pain

A kinematic analysis of relative stability of the lower extremities between subjects with and without chronic low back pain

Factors affecting shoulder–pelvic integration during axial trunk rotation in subjects with recurrent low back pain

Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion

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