Comparison of Lumbopelvic and Hip Movement Patterns During Passive Hip External Rotation in Two Groups of Low Back Pain Patients with and without Rotational Demand Activities.

BACKGROUND Because different groups of people with low back pain (LBP) engage in different tasks, their lumbopelvic-hip complex may move in different ways in those groups. The purpose of this study was to quantify the differences in lumbopelvic movement pattern during the passive hip external rotation (PHER) test in LBP patients with and without rotational demand activities (RDA). MATERIAL AND METHODS A total of 30 subjects with LBP, including 15 patients with-RDA and 15 patients without-RDA were enrolled. A passive hip external rotation test was performed. Pelvic and hip rotation over the full range of the test, timing of hip and pelvic motion, and pelvic rotation in the first half of the movement were measured using a 3-D motion analysis system. RESULTS Passive pelvic rotation during the test in the group with RDA was significantly greater than in the other group. However, there was no significant difference between the groups in other kinematic variables, including hip external rotation, timing of hip and pelvic motion and pelvic rotation in the first half of the movement (p > 0.05). CONCLUSIONS 1. A greater lumbopelvic rotation ROM during the PHER existed in LBP patients who regularly participated in RDA. 2. Different groups of patients with LBP who engage in different specific activities may have a specific lumbopelvic movement pattern impairment. Therefore, each group of LBP patients in regard to their specific activities may need a different, specific plan of treatment

Altered Motor Control in Athletes with Low Back Pain: a Literature Review

Low back pain (LBP) is also one of the most common medical conditions in athletes. There is little doubt that patients with LBP use from their body differently than pain free individuals. The purpose of this review was to investigate changes in motor control which may be present in athletes with LBP. The search strategy for this review consisted of an electronic database search of full text in MEDLINE database. 28 studies met the eligibility criteria, most of which were cross-sectional in nature. The studies were analyzed separately according to the specific sports involved. The studies demonstrate that athletes with LBP exhibit a range of MCI in the trunk, lumbopelvic region and lower extremities. However, inconsistencies were apparent between the results. Athletes with LBP demonstrate MCI during functional and non-functional tasks, similar to non-athletes. More studies, especially large prospective studies which control for non-mechanical factors which may also differ among athletes with LBP are required to determine the relationship between LBP and MCI in athletes

INVESTIGATION OF WEIGHT-BEARING SYMMETRY IN A GROUP OF ATHLETES WITH LOW BACK PAIN AND HEALTHY PEOPLE DURING GAIT

The asymmetrical loading applied to legs was proposed as a risk factor for low back pain development. However, this proposed mechanical risk factor was not investigated in the athletes with LBP engaged in rotational demand activities. The aim of the present study was to examine symmetry of weight-bearing in patients with rotational demand activities compared to that in healthy people during gait. In total, 35 subjects, 15 males with LBP and 20 males without LBP, participated in the study. The participants were asked to walk 12 trials in gait lab. Forces applied to legs were recorded by a force plate. Then, the peaks of anteroposterior, mediolateral, and vertical forces were measured. Next, the asymmetrical loads applied to the legs were calculated. The results of our study demonstrated that people with LBP exhibit more asymmetry of vertical peak forces in heel strike and mid-stance. They also exhibited more asymmetry of loading in the anterior direction. But the mean values of ASI of mediolateral and posterior forces in these participants were not significantly different compared to those in the control group. It can be concluded that, in comparison to the healthy subjects, patients with LBP walk with a greater magnitude of asymmetrical weight-bearing at a comfortable speed

A COMPARISON of the LUMBOPELVIC-HIP COMPLEX MOVEMENT PATTERNS in PEOPLE with and WITHOUT NON-SPECIFIC LOW BACK PAIN during AN ACTIVE HIP TEST

The current study aimed to compare the rhythm of complex lumbopelvic-hip movements in subjects with and without low back pain (LBP) during an active hip internal rotation (AHIR) test. Fifteen professional athletes with LBP were recruited in this analytical study and were compared with 20 age-sex matched healthy people with no history of sports-related rotational movements. A 3D optoelectronic motion analysis system recorded the kinematics of all subjects during an AHIR in the prone position. The outcome measures included the values of hip and pelvic rotation across the test, pelvic rotation during the first half of the test and timing of hip/pelvic rotation in the transverse plane. Then, variables were compared between the two groups. The amount of internal hip rotation of the lower extremities, pelvic rotation in either first half of the pathway or throughout whole path length were all significantly higher in subjects with LBP than the healthy group (p<0.05). Additionally, subjects with LBP showed an earlier movement of the lumbopelvic area than healthy group during the task. Asymmetric movement was seen between the right and left sides of the subjects with LBP for lower limb and hip internal rotation (HIR) ROM. The results demonstrated that the athletes with LBP who use more repetitive movements of their trunk and lower extremities during sports, show increased tendency of lumbopelvic rotation motion during AHIR test

Kinematic differences in lumbopelvic and hip movement patterns during a lower limb movement test between two groups of people with low back pain

Increased lumbopelvic motion during limb movements' tests was reported in low back pain (LBP) patients with and without rotational demand activities. The aim of this study was to compare lumbopelvic movement pattern between two groups of LBP patients with and without rotational demand activity during active hip external rotation test. A total of 39 patients with non-specific chronic LBP participated in this study. Patients were allocated into two groups, in first group 15 subjects (mean age=31.5 years) with rotational demand activities such as tennis, squash and golf, and in second group 24 subjects (mean age=31.2) without rotational demand activities participated in current study. Kinematic data from lumbopelvic-hip region during active hip external rotation test (AHER) were collected by a 3D motion analysis system. Variables including range of motion (ROM) of hip external rotation, pelvic rotation, pelvic rotation during first half of hip rotation motion and timing of pelvic-hip movement were calculated by MATLAB software for both sides and after this, independent t-test was used to compare the variables between two groups of study. The mean lumbopelvic rotation in lower extremities tests for both sides and lumbopelvic rotation in the dominant limb external rotation test in the patients with rotational demand activities were significantly more than other group (p0.05). The result of the study suggest that LBP patients who have rotational demand sports activities may move their lumbopelvic region in a greater magnitude during the AHER test than LBP people without rotational demand activities. Therefore, Lumbopelvic movement pattern in different groups of patients with LBP and based on their specific activities is different with each other