Lumbar-Hip Flexion Motion: A Comparative Study Between Asymptomatic and Chronic Low Back Pain in 18- to 36-year-old Men

Study Design. The amount of lumbar and hip flexion and the relative contribution within movement during standing forward bending was recorded on a group of asymptomatic men and a group of men with a history of chronic low back pain. Objectives. To compare the relative contribution of the hip and lumbar spine to forward bending in the two groups. Summary of Background Data. The hips and lumbar spine both contribute to the forward bending motion, and an aberrant pattern of contribution in one or both regions could be related to the presence of chronic low back pain. Methods. Thirty-two white men aged 18-36 years (15 with chronic low back pain and 17 asymptomatic) were assessed using a three-dimensional motion analysis system that allowed uninterrupted forward bending. Results. The men with chronic low back pain demonstrated a significant reduction in the mean total range and mean maximum lumbar flexion relative to the asymptomatic group. Mean hip flexion was not significantly different. Data analysis from 120° of gross flexion revealed a subgroup of men with chronic low back pain with a significant decrease in hip flexion. Conclusions. When assessing the relative motion of the lumbar spine and hips in standing forward flexion, there was a measurable difference between asymptomatic men and a group of chronic low back pain patients. In particular, two subgroups of individuals with chronic low back pain appeared; one moved relatively similarly to the asymptomatic group, whereas the other subgroup demonstrated reduced hip mobility. These findings indicate the importance of assessing the lumbar and hip flexion motion in chronic low back pain patients to determine if a movement abnormality is present.

[1]  P. Pynsent,et al.  Influence of Anthropometric Factors and Joint Laxity in the Incidence of Adolescent Back Pain , 1984, Spine.

[2]  T. Mayer,et al.  Use of noninvasive techniques for quantification of spinal range-of-motion in normal subjects and chronic low-back dysfunction patients. , 1984, Spine.

[3]  L. Haugh,et al.  Repeatability of Four Clinical Methods for Assessment of Lumbar Spinal Motion , 1988, Spine.

[4]  M J Pearcy,et al.  New method for the non-invasive three-dimensional measurement of human back movement. , 1989, Clinical biomechanics.

[5]  S. Sahrmann,et al.  Patterns of hip rotation range of motion: a comparison between healthy subjects and patients with low back pain. , 1990, Physical therapy.

[6]  G. Mellin.  Decreased joint and spinal mobility associated with low back pain in young adults. , 1990, Journal of spinal disorders.

[7]  M J Pearcy,et al.  Three-dimensional kinematics of the human back. , 1990, Clinical biomechanics.

[8]  R. Rondinelli,et al.  ESTIMATION OF NORMAL LUMBAR FLEXION WITH SURFACE INCLINOMETRY: A Comparison of Three Methods , 1992, American journal of physical medicine & rehabilitation.

[9]  M. Adams,et al.  Influence of lumbar and hip mobility on the bending stresses acting on the lumbar spine. , 1993, Clinical biomechanics.

[10]  C. Richards,et al.  Hip-spine movement interaction and muscle activation patterns during sagittal trunk movements in low back pain patients. , 1994, Spine.

[11]  T. Mayer,et al.  Physical progress and residual impairment quantification after functional restoration. Part I: Lumbar mobility. , 1994, Spine.

[12]  S. Siegler,et al.  Analysis of Lumbar Spine and Hip Motion During Forward Bending in Subjects With and Without a History of Low Back Pain , 1996, Spine.