Differences in lumbopelvic motion between people with and people without low back pain during two lower limb movement tests

Abstract

Background: Clinical data suggest that active limb movements may be associated with early lumbopelvic motion and increased symptoms in people with low back pain.

Methods: Forty-one people without low back pain who did not play rotation-related sports and 50 people with low back pain who played rotation-related sports were examined. Angular measures of limb movement and lumbopelvic motion were calculated across time during active knee flexion and active hip lateral rotation in prone using a three-dimensional motion capture system. Timing of lumbopelvic motion during the limb movement tests was calculated as the difference in time between the initiation of limb movement and lumbopelvic motion normalized to limb movement time.

Findings: During knee flexion and hip lateral rotation, people with low back pain demonstrated a greater maximal lumbopelvic rotation angle and earlier lumbopelvic rotation, compared to people without low back pain (P<0.05).

Interpretation: The data suggest that people with low back pain who play rotation-related sports may move their lumbopelvic region to a greater extent and earlier during lower limb movements than people without low back pain. Because people perform many of their daily activities in early to midranges of joint motion the lumbopelvic region may move more frequently across the day in people with low back pain. The increased frequency may contribute to increased lumbar region tissue stress and potentially low back pain symptoms. Lower limb movements, therefore, may be important factors related to the development or persistence of low back pain.

Figure 1

Kinematic model with lumbopelvic rotation (θ) calculation. IC = iliac crest.

Figure 2

Kinematic model with calculations for knee flexion (β) and anterior pelvic tilt (λ). LM = lateral malleolus, K = lateral knee joint line, GT = greater trochanter, IC = iliac crest.