Abstract
BackgroundImpaired lumbo-pelvic movement in people with low back pain during bending task has been reported previously. However, the regional mobility and the pattern of the lumbo-pelvic movement were found to vary across studies. The inconsistency of the findings may partly be related to variations in the speed at which the task was executed. This study examined the effects of bending speeds on the kinematics and the coordination lumbo-pelvic movement during forward bending, and to compare the performance of individuals with and without low back pain.MethodsThe angular displacement, velocity and acceleration of the lumbo-pelvic movement during the repeated forward bending executed at five selected speeds were acquired using the three dimensional motion tracking system in seventeen males with low back pain and eighteen males who were asymptomatic. The regional kinematics and the degree of coordination of the lumbo-pelvic movement during bending was compared and analysed between two groups.ResultsSignificantly compromised performance in velocity and acceleration of the lumbar spine and hip joint during bending task at various speed levels was shown in back pain group (p < 0.01). Both groups displayed a high degree of coordination of the lumbo-pelvic displacement during forward bending executed across the five levels of speed examined. Significant between-group difference was revealed in the coordination of the lumbo-pelvic velocity and acceleration (p < 0.01). Asymptomatic group moved with a progressively higher degree of lumbo-pelvic coordination for velocity and acceleration while the back pain group adopted a uniform lumbo-pelvic pattern across all the speed levels examined.ConclusionsThe present findings show that bending speed imposes different levels of demand on the kinematics and pattern of the lumbo-pelvic movement. The ability to regulate the lumbo-pelvic movement pattern during the bending task that executed at various speed levels was shown only in pain-free individuals but not in those with low back pain. Individuals with low back pain moved with a stereotyped strategy at their lumbar spine and hip joints. This specific aberrant lumbo-pelvic movement pattern may have a crucial role in the maintenance of the chronicity in back pain.
Highlights
Impaired lumbo-pelvic movement in people with low back pain during bending task has been reported previously
The average peak values of the kinematic variables obtained from the three selected cycles of bending at each of the 5 speed levels were used for the data analysis
The reliability of the data on the kinematic lumbar spine/hip joint variables was examined by calculating intra-class correlation coefficients (ICCs [1, 3]) (Table 2)
Summary
Impaired lumbo-pelvic movement in people with low back pain during bending task has been reported previously. This study examined the effects of bending speeds on the kinematics and the coordination lumbo-pelvic movement during forward bending, and to compare the performance of individuals with and without low back pain. Forward bending while standing is frequently used in the clinical assessment of spinal movement and motor control in people with back dysfunctions [8,9,10]. Previous studies have shown conflicting results in the motion analysis of the lumbo-pelvic region during trunk flexion in patients with LBP. Esola et al reported that, in bending forward while standing, people with LBP moved with a similar degree of mobility at both the lumbar spine and hip joint as healthy individuals [11]. It is not possible to assess the control and coordination of movements of the lumbar and hip complex
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