Lumbar Mobility Research Articles

Effects of Decompression therapy in leg pain and straight leg rise in patient with lumbar radiculopathy due to disc protrusion

One among many disc problems is disc protrusion, which has more prevalence in outpatient department physical therapy management Centre globally. The purpose of this study was to compare the effect of lumbar spine decompression therapy and standard physical therapy treatment in patients with lumbar radiculopathy due to disc protrusion. The single-blind randomized control trial of 71 patients was conducted at Max Rehab & Physical Therapy Centre Islamabad, Pakistan. After setting inclusion criteria all the patients were randomly allocated into treatment and control group. Both group received standard physical therapy treatment including, Moist Hot pack, Lumbar Mobilization, Stretching & strengthening exercises. The only difference was that Decompression Group received additional Decompression therapy. The data included demographics and Numeric Pain Rating Scale score in supine lying position for the painful leg and Straight Leg Raise Range for the painful side. The values for leg pain for control group decreased from 6 to 3 and the value for straight leg raise increased from 15° to 49°. The values for leg pain for the Decompression Group decreased from 6 to 2 and the value for the straight leg raise increased from 10° to 48°, the p value for both the variables was <.001 showing statistically significant difference between pre and post values in treating patients leg pain and straight leg raise range of motion. It is concluded that decompression therapy is more effective in managing lumbar radiculopathy.

Effectiveness of Lumbar Belt on Pain and Lumbar Mobility in Patients with Chronic Low Back Pain- An Experimental Study

Effectiveness of Lumbar Belt on Pain and Lumbar Mobility in Patients with Chronic Low Back Pain- An Experimental Study

The relationship between trunk control, spinal posture, and spinal mobility in patients with multiple sclerosis: a cross-sectional study.

Trunk control, which plays a key role in balance and mobility, decreases in patients with multiple sclerosis (PwMS) and many parameters such as sensory, motor, and musculoskeletal systems affect trunk control. The aim of this study was to compare trunk control, spinal mobility, and spinal posture in PwMS with healthy controls and investigate the relationship between trunk control with spinal posture and spinal mobility in PwMS. The study was completed with 38 PwMS and 38 healthy controls with matched age and sex. Trunk control was evaluated with the Trunk Impairment Scale (TIS). Spinal posture and mobility were evaluated in sagittal and frontal planes using an IDIAG M360 Spinal Mouse. Spinal posture was evaluated in upright, maximum flexion, extension, left and right lateral flexion positions, and spinal mobility was evaluated from upright to flexion, extension, right and left flexion positions in sagittal and frontal planes. TIS scores, thoracic mobility angles (from upright to flexion and left lateral flexion), lumbar mobility angles (from upright to extension and right lateral flexion) and lumbar posture angle (maximum right lateral flexion) were lower, and thoracic posture angles (upright and maximum extension) were higher in PwMS than healthy controls (p < 0.05). No significant difference was found between other spinal postures and mobility values. In addition, there was only a negative relationship between thoracic spinal mobility from upright to extension and trunk control in PwMS (r = -0.349; p = 0.032). These findings indicate the importance of early detection of trunk disturbances in PwMS. Thus, even in the early stages of multiple sclerosis, detailed trunk assessment will guide the implementation of comprehensive exercise programs.

The effect of stretching exercises on the mobility of the spine in the sagittal plane in people using digital devices – preliminary observations

Introduction. Digital devices and a sedentary lifestyle pose significant health risks in today’s society, further exacerbated by the regular adoption of incorrect posture. Prolonged adoption of an incorrect posture can result in pain and impaired spinal mobility. Aim of the study. The study aims to evaluate the impact of stretching exercises on improving cervical, thoracic and lumbar spine mobility in the sagittal plane. Furthermore, it sought to examine the potential correlation between the occurrence of pain and the duration of digital equipment usage. Study materials and methodology. The study was conducted on a sample group of 22 individuals aged 18 to 21 (20.11 ± 1.56) years. Linear measurements, including the Schober and Otto-Wurm tests, were used to examine spinal mobility in the sagittal plane. The subjects were given a 10-day programme comprising six stretching exercises to perform autonomously daily. After ten days, line measurements were retaken. Results. Significant statistical values were observed for spinal ranges of motion in the sagittal plane; no statistically significant value was obtained for the incidence of pain and the duration of use of digital devices. Conclusions. The subjects demonstrated improvement in cervical, thoracic, and lumbar spine mobility in the sagittal plane following the implementation of stretching exercises. Additionally, a decrease in spinal pain was observed.

Investigation of the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in unilateral breast cancer surgery survivors: a cross-sectional study.

Despite the research on structural and functional changes that may occur in breast cancer survivors, no study has investigated the relationship between spinal characteristics and the respiratory system. Therefore, we aimed to investigate the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in breast cancer patients who have completed their treatment METHODS: This cross-sectional study included 38 female breast cancer surgery survivors. Participants underwent the following evaluations: Chest wall mobility with a tapeline; postural assessments (spinal curvature, spinal mobility, and spinal inclination) with a non-invasive, computer-assisted electromechanical device; and pulmonary function test and respiratory muscle strength with a portable digital spirometer device. The relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions was analyzed by the bivariate correlation analysis. Increased thoracic curvature angle was associated with decreased FEV1 (r=-0.360, p=0.026) and decreased subcostal mobility (r=-0.385, p=0.017), and the increase in thoracic frontal mobility was associated with decrease in PEF (r=-0.342, p=0.036). Increased lumbar mobility was associated with increased FVC (r=0.324, p=0.047), and increased total spinal inclination mobility was associated with decreased MIP (r=-0.396, p=0.017). Chest wall mobility was associated with postural assessments at varying rates (the r value ranged from -0.357 to 0.661, p<0.05). The changes in spinal posture and mobility of women who have undergone unilateral breast cancer surgery were associated with respiratory parameters and thoracic cage mobility. These patients' spinal posture and mobility should be taken into account in conjunction with respiratory functions for a comprehensive assessment.

The impact of protrusion size on pain, range of motion, functional capacity, and multifidus muscle cross-sectional area in lumbar disc herniation.

To investigate the effect of protrusion amount on pain, lumbar mobility, physical dysfunction, and the cross-sectional area of the multifidus muscle in patients with lumbar disc herniation. 54 male patients aged 20 to 50 years were included in this study in 2 groups. The control group (n = 18) consisted of patients with disc herniation without nerve root compression, and the study group (n = 36) consisted of patients with lumbar disc herniation and nerve root compression in 3 subgroups according to the amount of protrusion. The multifidus muscle cross-sectional area and the amount of protrusion were measured using Magnetic Resonance Imaging. Pain intensity was measured using the Visual Pain Scale, physical dysfunction was measured using the Oswestry Disability Index, flexion-extension was measured with TiltMeter, and trunk rotation was measured with smartphone applications called iPhone Compass. There were no differences in pain levels (P > .05), mean trunk rotation movements of the affected and unaffected sides (P = .001, P = .001, P = .983, and P = .954, respectively), Oswestry Disability Index results (P = .967), or cross-sectional area sizes of the multifidus muscle (P = .866, P = .552, P = .787, respectively). There was a difference between the groups in terms of the mean trunk flexion and extension movement values (P = .001). The regression analysis indicated that there was no significant correlation between the binary variables, and the models exhibited a low explanatory rate for the dependent variable. A relationship has been identified between lumbar disc herniation and low back pain, lumbar movement limitation, and physical functionality. Nevertheless, subsequent to the regression analysis, it became evident that the binary variables did not exhibit a noteworthy relationship, leading to a decrease in the explanatory capacity of the models for the dependent variable. In forthcoming studies, it is advisable to contemplate the augmentation of the subject pool or the incorporation of multiple independent variables into the regression analysis as potential strategies to enhance the model capability in elucidating variations in the dependent variable.

Treatment of Lumbar Degenerative Disease with a Novel Interlaminar Screw Elastic Spacer Technique: A Finite Element Analysis.

A novel interlaminar elastic screw spacer technique was designed to maintain lumbar mobility in treating lumbar degenerative diseases. A validated finite element model of L4/5 was used to establish an ISES-1/2 model and an ISES-1/3 model based on different insertion points, a unilateral fixation model and a bilateral fixed model based on different fixation methods, and a Coflex-F model based on different implants. The elastic rods were used to fix screws. Under the same mechanical conditions, we compared the biomechanical characteristics to investigate the optimal entry point for ISES technology, demonstrate the effectiveness of unilateral fixation, and validate the feasibility of the ISES technique. Compared to ISES-1/3, the ISES-1/2 model had lower intradiscal pressure, facet cartilage stress, and posterior structural stress. Compared to the ISES-BF model, the ISES-UF model had lower intervertebral pressure, larger mobility, and smaller stress on the posterior structures. The ISES model had a similar intervertebral pressure and limitation of extension as the Coflex-F model. The ISES model retained greater mobility and reduced the stress on the facet cartilage and posterior structure compared with the Coflex-F model. Our study suggests that the ISES technique is a promising treatment of lumbar degenerative diseases, especially those with osteoporosis.

Differences in spinal postures and mobility among adults with Prader-Willi syndrome, essential obesity, and normal-weight individuals.

Spinal kinematics/motion are reported to be altered in adolescents and adults with essential obesity, while no information is available in patients with Prader-Willi syndrome so far. The aim of this study was to examine cross-sectionally the characteristics of spinal postures and mobility in 34 patients with PWS, in 35 age- and sex-matched adults with essential obesity, and in 37 normal-weight individuals. Spinal posture and mobility were assessed using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Differences in spinal posture and mobility between the three groups were determined using a two-way analysis of variance. Adults with Prader-Willi syndrome had greater thoracic kyphosis [difference between groups (Δ) = 9.60, 95% CI 3.30 to 15.60, p = 0.001], less lumbar lordosis (Δ = -6.50, 95% CI -12.70 to -0.30, p = 0.03) as well as smaller lumbar and hip mobility than those with normal weight. Although the characteristics of the spine in patients with Prader-Will syndrome appear to be similar to that found in subjects with essential obesity, Prader-Willi syndrome was found to influence lumbar movements more than thoracic mobility. These results provide relevant information about the characteristics of the spine in adults with Prader-Willi syndrome to be taken into careful consideration in the management of spinal conditions. These findings also highlight the importance of considering the musculoskeletal assessment of spinal postures and approaches targeting spinal and hip flexibility in adults with Prader-Willi syndrome.

Electrical dry needling versus a non-invasive multicomponent intervention in the treatment of myofascial trigger points in patients with chronic low back pain: A randomised clinical trial

Objective To compare the effects of electrical dry needling with a non-invasive multi-component intervention in patients with chronic low back pain. Design A randomised single-blind clinical trial. Setting Outpatient Physiotherapy Clinic; home. Participants Sixty-four patients with chronic low back pain aged 30–65 years. Interventions Six-week electrical dry needling on myofascial trigger points, and a non-invasive multicomponent intervention (home exercise programme, stretching and ischemic compression). Main measures Pain (Visual Analogue Scale), disability (Roland-Morris Disability Questionnaire and Oswestry Disability Index), kinesiophobia (Tampa Scale of Kinesiophobia), quality of life and sleep (Short Form 36-item Health Survey and Pittsburgh Sleep Quality Index), isometric endurance of trunk flexor muscles (McQuade test), lumbar mobility in flexion (finger-to-floor distance), and pressure pain threshold (algometer) were assessed at baseline, after 6 weeks, and after 2 months. Results ANOVA showed statistically significant differences in group-by-time interaction for most pain pressure thresholds of myofascial trigger points (P < 0.05), for disability (Roland-Morris Disability Questionnaire: F = 6.14, P = 0.016; and Oswestry Disability Index: F = 7.36, P = 0.009), for trunk anteflexion (F = 10.03, P = 0.002) and for habitual sleep efficacy (F = 6.65, P = 0.012), use of hypnotics (F = 4.77, P = 0.033) and total score of quality of sleep (F = 8.23, P = 0.006). Conclusions In comparison to a non-invasive multicomponent intervention, electrical dry needling has more positive effects on disability, pain intensity, kinesiophobia, and reducing patients’ sensitivity to myofascial trigger points pressure, at post-treatment and at 2 months. Clinical Trial Registration number NCT04804228. Registered on May 28th, 2021. Available at https://clinicaltrials.gov/ct2/show/NCT04804228

To Compare The Two Approaches Of Nerve Flossing Technique On Pain, Lumbar Mobility And Straight Leg Raise In Subjects With Sciatica

Background: Sciatica is one of the most common painful and disabling conditions. Nerve flossing technique commonly called as neural mobilization are the forms of manual therapy that are used in an effort to reduce radiating pain and improve range of motion. A wide range of physical therapy interventions have been proposed to be effective, however the efficacy of neural mobilization technique is still undetermined in developing countries like India. Purpose: A study to compare the two approaches of nerve flossing technique on pain, lumbar mobility and striaght leg raise in subjects with sciatica. Study design: Quasi- Experimental study, comparative in nature Methodology: A total of 45 subjects were selected for the study as per inclusion and exclusion criteria between age group of 20-55 years. Participants were divided into 3 groups of 15 subjects each. Group A (control), Group B (Experimental-1) and Group C (experimental-2). Group A was receive Transcutaneous Electrical Nerve Stimulation (TENS), Hydro-collateral pack, Group B was receive slider mobilization (Nerve Flossing Technique) and Group C was receive single joint mobilization on knee (Nerve Flossing Technique). The baseline data was recorded on 1th day (pre- intervention) and 5th day (post-intervention) and then on 10th day (post-intervention). Total 10 sessions per subject was given over 2 weeks i.e., 5 sessions per week. The collected Data was analyzed by using ANOVA and other statistical tests as appropriate Results: The result showed significant improvement in slider mobilization on pain, lumbar mobility and striaght leg raise in subjects with sciatica. Conclusion: The present study concludes that slider mobilization is most effective nerve flossing technique in improving pain, lumbar mobility and striaght leg raise in subjects with sciatica. Trial registration number (TRN): Not applicable.

Relationship between low back mobility test and low back pain in amateur paddle tennis players

BACKGROUND: There is not enough scientific literature to determine whether the deficit in lumbar mobility may be associated with pain in the lumbar region in paddle tennis players.METHODS: Analytical, observational, and cross-sectional study design. The range of low back mobility was assessed among a sample of 34 paddle tennis players. Modified-Modified Schöber Test (MMST), Toe-touch Test (TTT), FMS® scores from the Deep Squat (DS) and lumbar flexion measurement in the final position of the deep squat (LBM in FMS® DS) were selected.RESULTS: Significant differences were obtained in LBM in FMS® DS (P=0.014) in relation to presence/absence of low back pain. A moderate positive correlation was obtained between TTT and LBM in FMS® DS (0.517) in the no low back pain group, whereas a considerable negative correlation between TTT and LBM in FMS® DS (-0.592) was stated in the group with low back pain. A “high” positive correlation (0.721) between the MMST and the LBM in FMS® DS. A “considerable” negative correlation (-0.672) be-tween TTT and LBM in FMS® DS was also found.CONCLUSIONS: Low back mobility test and low back pain are related in amateur paddle tennis players.

Lumbopelvic Muscle Mobility and Resistance and their Association with Musculoskeletal Pain in Ballet Dancers.

Objective The present study analyzes ankle mobility and lumbopelvic muscle mobility and resistance. In addition, it identifies factors associated with musculoskeletal pain in young ballet dancers. Methods This is a quantitative, descriptive, cross-sectional study evaluating 14 ballet dancers aged 12 to 16 years old. We used the following instruments: a) Nordic Musculoskeletal Symptom Questionnaire (NSQ) for musculoskeletal pain assessment; b) leg lateral reach test, lumbar lock, and rotation test (for trunk mobility analysis) and lunge test (for ankle mobility evaluation); c) front bridge, lumbar extensor, and lumbar flexor muscles tests to assess lumbopelvic complex resistance. Results The main complaints reported by ballet dancers were pain in the low back area and in the lower extremities, especially in the knee (57.1%). Those with low back pain had significantly lower lumbar mobility ( p = 0.05) and lower ankle mobility on both sides ( p ≤ 0.05). Dancers with knee pain presented significantly lower muscular trunk extensor muscle resistance ( p = 0.05). Conclusions Our study revealed significant associations between the lumbopelvic complex function and musculoskeletal symptoms, supporting the implementation of preventive strategies.

Study on the Effect of Acupuncture, Massage, and Functional Exercise in the Treatment of Patients with Lumbar Disc Herniation

Lumbar intervertebral disc herniation is a common orthopedic disease, mainly manifested by low back pain, weakness, paralysis of lower extremity sarcomere, or abnormal distribution of dermatomes. Surgery is required in 10%-18% of patients. For lumbar disc herniation, the common ones include posterior small incision discectomy, percutaneous endoscopic lumbar discectomy, posterior microendoscopic discectomy, and foraminal endoscopic nucleus pulposus removal, Intervertebral fusion, etc. However, it is often accompanied by residual symptoms such as lumbar mobility disorder, lumbar swelling and pain, abdominal distension, constipation, lower limb strength, and hyperalgesia in the nerve root innervation area of the lower limb. Acupuncture has the characteristics of simple treatment, effective effect, and high acceptance. It can relieve postoperative pain and improve various physiological and biochemical functions by regulating qi, blood, yin, and yang. With the continuous development and change of acupuncture techniques, traditional acupuncture treatments and various innovative acupuncture treatments have achieved good clinical effects in rehabilitation.

Effectiveness of a Manual Therapy Protocol in Women with Pelvic Pain Due to Endometriosis: A Randomized Clinical Trial.

A randomized controlled trial was carried out to assess the effectiveness of a manual therapy protocol in terms of the clinical characteristics, quality of life, and emotional condition of the women with endometriosis-related pelvic pain. Forty-one women (mean age of 36.10 (6.97) years) with pelvic pain due to endometriosis were randomly divided into (i) a manual therapy group (MTG) (n = 21) and (ii) a placebo group (PG) (n = 20). Both groups received an 8-week intervention. Pain, lumbar mobility, endometriosis health profile, quality of life, depression and anxiety levels, and the patient's perception of change were assessed before (T0) and after (T1) the intervention, as well as at a one-month follow-up (T2) and a six-month follow-up (T3). The MTG significantly improved pain intensity, powerlessness, lumbar mobility, and physical quality of life at T1 (p < 0.05). The results were maintained for pain intensity at T2 and T3. In addition, both the MTG and PG improved emotional wellbeing at T1 (p < 0.05). Neither group improved in terms of social support, self-image, and depression and anxiety levels after the intervention (p > 0.05). In conclusion, manual therapy may be an excellent complement to the gynecological treatment of endometriosis-related pelvic pain by alleviating pain and improving women's endometriosis health profile and physical quality of life.

Effect of Posteroanterior Lumber Spine Mobilization Versus McKenzie Prone Push Ups on Pain and Functional Disability in Subjects with Non-Specific Low Back Pain

85% of the population has non-specific back pain. Posteroanterior (PA) lumbar mobilization and Push-up exercises are primarily used in physical therapy for back pain. Objective: To know the outcomes of posteroanterior spinal mobilization and prone push-ups on nonspecific lower back pain. Methods: The randomized clinical trial was done with 30 subjects meeting inclusion criteria and were randomly selected by non-probability/purposive sampling technique from the Department of Physical Therapy, Mayo Hospital Lahore. The 4 weeks study was conducted in which 2 groups with 15 in each group were formed. Group I was treated with PA lumbar glide while group II was treated with prone Push-ups. VAS and functional disability index were used to evaluate pre-treatment and post-treatment. Results: A significant decrease in mean pain score was noted in both groups. Results did not show any statistically significant differences between groups for any parameter. The study has given evidence that supports the use of posteroanterior mobilization and prone push-ups to reduce pain, improve range of movement, and disability reduction in patients with nonspecific low back pain. It also showed that posteroanterior mobilization was more beneficial than prone Push-ups. Conclusion: Both PA mobilization and Push-ups can be used as effective maneuvers for the treant of non-specific low back pain

Finger-Floor Distance Is Not a Valid Parameter for the Assessment of Lumbar Mobility

Low back pain (LBP) could be associated with a reduced lumbar mobility. For the evaluation of lumbar flexibility, parameters such as finger-floor distance (FFD) are historically established. However, the extent of the correlation of FFD to lumbar flexibility or other involved joint kinematics such as pelvic motion, as well as the influence of LBP, is not yet known. We conducted a prospective cross-sectional observation study with 523 participants included (167 with LBP > 12 weeks, 356 asymptomatic). LBP-participants were matched for sex, age, height, and body-mass-index with an asymptomatic control cohort, resulting in two cohorts with 120 participants each. The FFD in maximal trunk flexion was measured. The Epionics-SPINE measurement-system was used to evaluate the pelvic and lumbar Range-of-Flexion (RoF), and the correlation of FFD to pelvic- and lumbar-RoF was evaluated. In an asymptomatic sub-cohort of 12 participants, we examined the individual correlation of FFD to pelvic- and lumbar-RoF under gradual trunk flexion. Participants with LBP showed a significantly reduced pelvic-RoF (p < 0.001) and lumbar-RoF (p < 0.001) as well as an increased FFD (p < 0.001) compared to the asymptomatic control cohort. Asymptomatic participants exhibited a weak correlation of FFD to pelvic-RoF and lumbar-RoF (r < 0.500). LBP patients revealed a moderate correlation of FFD to pelvic-RoF (male: p < 0.001, r = -0.653, female: p < 0.001, r = -0.649) and sex-dependent to lumbar-RoF (male: p < 0.001, r = -0.604, female: p = 0.012, r = -0.256). In the sub-cohort of 12 participants, gradual trunk flexion showed a strong correlation of FFD to pelvic-RoF (p < 0.001, r = -0.895) but a moderate correlation to lumbar-RoF (p < 0.001, r = -0.602). The differences in FFD in an individual patient, assuming consistent hip function, may be attributed partially to the differences in lumbar flexibility. However, the absolute values of FFD do not qualify as a measure for lumbar mobility. Rather, using validated non-invasive measurement devices should be considered.

Effects of a microgravity SkinSuit on lumbar geometry and kinematics

PurposeAstronauts returning from long ISS missions have demonstrated an increased incidence of lumbar disc herniation accompanied by biomechanical and morphological changes associated with spine elongation. This research describes a ground-based study of the effects of an axial compression countermeasure Mk VI SkinSuit designed to reload the spine and reduce these changes before return to terrestrial gravity.MethodsTwenty healthy male volunteers aged 21–36 without back pain participated. Each lay overnight on a Hyper Buoyancy Flotation (HBF) bed for 12 h on two occasions 6 weeks apart. On the second occasion participants donned a Mk VI SkinSuit designed to axially load the spine at 0.2 Gz during the last 4 h of flotation. Immediately after each exposure, participants received recumbent MRI and flexion–extension quantitative fluoroscopy scans of their lumbar spines, measuring differences between spine geometry and intervertebral kinematics with and without the SkinSuit. This was followed by the same procedure whilst weight bearing. Paired comparisons were performed for all measurements.ResultsFollowing Mk VI SkinSuit use, participants evidenced more flexion RoM at L3–4 (p = 0.01) and L4–5 (p = 0.003), more translation at L3–4 (p = 0.02), lower dynamic disc height at L5–S1 (p = 0.002), lower lumbar spine length (p = 0.01) and greater lordosis (p = 0.0001) than without the Mk VI SkinSuit. Disc cross-sectional area and volume were not significantly affected.ConclusionThe MkVI SkinSuit restores lumbar mobility and lordosis following 4 h of wearing during hyper buoyancy flotation in a healthy control population and may be an effective countermeasure for post space flight lumbar disc herniation.

Relationship of lumbar-hip kinematics during trunk flexion and sex, body mass index, and self-reported energy expenditure: a cross-sectional analysis

Purpose Physical activity (PA) is a well-known, simple and effective preventive and therapeutic intervention for low back pain (LBP). In spite of the growing interest in active lifestyles and its benefits, more needs to be known about the relationship between energy expenditure, body mass and lumbar-pelvic kinematics during the forward bending movement in a group of young asymptomatic people who met PA guidelines. Young people can be identified as a future risk group of civilisation diseases and lumbar-hip kinematics can be considered as a predictor of LBP occurrence. The aim of this study was to identify the association of sex, self-reported energy expenditure, body mass index, and lumbar-hip kinematics in young people. Methods Sixty-four students at pre-employment stage participated in the study. They declared moderate-to-high PA and activity-induced energy expenditure (AEE) was self-reported. Kinematic data of the lumbar spine, pelvis, and hip were collected during forward bending using a 3D motion capture system. Results Sex was found to be associated with pelvis (β=-0.38 p=0.002) and lumbar mobility (β=0.49, p&lt;0.001) during forward bending and BMI was related only to lumbar mobility (β=-0.41, p=0.001). Recreation AEE significantly predicted hip flexion mobility (β =0.38, p=0.002). Conclusions This study showed that among a sample of physically active young people, BMI, self-reported AEE, and sex can partially predict lumbar-hip kinematics during trunk flexion. Recreational PA can be regarded as improving hip mobility and thus making forward bending more effective and less prone to injury.

The Impact of Hip Mobility on Lumbar and Pelvic Mobility before and after Total Hip Arthroplasty

Hip arthrosis and total hip arthroplasty (THA) can alter a patient's balance and spinopelvic mobility. In this study, we hypothesized that lumbar, pelvic, and hip mobility and their inter-relations are affected by THA and that their study could give an insight in our understanding of postoperative balance and mobility. A total of 165 patients with hip arthrosis and with an indication for THA were included in this single-center prospective cohort. Sagittal radiographs were acquired in four positions: free-standing, standing extension, relaxed-seating and flexed-seating preoperatively and at 6 and 12 months. Spinopelvic parameters were measured (pelvic tilt and incidence, sacral slope, lumbar lordosis, pelvic-femoral angle). Standing spinopelvic parameters did not significantly change postoperatively. However, the postural changes occurring between positions were significantly altered after THA. In particular, pelvic and lumbar mobility was significantly reduced postoperatively, while hip mobility was increased. Correlations were observed between the changes in lumbar, pelvic and hip mobility before and after THA. This study confirmed that there is a relationship between lumbar, pelvic and hip mobility in osteoarthritis, and that this relationship is modified by the postoperative compensation mechanisms deployed by the patient in dynamic postures. Hence, surgeons should consider these relationships when planning surgery, in order to obtain a physiological pelvic tilt postoperatively and to account for the potential increased risk of impingement and dislocation with hip hypermobility.

Variations in lower limb alignments indicate pelvic tilt after total hip arthroplasty

ObjectiveWe sought to correlate various spinopelvic and lower limb alignments, and to examine the current spinopelvic theories on a Chinese cohort.MethodsWe retrospectively reviewed 166 patients undergoing THA. Among them, 138 patients with unilateral THA met the inclusion criteria. Sagittal alignments and cup orientations were measured on standing and sitting lateral EOS images. Patients were categorized into two groups with a scoring system for lumbar spine degeneration. Patients’ demographics including age, sex, lumbar spine degeneration and radiographic measurements were studied.ResultsPT, SS, LL and TK differed significantly between standing and sitting within each group except for TK in degenerative group (32.8 ± 13.9 vs. 32.9 ± 14.2, p = 0.905). Compared with degenerative spine group, non-degenerative spine patients have great pelvic mobility (ΔPT, -24.4 ± 12.5° vs. -17.6 ± 10.7, p = 0.0008), greater lumbar mobility (ΔLL, -34.8 ± 15.2 vs. -21.7 ± 12.2, p = < 0.0001) and compensatory cup orientation changes (ΔRA, -15.5 ± 11.1 vs. -12.0 ± 8.4, p = 0.00920; ΔRI, -10.8 ± 11.5 vs. -5.6 ± 7.5, p = 0.0055). Standing PT and ankle dorsiflexion angle correlated positively (R2 = 0.236, p = 0.005).ConclusionTHA patients in this cohort showed a spinopelvic motion paradigm similar to that from previous studies on Caucasians. Ankle dorsiflexion indicate greater posterior pelvic tilt on standing. Surgeons should beware of risks of instability in patients with lower limb compensations.Advances in knowledgeThis study provides new insights into the clinical relevance of lower limb alignments to spinopelvic motion after THA in a relatively young Chinese population.