Lumbopelvic Posture Research Articles

Effects of vibration-based biofeedback on multifidus muscle activity and pelvic tilt angle in subjects with hip flexion limitation.

Sedentary work may lead to low back pain. In particular, a slumped sitting position may exacerbate low back pain because of tissue damage caused by excessive lumbar flexion and posterior pelvic tilting. Subjects with low back pain may have excessive changes in the lumbopelvic posture and back muscle activity in the sitting position. The purpose of this study was to compare the effects of vibration-based biofeedback using a motion sensor belt and no biofeedback on multifidus (MF) muscle activity and pelvic tilt angle during typing. Thirty subjects with low back pain accompanied by hip flexion limitation (15 each in the biofeedback and non-biofeedback groups) were enrolled. Electromyography was used to investigate MF muscle activity before and after typing for 30 min. Pelvic tilt was measured after typing in a sitting position for 30 min. Independent t-tests were used to compare MF muscle activity, and pelvic and second sacrum tilt angles, between the biofeedback and non-biofeedback groups. After typing for 30 min, changes in MF muscle activity (11.45% and -7.19% for the biofeedback and nonbiofeedback groups, respectively) and pelvic and second sacrum tilt angles (3.15∘ and 4.12∘ for the biofeedback group and -11.05∘ and -18.16∘ for the non-biofeedback group, respectively) were significantly smaller in the biofeedback than non-biofeedback group (p< 0.05). Vibration-based biofeedback minimizes the reduction in MF muscle activity and changes in pelvic and second sacrum tilt angles during typing in individuals with low back pain accompanied by hip flexion limitation.

The relationship between low back pain, pelvic tilt, and lumbar lordosis with urinary incontinence using the DIERS formetric 4D motion imaging system.

Urinary incontinence (UI) is a common public health problem and postural changes may be crucial in women presenting with UI. This study was aimed at evaluating the relationship between low back pain (LBP), pelvic tilt (PT), and lumbar lordosis (LL) in women with and without UI using the DIERS formetric 4D motion imaging system. To date no study has to our knowledge compared postural changes and LBP in women with UI using the DIERS 4D formetric system. This was a case-control study. We included 33 women with UI and 33 without incontinence. The severity of urogenital symptoms was assessed by the IIQ-7 (Incontinence Impact Score) and UDI-6 (Urogenital Distress Inventory), and disability owing to LBP was evaluated using the Oswestry Disability Index (ODI). Posture and movement assessment, LL angle, thoracic kyphosis, and PT assessment were performed with the DIERS Formetric 4D motion imaging system. The LL angle and pelvic torsion degree were higher in the incontinence group than in the control group (53.9 ± 9.5° vs 48.18 ± 8.3°; p= 0.012, 3.9 ± 4.1 vs 2.03 ± 1.8 mm; p= 0.018 respectively). The LBP visual analog scale value was also significantly higher in the incontinence group (5.09 ± 2.3 vs 1.7 ± 1.8 respectively, p< 0.0001). The LL angle showed a positive correlation with pelvic obliquity, (r = 0.321, p< 0.01) and fleche lombaire (r = 0.472, p< 0.01) and a negative correlation with lumbar range of motion measurements. Pelvic obliquity correlated positively with pelvic torsion (r = 0.649, p< 0.01), LBP (r = 0.369, p< 0.01), and fleche lombaire (r = 0.269, p< 0.01). Women with UI were more likely to have lumbopelvic sagittal alignment changes and a higher visual analog scale for LBP. These findings show the need for assessment of lumbopelvic posture in women with UI.

Comparison of affected lumbar proprioception due to different injuries with healthy controls: An observational study

BackgroundThere is limited evidence about spinal proprioception deficiency due to different injuries. ObjectiveTo compare spinal proprioception in patients with Lumbal Spinal Stenosis (LSS) and healthy controls. Secondary objective is to investigate the effect of pain intensity and Thoracolumbar fascia (TLF) flexibility on spinal proprioception deficiency. DesignCross-sectional and healthy controlled study. SettingThis study was conducted in a state hospital. MethodsNinety participants (mean age: 46.98 ± 12.94 years) were grouped as: Healthy control (n = 30) (Group I), chronic low back pain due to LSS (n = 30) (Group II) and undergoing surgery due to LSS (n = 30) (Group III). Lumbar repositioning error (RE) was defined as reproducing a target position (neutral lumbo-pelvic posture) after tasks. Tasks were: 30° forward bending and 15° backward bending in sitting and standing. Primary outcome measuresRE, pain intensity and TLF flexibility were assesed with iphone tilt-meter app, VAS and goniometric platform, respectively. ParticipantsSixty patients with LSS and 30 healthy controls. ResultsRE scores of Group II and Group III were significantly higher than Group I (p < 0.001). Group III had lower VAS scores (p < 0.001) than Group II, except during standing with backward bending task. TLF flexibility was not differed between Group II and Group III (p˃0.05). There was no significant association between VAS and RE scores in Group II and Group III (p˃0.05). ConclussionIndividuals with LSS and healthy controls have different lumbar proprioception sense. TLF flexibility did not differ, due to different injury, in patients with LSS compared to healthy controls.

Extraction of Lumbar Spine Motion Using a 3-IMU Wearable Cluster.

Spine movement is a daily activity that can indicate health status changes, including low back pain (LBP) problems. Repetitious and continuous movement on the spine and incorrect postures during daily functional activities may lead to the potential development and persistence of LBP problems. Therefore, monitoring of posture and movement is essential when designing LBP interventions. Typically, LBP diagnosis is facilitated by monitoring upper body posture and movement impairments, particularly during functional activities using body motion sensors. This study presents a fully wireless multi-sensor cluster system to monitor spine movements. The study suggests an attempt to develop a new method to monitor the lumbopelvic movements of interest selectively. In addition, the research employs a custom-designed robotic lumbar spine simulator to generate the ideal lumbopelvic posture and movements for reference sensor data. The mechanical motion templates provide an automated sensor pattern recognition mechanism for diagnosing the LBP.

Lumbopelvic postural differences in adolescent idiopathic scoliosis: A pilot study

BackgroundA primary etiology of adolescent idiopathic scoliosis (AIS) is currently unknown, but poor postural control of the spinal extensor musculature has been identified as an AIS risk factor. Identifiable postural differences would aid in advancing the precise postural behaviors that should be modified during Physiotherapy Scoliosis Specific Exercise (PSSE) to help limit the progression of AIS. Research questionAre there any determinable differences in lumbopelvic posture or range of motion between subjects with AIS and controls? MethodsThis prospective cohort pilot study consisted of 53 subjects (27 AIS and 26 control) aged 11–17 years. Subjects had their lumbopelvic posture assessed and monitored using the ViMove DorsaVi sensor package. All subjects underwent a live assessment to obtain initial lumbopelvic (LP) range of motion (ROM) measurements. Subjects were then monitored while continuing with normal activities of daily living (ADLs) for 12 h. With an alpha level of 0.05, nonparametric analyses were performed for each variable via a Mann-Whitney U-test. ResultsDuring the live assessment, controls exhibited a significantly greater anterior pelvic tilt ROM in the sitting position than the AIS group (p = 0.0433). When compared to female controls, females with AIS had a sitting pelvic tilt ROM that was significantly more retroverted (p = 0.0232) and less anteverted (p = 0.0010). During ADLs, female controls exhibited a higher total number of extension events than their female with AIS (p = 0.0263). These associations did not strengthen with greater spinal deformity. SignificanceThis work demonstrates postural differences between patients with AIS and controls. Further study is necessary to determine why patients with AIS adopt these postures, and if PSSEs can be utilized to limit the progression of AIS.

Self-selection of gestational lumbopelvic posture and bipedal evolution.

Not all pregnant women seem to select the more curved lumbopelvic posture that their sexual dimorphic anatomy allows even though many previous researchers have assumed lumbopelvic curvature to be standard during pregnancy. This study is vital to understanding coevolution of lumbopelvic sexual dimorphism and bipedalism, and understanding some clinical implications of intervening in gestational posture changes. Are there anthropometric changes that correspond with selection of lumbopelvic curvature change during pregnancy? What are the biomechanical costs and benefits of gestational lumbopelvic curvature change? Twenty pregnant women were tested at five different times in the 2nd and 3rd trimesters of pregnancy. Lumbopelvic posture, standing kinetics and gait kinetics were measured longitudinally. Additionally, we modeled the effects on standing and gait without lumbopelvic postural changes, but with anthropometric changes, for each individual. We found greater lumbopelvic angulation to correspond with a shorter body height (6 cm difference between groups, p = 0.048) and deeper 2nd trimester abdomen (2 cm difference between groups, p = 0.013). Lumbopelvic angulation lowers support requirements (in standing and walking (6% lower support impulse, p = 0.056), but at the cost of shifting the propulsive actions to a less efficient pulling action rather than pushoff (13 % reduction in pushoff time, p = 0.001). We observed minimal effects on walking kinematics and balance control. Our findings suggest the evolutionary advantage of the female lumbopelvic unit is the adaptability it provides to adjust for the individual needs of the pregnant woman. We discuss multiple potential contributing factors that may have shaped hominin female lumbopelvic evolution and are involved in self-selecting lumbopelvic posture.

Lumbopelvic sagittal standing posture associations with anthropometry, physical activity levels and trunk muscle endurance in healthy adults.

Background:Various factors, inherited and acquired, are associated with habitual spinal postures.Objective:The purpose of this study was to identify the relationships between trunk muscle endurance, anthropometry and physical activity/inactivity and the sagittal standing lumbopelvic posture in pain-free young participants.Methods:In this study, 112 healthy young adults (66 females), with median (IQR) age of 20 years (18.2–22 years), without low back pain, injury or trauma were included. Lumbar curve (LC) and sacral slope (SS) angles were measured in standing with a mobile phone application (iHandy level). Anthropometric, physical activity/inactivity levels (leisure-time sport involvement and sitting hours/day) and abdominal (plank prone bridge test) and paraspinal (Sorensen test) isometric muscle endurance measures were collected.Results:LC and SS angles correlated significantly (, ). Statistically significant differences for both LC () and SS () angles were identified between the male and female participants. A significant negative correlation was identified between the abdominal endurance time and LC (, ); however, the power of this result (56%) was not sufficiently high. The correlation between abdominal endurance and SS was non-significant (, ). In addition, no significant associations were identified between either of the sagittal lumbopelvic angles (LC–SS) in standing and the participants’ body mass index (BMI), paraspinal endurance, leisure-time sport involvement or sitting hours/day.Conclusion:The potential role of preventive exercise in controlling lumbar lordosis via enhancement of the abdominal muscle endurance characteristics requires further confirmation. A subsequent study, performed in a larger population of more diverse occupational involvement and leisure-time physical activity levels, is proposed.

Association between hamstring flexibility and lumbopelvic posture and kinematics during ergometer rowing

Restricted pelvic range of motion leading to extreme flexion of the lumbar spine during rowing has been associated with higher loads within the spine and therefore may contribute to low back pain. It is further indicated that tight hamstrings have a negative influence on the rowing posture. In this study, the relationships between hamstring flexibility and lumbopelvic kinematics during ergometer rowing in 17 male adolescent rowers were examined. Hamstring flexibility was assessed using the passive knee extension test, and lumbopelvic kinematics was assessed via flexible sensor strips at the back and pelvis. No associations were found between hamstring flexibility and pelvic kinematics during rowing (RoM: P > .18, r = .35 and angle at catch: P > .48, r = .19), suggesting that there is no relevant influence of hamstring flexibility on lumbopelvic kinematics in adolescent male rowers. Therefore, techniques to increase hamstring flexibility might be ineffective in low back pain prevention and rehabilitation. In contrast, years of rowing experience showed a strong effect on lumbar RoM (P < .01, r = −.726) and a weak effect on pelvic motions (P < .04, r = .542), suggesting that the level of technical skills is of more important matter.

Management of Antenatal Pelvic Girdle Pain Study (MAPS): A Double Blinded, Randomised Trial Evaluating the Effectiveness of Two Pelvic Orthoses

Pelvic girdle pain (PGP) occurs in 70% of pregnant women; of whom 25% have severe pain and 8% severe disability requiring the use of crutches, wheelchair or confinement to bed [1]. Patients with pregnancy related PGP have been shown to have increased pelvic joint motion compared with healthy pregnant controls, probably due to a combination of hormonal and biomechanical factors, leading to an increase in pelvic joint laxity, changes in lumbopelvic posture and increase in shearing forces through pelvic joints, thus leading to pain [2,3]. PGP is difficult to manage; activities such as turning in bed, prolonged walking, or carrying items may cause pain; impacting negatively on quality of life [4]. In economic terms societal costs are significant, mainly as a consequence of work absenteeism; with 20% of people requiring an average of 7-11 weeks sick leave [5-8]. There are high direct health costs as well as increased health risks as women with PGP have a higher request for induction of labour and elective caesarean section to achieve symptomatic relief [3,5,7].

Habitual pelvic posture and time spent sitting: Measurement test-retest reliability for the LUMOback device and preliminary evidence for slouched posture in individuals with low back pain.

Objectives:It has been difficult to monitor the pelvic position during actual daily life. However, recent developments in wearable device technologies, such as the LUMOback device, provide the possibility to evaluate habitual pelvic posture and time spent sitting during daily life. The current study aimed (1) to investigate test–retest reliability for habitual pelvic posture and time spent sitting with the LUMOback in individuals with prolonged low back pain (low back pain group) and without low back pain (control group), and (2) to preliminarily investigate differences in those measures between groups.Methods:Fifteen individuals in each group wore the LUMOback daily for 2 weeks. Intraclass correlation coefficients were calculated in each group by comparing the mean from the first week with the mean from the second week: (1) for the posture score, which is a proportion of time with neutral posture, and (2) for time spent sitting. The two measures for the first week were compared between the low back pain and control groups.Results:The intraclass correlation coefficients for the posture score were .82 in the low back pain group and .91 in the control group. The intraclass correlation coefficients for time spent sitting were .75 in the low back pain group and .85 in the control group. The posture score in the low back pain group (mean ± SD: 37.5% ± 10.3%) was less than that in the control group (49.6% ± 6.0%; p < .001), but there was no difference in time spent sitting between the groups (p > .05).Conclusions:The current study found (1) acceptable test–retest reliability for the posture score and time spent sitting evaluated by the LUMOback device, and (2) preliminary evidence of a difference in the posture score, indicating a more slouched lumbopelvic posture in individuals with prolonged low back pain than those without low back pain.

The immediate effects of exercise using the Functional Re-adaptive Exercise Device on lumbopelvic kinematics in people with and without low back pain

BackgroundDysfunction of the lumbar multifidus (LM) and transversus abdominis (TrA) muscles is associated with low back pain (LBP). The Functional Re-adaptive Exercise Device (FRED) has shown potential as a non-specific LBP intervention by automatically recruiting LM and TrA. Loss or lordosis and altered lumbopelvic positioning has also been linked to LBP and is often trained within LM and TrA interventions. The effect that FRED exercise has on lumbopelvic positioning and lumbar lordosis is unknown. ObjectivesTo assess the effect of FRED exercise on lumbopelvic kinematics and alignment to establish whether FRED exercise promotes a favourable lumbopelvic posture for training LM and TrA. DesignWithin and between-group comparison study. MethodOne hundred and thirty participants, 74 experiencing LBP, had lumbopelvic kinematic data measured during over-ground walking and FRED exercise. Magnitude-based inferences were used to compare walking with FRED exercise within participants and between the asymptomatic and LBP groups, to establish the effects of FRED exercise on lumbopelvic kinematics, compared to walking, in each group. ResultsFRED exercise promotes an immediate change in anterior pelvic tilt by 8.7° compared to walking in the no-LBP and LBP groups. Sagittal-plane spinal extension increased during FRED exercise at all spinal levels by 0.9° in the no-LBP group, and by 1.2° in the LBP group. ConclusionsFRED exercise promotes a lumbopelvic position more conducive to LM and TrA training than walking in both asymptomatic people and those with LBP.

How consistent are lordosis, range of movement and lumbo-pelvic rhythm in people with and without back pain?

BackgroundComparing movements/postures in people with and without lower back pain (LBP) may assist identifying LBP-specific dysfunction and its relationship to pain or activity limitation. This study compared the consistency in lumbo-pelvic posture and movement (range and pattern) in people with and without chronic LBP (>12 week’s duration).MethodsWireless, wearable, inertial measurement units measured lumbar lordosis angle, range of movement (ROM) and lumbo-pelvic rhythm in adults (n = 63). Measurements were taken on three separate occasions: two tests on the same day with different raters and a third (intra-rater) test one to two weeks later. Participants performed five repetitions of tested postures or movements. Test data were captured automatically. Minimal detectable change scores (MDC90) provided estimates of between-test consistency.ResultsThere was no significant difference between participants with and without LBP for lordosis angle. There were significant differences for pelvic flexion ROM (LBP 60.8°, NoLBP 54.8°, F(1,63) = 4.31, p = 0.04), lumbar right lateral flexion ROM (LBP 22.2°, NoLBP 24.6° F(1,63) = 4.48, p = .04), trunk right lateral flexion ROM (LBP 28.4°, NoLBP 31.7°, F(1,63) = 5.9, p = .02) and lumbar contribution to lumbo-pelvic rhythm in the LBP group (LBP 45.8 %, F(1,63) = 4.20, NoLBP 51.3 % p = .044). MDC90 estimates for intra and inter-rater comparisons were 10°–15° for lumbar lordosis, and 5°–15° for most ROM. For lumbo-pelvic rhythm, we found 8–15 % variation in lumbar contribution to flexion and lateral flexion and 36–56 % variation in extension. Good to excellent agreement (reliability) was seen between raters (mean r = .88, ICC (2,2)).ConclusionComparisons of ROM between people with and without LBP showed few differences between groups, with reduced relative lumbar contribution to trunk flexion. There was no difference between groups for lordosis. Wide, within-group differences were seen for both groups for ROM and lordosis. Due to variability between test occasions, changes would need to exceed 10°–15° for lumbar lordosis, 5°–15° for ROM components, and 8–15 % of lumbar contribution to lumbo-pelvic rhythm, to have 90 % confidence that movements had actually changed. Lordosis, range of movement and lumbo-pelvic rhythm typically demonstrate variability between same-day and different-day tests. This variability needs to be considered when interpreting posture and movement changes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1250-1) contains supplementary material, which is available to authorized users.

The effects of yoga on shoulder and spinal actions for women with breast cancer-related lymphoedema of the arm: A randomised controlled pilot study.

BackgroundWe aimed to evaluate the effect of an 8-week yoga intervention on the shoulder and spinal actions of women with breast cancer-related arm lymphoedema.MethodA randomised controlled pilot trial. The intervention group (n = 12) completed eight weeks of daily yoga sessions while the control group (n = 11) continued with best current care including information on compression sleeves, skin care, risks of temperature variations and recommended safe use of affected arm. Lumbo-pelvic posture, range of motion (ROM) in the shoulder and spine, and strength in shoulder and pectoral major and minor, and serratus anterior were taken at baseline, week 8 and after a 4-week follow-up. Outcome assessors were blinded to allocation.ResultsAt week eight the intervention group had an improvement in lumbo-pelvic posture, as indicated by a reduction in pelvic obliquity compared to the control group (mean difference = −8.39°, 95 % CI: −15.64 to −1.13°, p = 0.023). A secondary finding was that strength in shoulder abduction significantly increased following the yoga intervention in both the affected (9.5 kg; CI: 0.34 to 18.66, p = 0.042) and non-affected arm (11.58 kg; CI: 0.25 to 22.91; p = 0.045). There were no significant between group changes in any ROM measures as a result of the yoga intervention.ConclusionThis pilot study demonstrates that participation in yoga may provide benefits for posture and strength in women with Breast Cancer Related Lymphoedema. The improvements may be attributed to the focus of yoga on overall postural and functional movement patterns. Further trials with longer intervention that follow this methodology are warranted.Trial registrationThe Australian New Zealand Clinical Trials Registry ACTRN12611000202965.

A radiographic assessment of lumbar spine posture in four different upright standing positions

BackgroundApproximately 50% of a sample population will develop prolonged standing induced low back pain. The cause of this pain may be due to their lumbar spine posture. The purpose of this study was to investigate differences in lumbar posture between 17 participants categorized as a pain or non-pain developers during level ground standing. A secondary purpose was to evaluate the influence of two standing aids (an elevated surface to act as a foot rest and declined sloped surface) on lumbopelvic posture. MethodsFour sagittal plane radiographs were taken: a normal standing position on level ground, when using an elevated foot rest, using a declined sloped surface, and maximum lumbar spine extension as a reference posture. Lumbosacral lordosis, total lumbar lordosis, and L1/L2 and L5/S1 intervertebral joint angles were measured on each radiograph. FindingsThere was a significant difference between the lumbosacral lordosis angle and L5/S1 angles in upright versus maximum extension; however, this was independent of pain group. The elevated surface was most effective at causing lumbosacral spine flexion. InterpretationPotentially successful postures for eliminating low back pain during prolonged standing mainly influence the lower lumbar lordosis. Future work should assess the influence of hip posture on low back pain development during standing.

Lumbopelvic Posture: Is Pelvic Incidence the Best Indicator for Lordosis?

Lumbopelvic Posture: Is Pelvic Incidence the Best Indicator for Lordosis?

Comparing lumbo-pelvic kinematics in people with and without back pain: a systematic review and meta-analysis.

BackgroundClinicians commonly examine posture and movement in people with the belief that correcting dysfunctional movement may reduce pain. If dysfunctional movement is to be accurately identified, clinicians should know what constitutes normal movement and how this differs in people with low back pain (LBP). This systematic review examined studies that compared biomechanical aspects of lumbo-pelvic movement in people with and without LBP.MethodsMEDLINE, Cochrane Central, EMBASE, AMI, CINAHL, Scopus, AMED, ISI Web of Science were searched from inception until January 2014 for relevant studies. Studies had to compare adults with and without LBP using skin surface measurement techniques to measure lumbo-pelvic posture or movement. Two reviewers independently applied inclusion and exclusion criteria, and identified and extracted data. Standardised mean differences and 95% confidence intervals were estimated for group differences between people with and without LBP, and where possible, meta-analyses were performed. Within-group variability in all measurements was also compared.ResultsThe search identified 43 eligible studies. Compared to people without LBP, on average, people with LBP display: (i) no difference in lordosis angle (8 studies), (ii) reduced lumbar ROM (19 studies), (iii) no difference in lumbar relative to hip contribution to end-range flexion (4 studies), (iv) no difference in standing pelvic tilt angle (3 studies), (v) slower movement (8 studies), and (vi) reduced proprioception (17 studies). Movement variability appeared greater for people with LBP for flexion, lateral flexion and rotation ROM, and movement speed, but not for other movement characteristics. Considerable heterogeneity exists between studies, including a lack of detail or standardization between studies on the criteria used to define participants as people with LBP (cases) or without LBP (controls).ConclusionsOn average, people with LBP have reduced lumbar ROM and proprioception, and move more slowly compared to people without LBP. Whether these deficits exist prior to LBP onset is unknown.

The effects of lumbo-pelvic postural taping on gait parameters in patients with lumbar spinal stenosis

BackgroundAltered gait patterns with lumbar-flexed posture threaten the quality of life in patients with lumbar spinal stenosis; however, few studies have developed management strategies to improve gait patterns and lumbo-pelvic posture. The present study investigated the effects of lumbo-pelvic postural taping on pelvic tilt, spatiotemporal gait parameters, and pain during walking in patients with lumbar spinal stenosis. MethodsThe pelvic tilt and gait parameters were assessed in 20 patients with lumbar spinal stenosis before sustained walking using a palpation meter and GAITRite system, respectively. Next, the participants were asked to walk on the ground for 20min or until they complained of symptoms of neurogenic claudication. Pelvic tilt and gait parameters were measured immediately after the manifestation of neurogenic claudication followed by the application of lumbo-pelvic postural taping. The participants rated the pain intensity using a visual analog scale. Changes in dependent variables among the conditions were analyzed using a one-way repeated-measures analysis of variance. FindingsThe results show a decreased pelvic anterior tilt, walking velocity, and step and stride lengths, as well as an increased base of support and pain after severe symptoms of neurogenic claudication (P<0.05). However, a greater pelvic anterior tilt, faster walking velocity with a longer step and stride length, and decreased base of support and pain were found after the application of postural taping (P≤0.001). InterpretationThese findings suggest that lumbo-pelvic postural taping can provide beneficial management for improving gait patterns and lumbo-pelvic posture in patients with lumbar spinal stenosis.

Lumbar repositioning error in sitting: Healthy controls versus people with sitting-related non-specific chronic low back pain (flexion pattern)

Studies examining repositioning error (RE) in non-specific chronic low back pain (NSCLBP) demonstrate contradictory results, with most studies not correlating RE deficits with measures of pain, disability or fear. This study examined if RE deficits exist among a subgroup of patients with NSCLBP whose symptoms are provoked by flexion, and how such deficits relate to measures of pain, disability, fear-avoidance and kinesiophobia. 15 patients with NSCLBP were matched (age, gender, and body mass index) with 15 painfree participants. Lumbo-pelvic RE, pain, functional disability, fear-avoidance and kinesiophobia were evaluated. Participants were asked to reproduce a target position (neutral lumbo-pelvic posture) after 5 s of slump sitting. RE in each group was compared by evaluating constant error (CE), absolute error (AE) and variable error (VE). Both AE (p = 0.002) and CE (p = 0.006) were significantly larger in the NSCLBP group, unlike VE (p = 0.165) which did not differ between the groups. There were significant, moderate correlations in the NSCLBP group between AE and functional disability (r = 0.601, p = 0.018), and between CE and fear-avoidance (r = −0.577, p = 0.0024), but all other correlations were weak (r < 0.337, rs < 0.377) or non-significant (p > 0.05). The results demonstrate increased lumbo-pelvic RE in a subgroup of NSCLBP patients, with the selected subgroup undershooting the target position. Overall, RE was only weakly to moderately correlated with measures of pain, disability or fear. The deficits observed are consistent with findings of altered motor control in patients with NSCLBP. The mechanisms underlying these RE deficits, and the most effective method of addressing these deficits, require further study.

Validity and reliability of the Spineangel® lumbo-pelvic postural monitor

Objective: to determine the reliability and the concurrent validity of the Spineangel® lumbo-pelvic postural monitoring device. Methods: the dynamic lumbo-pelvic posture of 25 participants was simultaneously monitored by the Spineangel® and FastrakTM devices. Participants performed six different functional tasks in random order. Within-task, within-session and between-day intraclass correlation coefficients (ICC(3,1), ICC(3,5), ICC(2,5), respectively) reliability were calculated for Spineangel® measurements. Concurrent validity of the Spineangel® was assessed by means of a Bland and Altman plot and by means of Pearson's correlation coefficient and paired t-test. Results: within-task, within-session and between-day ICC for the Spineangel® were found to be excellent (>0.93). The Spineangel® and FastrakTM pelvic measurements were found to have a good correlation (R = 0.77). Conclusion: the Spineangel® is a reliable and valid device for monitoring general lumbo-pelvic movements when clipped on the belt or waistband of workers' clothing during various occupational activities. Practitioner summary: The Spineangel® can be used for assessing lumbo-pelvic posture during work or daily-life activities. This device was found to provide reliable and valid measurements for lumbo-pelvic movements. Further research is required to determine whether the use of this device is clinically relevant for patients presenting with low back pain.

Towards monitoring lumbo-pelvic posture in real-life situations: Concurrent validity of a novel posture monitor and a traditional laboratory-based motion analysis system

Many factors are associated with low back pain (LBP), including provocative spinal postures. Consequently, lumbo-pelvic posture is commonly assessed in LBP patients. A novel wireless monitor (BodyGuard™) can monitor lumbo-pelvic sagittal plane movements reliably, and has demonstrated concurrent validity during non-functional tasks. This study evaluated the concurrent validity of this monitor during functional tasks, as a precursor to LBP field studies. Twelve painfree participants performed a series of postural tasks (in sitting and standing) three times. Simultaneous postural measurements were obtained by the wireless monitor and a laboratory-based system (CODA™). Postural measurements were strongly correlated ( r s = 0.88, r 2 = 0.78). The mean difference observed was small (<10% lumbo-pelvic ROM), however some tasks displayed greater error. The results support the concurrent validity of the wireless monitor for analysing lumbo-pelvic posture during functional tasks. Specific limitations of the monitor for certain postural tasks were identified, and should be considered before implementation in future field studies.