A compensation of angular displacements of the hip joints and lumbosacral spine between subjects with and without idiopathic low back pain during squatting

Abstract

Low back pain (LBP) is one of the most common symptoms reported in adults. However, the contribution of postural control on the lumbar spine and hips during squatting has not been carefully investigated in individuals with LBP. The aim of this study was to compare three-dimensional kinematic changes of the lumbar spine and hips between subjects with and without idiopathic chronic LBP during squatting activities. In total, 30 subjects enrolled in the study (15 control subjects and 15 subjects with idiopathic chronic LBP). All participants were asked to perform squatting activities five times repeatedly while holding a load of 2 kg in a basket. The outcome measures included the Oswestry Disability Index (ODI) and kinematic angular displacement for the hips and lumbar spine. The LBP group demonstrated increased range of motion (ROM) inflexion of the dominant (T = -2.14, p = 0.03) and non-dominant (T = -2.11, p = 0.03) hips during squatting. The lumbar spine flexion ROM significantly decreased (T = 2.20, p = 0.03). The kinematic changes demonstrated inter actions with region x group (F = 5.56, p = 0.02), plane x group (F = 4.36, p = 0.04), and region x plane (F = 2292.47, p = 0.001). The ODI level demonstrated significant interaction on combined effects of body region and plane (F = 4.91, p = 0.03). Therefore, the LBP group utilized a compensation strategy to increase hip flexion with a stiffened lumbar spine in the sagittal plane during squatting. This compensatory kinematic strategy could apply to clinical management used to enhance lumbar spine flexibility in subjects with idiopathic chronic LBP. (C) 2013 Elsevier Ltd. All rights reserved.