Effect of classification-specific treatment on lumbopelvic motion during hip rotation in people with low back pain

Abstract

Increased and early lumbopelvic motion during trunk and limb movements is thought to contribute to low back pain (LBP). Therefore, reducing lumbopelvic motion could be an important component of physical therapy treatment. Our purpose was to examine the effects of classification-specific physical therapy treatment (Specific) based on the Movement System Impairment (MSI) model and non-specific treatment (Non-Specific) on lumbopelvic movement patterns during hip rotation in people with chronic LBP. We hypothesized that following treatment people in the Specific group would display decreased lumbopelvic rotation and achieve more hip rotation before lumbopelvic rotation began. We hypothesized that people in the Non-Specific group would display no change in these variables. Kinematic data collected before and after treatment for hip lateral and medial rotation in prone were analyzed. The Specific group (N = 16) demonstrated significantly decreased lumbopelvic rotation and achieved greater hip rotation before the onset of lumbopelvic rotation after treatment with both hip lateral and medial rotation. The Non-Specific group (N = 16) demonstrated significantly increased lumbopelvic rotation and no change in hip rotation achieved before the onset of lumbopelvic rotation. People who received treatment specific to their MSI LBP classification displayed decreased and later lumbopelvic motion with hip rotation, whereas people who received generalized non-specific treatment did not.

Copyright © 2010 Elsevier Ltd. All rights reserved.

Figures

Figure 1

Kinematic model for calculating lower limb segment (α) and pelvic segment (σ) rotation. LS1: marker left of first sacral vertebra, RS1: marker right of first sacral vertebra, LatMal: lateral malleolus.

Figure 2

Lumbopelvic rotation range of motion in degrees (means ± standard errors) for each treatment group pre- and post-treatment.

Figure 3

Hip rotation completed at the onset of lumbopelvic rotation (means ± standard errors) for each treatment group pre- and post-treatment.

Figure 4

Hip rotation range of motion in degrees (means ± standard errors) for each treatment group pre- and post-treatment.