Lumbopelvic movement patterns during prone hip extension has been proposed as a clinical screening method for trunk muscle dysfunction in patients with chronic low back pain (CLBP). However, correlations between trunk muscle onset and pelvic kinematics have not been investigated.
OBJECTIVE:
To examine the correlation between trunk muscle onset and pelvic kinematics during prone hip extension in participants with CLBP.
METHODS:
Fifteen patients with CLBP and 15 healthy individuals participated. We evaluated the muscle activities of the lumbar multifidus, the longissimus, and the semitendinosus via electromyogram and the displacement angles of the pelvic tilt, oblique and rotation.
RESULTS:
The onset of the multifidus at the ipsilateral side of hip extension was significantly delayed in the patients with CLBP compared to the control group ( 0.001). The onset of the ipsilateral multifidus in the control group was significantly correlated with increased anterior pelvic tilt angle ( 0.019, 0.597), whereas no significant correlation was observed in the CLBP group ( 0.810, 0.068).
CONCLUSION:
The results suggest that pelvic kinematics during prone hip extension does not predict the delayed trunk muscle onset in patients with CLBP.
HartvigsenJHancockMJKongstedALouwQFerreiraMLGenevaySHoyDKarppinenJPranskyGSieperJSmeetsRJUnderwoodM, Lancet Low Back Pain Series Working Group. What low back pain is and why we need to pay attention. Lancet. 2018; 391(10137): 2356-2367. doi: 10.1016/S0140-6736(18)30480-X.
2.
GoreMSadoskyAStaceyBRTaiKSLeslieD. The burden of chronic low back pain: clinical comorbidities, treatment patterns, and health care costs in usual care settings. Spine (Philadelphia, PA 1976). 2012; 37(11): E668-77. doi: 10.1097/BRS.0b013e318241e5de.
3.
ItzCJGeurtsJWvan KleefMNelemansP. Clinical course of non-specific low back pain: a systematic review of prospective cohort studies set in primary care. Eur J Pain. 2013; 17(1): 5-15. doi: 10.1002/j.1532-2149.2012.00170.x.
4.
BergmarkA. Stability of the lumbar spine. A study in mechanical engineering. Acta Orthop Scand Suppl. 1989; 230: 1-54. doi: 10.3109/17453678909154177.
5.
HodgesPWRichardsonCA. Contraction of the abdominal muscles associated with movement of the lower limb. Phys Ther. 1997; 77(2): 132-42. doi: 10.1093/ptj/77.2.132.
6.
SuehiroTMizutaniMIshidaHKobaraKOsakaHWatanabeS. Individuals with chronic low back pain demonstrate delayed onset of the back muscle activity during prone hip extension. J Electromyogr Kinesiol. 2015; 25(4): 675-80. doi: 10.1016/j.jelekin.2015.04.013.
7.
MacDonaldDMoseleyGLHodgesPW. Why do some patients keep hurting their back? Evidence of ongoing back muscle dysfunction during remission from recurrent back pain. Pain. 2009; 142(3): 183-8. doi: 10.1016/j.pain.2008.12.002.
8.
HodgesPWCoppietersMWMacDonaldDCholewickiJ. New insight into motor adaptation to pain revealed by a combination of modelling and empirical approaches. Eur J Pain. 2013; 17(8): 1138-46. doi: 10.1002/j.1532-2149.2013.00286.x.
9.
YamashitaMIshidaTOsukaSWatanabeKSamukawaMKasaharaSKondoETohyamaH. Trunk Muscle Activities during Ergometer Rowing in Rowers with and without Low Back Pain. J Sports Sci Med. 2023; 22(2): 338-44. doi: 10.52082/jssm.2023.338.
10.
HodgesPWRichardsonCA. Contraction of the abdominal muscles associated with movement of the lower limb. Phys Ther. 1997; 77(2): 132-42. doi: 10.1093/ptj/77.2.132.
11.
PanjabiMM. The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disord. 1992; 5(4): 390-6; discussion 397. doi: 10.1097/00002517-199212000-00002.
12.
ArabAMHaghighatAAmiriZKhosraviF. Lumbar lordosis in prone position and prone hip extension test: comparison between subjects with and without low back pain. Chiropr Man Therap. 2017; 16: 25: 8. doi: 10.1186/s12998-017-0139-x.
13.
OhJCynnHWonJKwonOYiC. Effects of performing an abdominal drawing-in maneuver during prone hip extension exercises on hip and back extensor muscle activity and amount of anterior pelvic tilt. J Orthop Sports Phys Ther. 2007; 37(6): 320-4. doi: 10.2519/jospt.2007.2435.
14.
JandaV. Evaluation of muscular imbalance: rehabilitation of the spine. In C. Liebenson (Ed.), Rehabilitation of the Spine: A Practitioner’s Manual (pp. 97-112). Philadelphia: Lippincott Williams & Wilkins; 1996.
15.
SahrmannSA. Diagnosis and treatment of movement impairment syndromes. 1st ed. St. Louis: Mosby; 2002.
16.
TateuchiHTaniguchiMMoriNIchihashiN. Balance of hip and trunk muscle activity is associated with increased anterior pelvic tilt during prone hip extension. J Electromyogr Kinesiol. 2012; 22(3): 391-7. doi: 10.1016/j.jelekin.2012.03.003.
17.
FairbankJCPynsentPB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000; 25(22): 2940-2952. doi: 10.1097/00007632-200011150-00017.
18.
HermensHJFreriksB. SENIAM Sensor Locations. [homepage on the Internet]. Enschede: SENIAM; 2023. [updated 2023 April 30; accessed 2023 November 8] Available from: http//www.seniam.org/.
19.
HodgesPWBuiBH. A comparison of computer-based methods for the determination of onset of muscle contraction using electromyography. Electroencephalogr Clin Neurophysiol. 1996; 101(6): 511-9. doi: 10.1016/s0013-4694(96)95190-5.
20.
Sakamoto AnnaCLTeixeira-SalmelaLFde Paula-GoulartFRde Morais FariaCDCGuimarãesCQ. Muscular activation patterns during active prone hip extension exercises. J Electromyogr Kinesiol. 2009; 19(1): 105-12. doi: 10.1016/j.jelekin.2007.07.004.
21.
CohenJ. Statistical power analysis for the behavioral sciences. 2nd ed. London: Routledge; 1988.
22.
OsukaSKoshinoYYamanakaMMiuraTSaitoYUenoRIshidaTSamukawaMTohyamaH. The onset of deep abdominal muscles activity during tasks with different trunk rotational torques in subjects with non-specific chronic low back pain. J Orthop Sci. 2019; 24(5): 770-5. doi: 10.1016/j.jos.2018.12.028.
23.
HodgesPWMoseleyGL. Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electromyogr Kinesiol. 2003; 13(4): 361-70. doi: 10.1016/s1050-6411(03)00042-7.
24.
WattananonPSilfiesSPTretriluxanaJJalayondejaW. Lumbar Multifidus and Erector Spinae Muscle Synergies in Patients with Non-specific Low Back Pain During Prone Hip Extension: A Cross-sectional Study. PM R. 2019; 11(7): 694-702. doi: 10.1002/pmrj.12002.
25.
TonosuJTakeshitaKHaraNMatsudairaKKatoSMasudaKChikudaH. The normative score and the cutoff value of the Oswestry Disability Index (ODI). Eur Spine J. 2012; 21(8): 1596-602. doi: 10.1007/s00586-012-2173-7.
26.
SoerRHofsteAOosterveldFGJHermensHRavensbergRVWolffAPGroenGJ. A guide for standardized interpretation of lumbar multifidus ultrasonography; an observational study. BMC Musculoskelet Disord. 2022; 23(1): 680. doi: 10.1186/s12891-022-05590-5.
27.
OkuboYKaneokaKImaiAShimaITatsumuraMIzumiSMiyakawaS. Comparison of the activities of the deep trunk muscles measured using intramuscular and surface electromyography. J Mech Med Biol. 2010; 10(4): 611-20. doi: 10.1142/S0219519410003599.
