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

BMC Musculoskeletal Disorders

Jennifer L Keating¹  Peter Kent³  Jayce Gilbert⁴  Robert A Laird² 

[1] Department of Physiotherapy, Monash University, PO Box 527, Frankston, VIC 3199, Australia;7 Kerry Rd, Warranwood, Melbourne, VIC 3134, Australia;Research Department, Spine Centre of Southern Denmark, Lillebaelt Hospital, Institute of Regional Health Services Research, University of Southern Denmark, Middelfart 5500, Denmark;Peak MSK Physiotherapy, Suite 4/544 Hampton St, Hampton, VIC 3188, Australia

关键词: Proprioception;    Lordosis;    Range of movement;    Posture;    Movement disorders;    Low back pain;   

Others  :  848320
DOI  :  10.1186/1471-2474-15-229

 received in 2014-05-13, accepted in 2014-07-01,  发布年份 2014

【 摘 要 】

Background

Clinicians 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.

Methods

MEDLINE, 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.

Results

The 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).

Conclusions

On 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.

【 授权许可】

   
2014 Laird et al.; licensee BioMed Central Ltd.

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