Relationship of Impaired Lumbar Spine-Hip Coordination During Sit To Stand and Stand To Sit with Functional Disability in Chronic Nonspecific Low Back Pain Patients

Document Type : RESEARCH PAPER


1 Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

2 Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

3 Neuromuscular Rehabilitation Research Center, Department of Physiotherapy, Semnan University of Medical Sciences, Semnan, Iran


Background: This study aimed to investigate the relationships of lumbar spine-hip discoordination during sit-to-stand
(STD) and stand-to-sit (SIT) with pain and functional disability in chronic nonspecific low back pain (CNLBP) patients.
Methods: A cross-sectional observational study was conducted in a biomechanics laboratory of the physical therapy
department located at the School of Rehabilitation Sciences, Iran University of Medical Sciences (Tehran–Iran). A total
of 16 CNLBP patients (men 9, female 7) aged 18–40 years (mean 31.48) were selected according to our eligibility
criteria. Furthermore, ten reflective markers were placed on the spinous processes of T12 and S2, posterior and
anterior superior iliac spines, greater trochanters, and lateral epicondyles. The patients were instructed to perform
STD and SIT tasks at a preferred speed without using their hands. Relative phase angle was used as an indicator of
coordination and was identified as the inverse tangent of angular displacement/angular velocity. Moreover, the relative
phase angle between the lumbar spine and right and left hip joints was measured by subtracting the phase angle of
the hip joint from the lumbar spine joint. The ratios of the total movements of the lumbar spine to the total movements
of the right and left hip joints were also calculated in the sagittal plane. Finally, Pearson correlation coefficients (r) were
utilized to assess the association between variables.
Results: The results of this study indicated that kinematic parameters of the pain had statistically significant direct
relationships with functional disability in CNLBP participants during STD and SIT with r values ranging from 0.57
(Pvalue = 0.021) to 0.85 (Pvalue<0.001) and 0.54 (Pvalue=0.053) to 0.82 (Pvalue<0.001), respectively.
Conclusion: Out of the results of this study, it could be stated that pain and functional disability play a major role in
lumber spine-hip discoordination, and it altered the movement ratio in CNLBP patients during STD and SIT. In clinical
practice, clinicians should improve lumber spine-hip discoordination in patients with CNLBP since there is a linear
relationship between kinematic parameters of the pain and functional disability in patients with CNLBP.
Level of evidence: II


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