Kinematic Analysis of Pelvic and Lower Limb Joints during Stand-to-sit Movement in Individuals with Chronic Low Back Pain: A cross-sectional study

Document Type : RESEARCH PAPER

Authors

1 Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

2 Department of Physical Therapy, University of North Georgia, Dahlonega, USA

3 Bayesian Imaging and Spatial Statistics Group, Institute of Statistics, Ludwig-Maximilian-Universität München, Munich, Germany

4 Department of Biomedical Engineering, University of Kentucky, Lexington, KY, United States

Abstract

Objectives: It is crucial to investigate the daily functions commonly utilized by individuals with low back pain (LBP) due to their implications for recurrence and chronicity. Stand-to-sit (StTS) task is one of the more repetitive functions in human daily life. This study aims to evaluate pelvic and lower limb joint kinematics during the StTS task in individuals with Non-Specific Chronic Low Back Pain (NSCLBP) compared to a healthy control group.
Methods: Pelvic and lower limb joint kinematic data in all three planes were recorded from 20 individuals with LBP and 20 healthy individuals using a Qualisys motion capture system during the StTS task. A Functional Data Analysis statistical approach was employed to compare the kinematic data between the two groups.
Results: In the initial phase of the movement, we observed a greater anterior pelvic tilt (P=0.028) and an altered pelvic frontal plane motion pattern (P=0.029) in the LBP compared to the healthy group. The only significant differences between the lower limb joint kinematics of the two groups were a less hip external rotation position (P=0.025) and a more knee adduction pattern (P=0.002) on the right side in the LBP subjects compared to the healthy group.
Conclusion: Considering a few differences noted between the two groups across various joints and planes evaluated, it appears that the kinematic pattern of the lower limbs does not significantly differ between the NSCLBP and healthy groups during the StTS task in most comparisons. However, distinct kinematic patterns have been observed in the pelvic region, particularly in the sagittal and frontal planes, between the two groups.
        Level of evidence: III

Keywords

Main Subjects


  1. Hoy D, Bain C, Williams G, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012; 64(6):2028-37. doi: 10.1002/art.34347.
  2. Koes BW, Van Tulder M, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006; 332(7555):1430-4. doi: 10.1136/bmj.332.7555.1430.
  3. Orakifar N, Shaterzadeh-Yazdi MJ, Salehi R, Mehravar M, Namnik N, Haghpanah SA. Comparison of Kinematic Movement Patterns between 2 Subgroups of Females with Low Back Pain and Healthy Women during Sit-to-Stand and Stand-to-Sit. J Appl Biomech. 2022; 38(5):346-354. doi: 10.1123/jab.2022-0064.
  4. Sadeghisani M, Manshadi FD, Kalantari KK, Karimi MT, Azimi H, Aghazadeh A. Kinematics of the Lumbar Spine and Hip Joints in People with Persistent Low Back Pain during Sit to Stand and Stand to Sit Activities. Med J Islam Repub Iran. 2021:35:165. doi: 10.47176/mjiri.35.165.
  5. Rahimi A, Arab AM, Nourbakhsh MR, Hosseini SM, Forghany S. Lower limb kinematics in individuals with chronic low back pain during walking. J Electromyogr Kinesiol. 2020:51:102404. doi: 10.1016/j.jelekin.2020.102404.
  6. Van Dillen LR, Sahrmann SA, Norton BJ, Caldwell CA, McDonnell MK, Bloom NJ. Movement system impairment-based categories for low back pain: stage 1 validation. J Orthop Sports Phys Ther.2003; 33(3):126-42. doi: 10.2519/jospt.2003.33.3.126.
  7. O'Sullivan P. Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism. Man Ther. 2005; 10(4):242-55. doi: 10.1016/j.math.2005.07.001.
  8. Kamper SJ, Apeldoorn AT, Chiarotto A, et al. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ. 2015:350:h444. doi: 10.1136/bmj.h444.
  9. Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet.2018; 391(10137):2368-2383. doi: 10.1016/S0140-6736(18)30489-6.
  10. Negrini S, Pollet J, Ranica G, et al. Movement analysis could help in the assessment of chronic low back pain patients: Results from a preliminary explorative study. Int J Environ Res Public Health. 2022; 19(15):9033. doi: 10.3390/ijerph19159033.
  11. Kerr KM, White JA, Barr DA, Mollan RA. Analysis of the sit-stand-sit movement cycle in normal subjects. Clin Biomech (Bristol, Avon).1997; 12(4):236-245. doi: 10.1016/s0268-0033(96)00077-0.
  12. Sadeghi H, Allard P, Prince F, Labelle H. Symmetry and limb dominance in ablebodied gait: a review. Gait Posture. 2000; 12(1):34-45. doi: 10.1016/s0966-6362(00)00070-9.
  13. Shum GL, Crosbie J, Lee RY. Effect of low back pain on the kinematics and joint coordination of the lumbar spine and hip during sit-to-stand and stand-to-sit. Spine (Phila Pa 1976). 2005; 30(17):1998-2004. doi: 10.1097/01.brs.0000176195.16128.27.
  14. Pourahmadi MR, Takamjani IE, Jaberzadeh S,et al. Test-retest reliability of sit-to-stand and stand-to-sit analysis in people with and without chronic non-specific low back pain. Musculoskelet Sci Pract.2018:35:95-104. doi: 10.1016/j.msksp.2017.11.001.
  15. Claeys K, Dankaerts W, Janssens L, Brumagne S. Altered preparatory pelvic control during the sit-to-stance-to-sit movement in people with non-specific low back pain. J Electromyogr Kinesiol.2012; 22(6):821-8. doi: 10.1016/j.jelekin.2012.04.007.
  16. Jangjoo N, Alijanpour E, Khodabakhsh S, Shojaedin SS, Naemi R. Comparison of Spine–Pelvis Kinematics Variability during Sit-to-Stand and Stand-to-Sit in People with & without Chronic Low Back Pain: A Vector Coding and Statistical Parametric Mapping Approach. Applied Sciences. 2022; 12(22):11796.doi: 10.3390/app122211796.
  17. Ryan W, Harrison A, Hayes K. Functional data analysis of knee joint kinematics in the vertical jump. Sports Biomech.2006; 5(1):121-38. doi: 10.1080/14763141.2006.9628228.
  18. Lazennec JY, Brusson A, Rousseau MA. Hip–spine relations and sagittal balance clinical consequences. Eur Spine J.2011;20 Suppl 5(Suppl 5):686-98. doi: 10.1007/s00586-011-1937-9.
  19. Kim Y, Vergari C, Girinon F, Lazennec JY, Skalli W. Stand-to-sit kinematics of the pelvis is not always as expected: hip and spine pathologies can have an impact. J Arthroplasty.2019; 34(9):2118-2123. doi: 10.1016/j.arth.2019.04.059.
  20. Guerrero-Henriquez J, Mendez-Rebolledo G, LLancaleo L, Vargas M. Effects of dominance and vision on unipedal balance tests in futsal players using a triaxial accelerometer. Sports Biomech.2024:1-10. doi: 10.1080/14763141.2024.2301987.
  21. Gabbard C, Hart S. A question of foot dominance. J Gen Psychol.1996; 123(4):289-96. doi: 10.1080/00221309.1996.9921281.
  22. Tully EA, Fotoohabadi MR, Galea MP. Sagittal spine and lower limb movement during sit-to-stand in healthy young subjects. Gait Posture.2005; 22(4):338-45. doi: 10.1016/j.gaitpost.2004.11.007.
  23. Mourey F, Grishin A, d'Athis P, Pozzo T, Stapley P. Standing up from a chair as a dynamic equilibrium task: a comparison between young and elderly subjects. J Gerontol A Biol Sci Med Sci. 2000; 55(9):B425-31. doi: 10.1093/gerona/55.9.b425.
  24. Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng.1983; 105(2):136-44. doi: 10.1115/1.3138397.
  25. Leardini A, Benedetti MG, Catani F, Simoncini L, Giannini S. An anatomically based protocol for the description of foot segment kinematics during gait. Clin Biomech (Bristol, Avon).1999; 14(8):528-36. doi: 10.1016/s0268-0033(99)00008-x.
  26. Ramsay J, Hooker G, Graves S. Introduction to functional data analysis. In: Functional data analysis with R and MATLAB. New York, NY: Springer; 2009
  27. Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016; 15(2):155-63. doi: 10.1016/j.jcm.2016.02.012.
  28. Behdarvandan A, Shaterzadeh-Yazdi MJ, Negahban H, Mehravar M. Differences in timing and magnitude of lumbo-pelvic rotation during active and passive knee extension in sitting position in people with and without low back pain: A cross-sectional study. Hum Mov Sci. 2019:64:338-346. doi: 10.1016/j.humov.2019.02.012.
  29. Cooper NA, Scavo KM, Strickland KJ, et al. Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. Eur Spine J.2016; 25(4):1258-65. doi: 10.1007/s00586-015-4027-6.
  30. Sadeghisani M, Manshadi FD, Kalantari KK, et al. A comparison of the lumbopelvic-hip complex movement patterns in people with and without non-specific low back pain during an active hip test. Journal of Mechanics in Medicine and Biology. 2017; 17(01):1750004. doi:org/10.1142/S021951941750004X.
  31. Murray E, Birley E, Twycross-Lewis R, Morrissey D. The relationship between hip rotation range of movement and low back pain prevalence in amateur golfers: an observational study. Phys Ther Sport.2009; 10(4):131-5. doi: 10.1016/j.ptsp.2009.08.002.
  32. Neumann DA. Kinesiology of the hip: a focus on muscular actions. J Orthop Sports Phys Ther.2010; 40(2):82-94. doi: 10.2519/jospt.2010.3025.
  33. Jeon W, Whitall J, Griffin L, Westlake KP. Trunk kinematics and muscle activation patterns during stand-to-sit movement

 

and the relationship with postural stability in aging. Gait Posture. 2021:86:292-298. doi: 10.1016/j.gaitpost.2021.03.025.

  1. Levangie PK, Norkin CC. Joint structure and function: a comprehensive analysis. Fifth edition. Philadelphia. FA Davis; 2011.
  2. Gombatto SP, D'Arpa N, Landerholm S, et al. Differences in kinematics of the lumbar spine and lower extremities between people with and without low back pain during the down phase of a pickup task, an observational study. Musculoskelet Sci Pract.2017:28:25-31. doi: 10.1016/j.msksp.2016.12.017.
  3. Papi E, Bull AM, McGregor AH. Alteration of movement patterns in low back pain assessed by Statistical Parametric Mapping. J Biomech.2020:100:109597. doi: 10.1016/j.jbiomech.2019.109597.
  4. McGill SM. The biomechanics of low back injury: implications on current practice in industry and the clinic. J Biomech.1997; 30(5):465-75. doi: 10.1016/s0021-9290(96)00172-8.
  5. Cho M. Correlations among pelvic positions and differences in lower extremity joint angles during walking in female university students. J Phys Ther Sci.2015; 27(6):1941-4. doi: 10.1589/jpts.27.1941.
  6. Pourahmadi M, Barejahri AM, Sahebalam M, Bagheri R. 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. Archives of Bone and Joint Surgery. 2022;10(10):892. doi: 10.22038/abjs.2022.56903.2822.
  7. Khanzadeh R, Mahdavinejad R, Borhani A. The effect of suspension and conventional core stability exercises on characteristics of intervertebral disc and chronic pain in office staff due to lumbar herniated disc. Archives of Bone and Joint Surgery. 2020;8(3):445. doi: 10.22038/abjs.2019.40758.2102.
  8. Azadinia F, Ebrahimi-Takamjani I, Kamyab M, Asgari M, Parnianpour M. Immediate effects of lumbosacral orthosis on postural stability in patients with low back pain: a preliminary study. Archives of Bone and Joint Surgery. 2019;7(4):360. doi: 10.22038/abjs.2019.34753.1912