Hip Stiffness Patterns in Lumbar Flexion or Extension-Based Movement Syndromes.
Arch Phys Med Rehabil. 2014 Oct 10;
Authors: Zafereo J, Devanna R, Mulligan E, Wang-Price S
OBJECTIVE: To determine whether a relationship exists between sagittal plane hip range of motion (ROM) loss and sagittal plane lumbar Movement System Impairment (MSI) categories in patients with low back pain (LBP).
DESIGN: Correlational study SETTING: University outpatient physical therapy clinic PARTICIPANTS: Forty subjects with LBP INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: Classification into a flexion- or extension-based lumbar MSI category, and bilateral passive hip flexion and extension ROM testing. Using pre-defined criteria, subjects in each MSI category were sub-classified into one of three hip stiffness categories: (1) a considerable loss of either flexion or extension (pattern A), (2) a considerable loss of both flexion and extension (pattern B), or (3) minimally limited flexion or extension (pattern C).
RESULTS: Pattern A occurred in 23 (57.5%) of the subjects, with the primary direction of hip motion loss agreeing with the MSI category 78.3% of the time (?=.56, P=.007). Pattern B occurred in 10 (25%) of the subjects, with the primary direction of hip motion loss agreeing with the MSI category 70% of the time (?=.47, P=.197). Pattern C occurred in 7 (17.5%) of the subjects, with the primary direction of hip motion limitation agreeing with the MSI category 42.9% of the time (?=-.40, P=.290).
CONCLUSIONS: Considerable unidirectional hip motion loss in the sagittal plane was a common finding among subjects with LBP and yielded a strong positive relationship with the same direction MSI category. These results may inform future studies investigating whether treatment of hip stiffness patterns could improve outcomes in LBP management.
PMID: 25312581 [PubMed – as supplied by publisher]