Factors affecting shoulder-pelvic integration during axial trunk rotation in subjects with recurrent low back pain

Shoulder-pelvic integration could play a central role in the control of dynamic posture and movement. However, kinematic coordination during axial trunk rotation has not been carefully investigated in subjects with recurrent low back pain (LBP). The purpose of this study was to compare the maximum rotational angles of the shoulders and pelvis in the transverse plane between subjects with and without recurrent LBP.

A total of 38 age-matched subjects (19 control subjects: 69.00 ± 5.75 years old and 19 subjects with LBP: 68.79 ± 5.40 years old) participated in the study. The axial trunk rotation test was conducted in the upright position with bilateral hips and knees fully extended and both feet shoulder width apart.

The results of this study indicated that there was a difference in pelvic girdle rotation between groups (100.79 ± 26.46 in the control group, 82.12 ± 23.16 in the LBP group; t = 2.31, p = 0.02); however, there was no difference for the shoulder girdle (177.63 ± 36.98 in the control group, 156.42 ± 30.09 in the LBP group; t = 1.91, p = 0.06). There were interactions with age (F = 9.27, p = 0.004) and BMI (F = 7.50, p = 0.01) with the rotational angles of the shoulder and pelvis.

These results indicated a different pattern of trunk rotation movement with the age and BMI serving as important factors to consider for recurrent LBP. The results of our study also indicated a different pattern of shoulder and pelvic coordination with age and gender. Clinicians need to consider the consequences of limited shoulder-pelvic rotational angles, especially limited rotational angle on the pelvis during trunk axial rotation. Further studies are required to determine the causes of the underlying problems for clinical decision-making and altered shoulder-pelvic rotation in subjects with recurrent LBP.