Hip stiffness patterns in lumbar flexion- or extension-based movement syndromes
Jason Zafereo1, Raymond Devanna1, Edward Mulligan1
1Department of Physical Therapy, University of Texas Southwestern Medical Center, Dallas, TX.
Archives of Physical Medicine and Rehabilitation
|October 15, 2014
Summary
Unidirectional hip range of motion loss in patients with low back pain (LBP) strongly correlates with their Movement System Impairment (MSI) category. Addressing hip stiffness may improve LBP outcomes.
Area of Science:
- Orthopedics
- Physical Therapy
- Biomechanical Analysis
Background:
- Low back pain (LBP) is a prevalent condition often associated with musculoskeletal impairments.
- Movement System Impairment (MSI) is a classification system used to categorize patients with LBP based on movement dysfunctions.
- Hip range of motion (ROM) limitations, particularly in the sagittal plane, are frequently observed in individuals with LBP.
Purpose of the Study:
- To investigate the relationship between sagittal plane hip ROM loss and sagittal plane lumbar MSI categories in patients experiencing LBP.
- To determine if specific patterns of hip stiffness are associated with particular lumbar MSI classifications.
Main Methods:
- A correlational study design was employed.
- Forty subjects diagnosed with LBP were recruited from a university outpatient physical therapy clinic.
- Participants were classified into flexion- or extension-based lumbar MSI categories and underwent bilateral passive hip flexion and extension ROM testing. Subclassification into hip stiffness patterns (A, B, or C) was based on predefined criteria.
Main Results:
- A considerable unidirectional loss of hip motion (Pattern A) was observed in 57.5% of subjects, showing a strong positive relationship (φ=.56, P=.007) with the corresponding MSI category.
- A considerable loss of both hip flexion and extension (Pattern B) occurred in 25% of subjects, with a weaker association (φ=.47, P=.197) to the MSI category.
- Minimally limited hip motion (Pattern C) was found in 17.5% of subjects, with no significant relationship (φ=-.40, P=.290) to the MSI category.
Conclusions:
- Significant unidirectional sagittal plane hip ROM loss is a common finding in individuals with LBP.
- This hip motion loss demonstrates a strong positive correlation with the same-direction lumbar MSI category.
- The findings suggest that targeting hip stiffness patterns may be a valuable approach in the management of LBP.
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