Identifying the Problem Side with Single-Leg Squat and Hamstrings Flexibility for Non-Specific Chronic Low Back Pain

Area of Science:

• Biomechanics
• Musculoskeletal Health
• Rehabilitation Science

Background:

• Non-specific chronic low back pain (LBP) presents challenges as pain and problem sides can be discordant.
• Clinical Pilates assessment for identifying the problem side in LBP is subjective and requires expertise.

Purpose of the Study:

• To determine if objective measures of single-leg squat postural control and hamstring flexibility can identify the problem side in adults with non-specific chronic LBP.
• To compare objective measures with the established Clinical Pilates method for problem side identification.

Main Methods:

• Forty adults with non-specific chronic LBP underwent single-leg squat postural control and hamstring flexibility assessments.
• Paired t-tests compared postural sway and flexibility between problem and non-problem sides.
• Cohen's kappa assessed agreement between objective measures and the Clinical Pilates method.

Main Results:

• The problem side exhibited altered postural sway (e.g., larger sway path distances) and reduced hamstring flexibility compared to the non-problem side.
• Overall and anteroposterior sway path distances, terminal knee flexion angle, squat duration, and hamstring flexibility showed moderate to strong agreement with the Clinical Pilates method.

Conclusions:

• Objective single-leg squat postural sway parameters and hamstring flexibility measurements can reliably identify the problem side in adults with non-specific chronic LBP.
• These objective measures provide a more consistent and less subjective alternative to current clinical assessments for LBP.