Hip joint kinematic assessment in chronic non-specific low back pain patients. A Delphi study
Maya Abady Avman1, Peter G Osmotherly1, Suzanne J Snodgrass1
1School of Health Sciences, The University of Newcastle, Australia.
Background:
Chronic nonspecific low back pain (CNSLBP) has been associated with movement impairment (MI) of the hip joint. However, evidence supporting this is inconsistent. Agreement from experts may provide rationale and recommendations for the assessment of the hip joint in the management of CNSLBP patients.
Objective:
Gain expert consensus on whether hip MIs are related to CNSLBP, whether they should be assessed and which movement types and directions they recommend.
Methods:
Through a three-round e-Delphi process, international experts in the field rated levels of agreement for generated themes pertaining to assessing proposed hip joint MI in individuals with CNSLBP and underlying rationales. Consensus was defined a priori as ≥75% ratings on Likert scales with an IQR≤ 1.
Results:
International expert panel consisted of a mix of researchers and clinicians with the majority involved in both. Response for round I was 27, round 2 was 21 and round III was 26 individuals. Consensus was achieved for the association of active and passive hip joint MI in CNSLBP and their assessment. 100% agreement was achieved for the rationale regarding compensatory movement of the lumbar spine, and the assessment of passive hip movements, in particular extension. Consensus was also achieved for assessing hip passive flexion, extension, rotations, and abduction, active flexion, extension, and abduction. No agreement was attained regarding passive accessory movement.
Conclusion:
The assessment of active and passive hip joint MI is regarded by experts as appropriate and informative in the management of and research pertaining to CNSLBP.
