Regional Differences in Lumbar Spinal Posture and the Influence of Low Back Pain

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2008 Nov 19

PMID 19014712

Citations 37

Authors

Tim Mitchell

Peter B OSullivan

Angus F Burnett

Leon Straker

Anne Smith

Affiliations

Soon will be listed here.

Abstract

Background: Spinal posture is commonly a focus in the assessment and clinical management of low back pain (LBP) patients. However, the link between spinal posture and LBP is not fully understood. Recent evidence suggests that considering regional, rather than total lumbar spine posture is important. The purpose of this study was to determine; if there are regional differences in habitual lumbar spine posture and movement, and if these findings are influenced by LBP.

Methods: One hundred and seventy female undergraduate nursing students, with and without LBP, participated in this cross-sectional study. Lower lumbar (LLx), Upper lumbar (ULx) and total lumbar (TLx) spine angles were measured using an electromagnetic tracking system in static postures and across a range of functional tasks.

Results: Regional differences in lumbar posture and movement were found. Mean LLx posture did not correlate with ULx posture in sitting (r = 0.036, p = 0.638), but showed a moderate inverse correlation with ULx posture in usual standing (r = -0.505, p < 0.001). Regional differences in range of motion from reference postures in sitting and standing were evident. BMI accounted for regional differences found in all sitting and some standing measures. LBP was not associated with differences in regional lumbar spine angles or range of motion, with the exception of maximal backward bending range of motion (F = 5.18, p = 0.007).

Conclusion: This study supports the concept of regional differences within the lumbar spine during common postures and movements. Global lumbar spine kinematics do not reflect regional lumbar spine kinematics, which has implications for interpretation of measures of spinal posture, motion and loading. BMI influenced regional lumbar posture and movement, possibly representing adaptation due to load.

Citing Articles

Breast size, thoracic kyphosis, and thoracic spine pain: a correlational survey of Nigerian postpartum mothers.

Petronilla O, Chinecherem E, Sunday E BMC Musculoskelet Disord. 2024; 25(1):934.

PMID: 39563285 PMC: 11577858. DOI: 10.1186/s12891-024-07978-x.

Lumbar Sitting Behavior of Individuals with Low Back Pain: A Preliminary Study Using Extended Real-World Data.

McClintock F, Callaway A, Clark C, Alqhtani R, Williams J Sensors (Basel). 2024; 24(20).

PMID: 39460231 PMC: 11510775. DOI: 10.3390/s24206751.

Can 5-weeks of Hypopressive Exercise Influence Sagittal Lumbo-Pelvic Position in Athletic and Non-Athletic Females?.

Wojcik K, Machado L, Bastos DE Brito C, Rebullido T Int J Exerc Sci. 2024; 16(4):550-562.

PMID: 38288077 PMC: 10824316. DOI: 10.70252/KHQG8688.

Concurrent Validity of the Ergotex Device for Measuring Low Back Posture.

Garcia-Luna M, Jimenez-Olmedo J, Pueo B, Manchado C, Cortell-Tormo J Bioengineering (Basel). 2024; 11(1).

PMID: 38275578 PMC: 10812927. DOI: 10.3390/bioengineering11010098.

Fuzzy Controller Implemented for Movement of a Tendon-Driven 3D Robotic Lumbar Spine Mechanism.

Paixao T, Alvarez A, Florez R, Palomino-Quispe F Sensors (Basel). 2023; 23(24).

PMID: 38139479 PMC: 10747253. DOI: 10.3390/s23249633.

References

Rose S . Physical therapy diagnosis: role and function. Phys Ther. 1989; 69(7):535-7. DOI: 10.1093/ptj/69.7.535. View

Eriksen W, Bruusgaard D, Knardahl S . Work factors as predictors of intense or disabling low back pain; a prospective study of nurses' aides. Occup Environ Med. 2004; 61(5):398-404. PMC: 1740782. DOI: 10.1136/oem.2003.008482. View

Glatt B, Sarwer D, OHara D, Hamori C, Bucky L, LaRossa D . A retrospective study of changes in physical symptoms and body image after reduction mammaplasty. Plast Reconstr Surg. 1999; 103(1):76-82; discussion 83-5. DOI: 10.1097/00006534-199901000-00013. View

Boersma K, Linton S . Screening to identify patients at risk: profiles of psychological risk factors for early intervention. Clin J Pain. 2004; 21(1):38-43. DOI: 10.1097/00002508-200501000-00005. View

Korovessis P, Stamatakis M, Baikousis A . Segmental roentgenographic analysis of vertebral inclination on sagittal plane in asymptomatic versus chronic low back pain patients. J Spinal Disord. 1999; 12(2):131-7. View

Adams M, Dolan P . A technique for quantifying the bending moment acting on the lumbar spine in vivo. J Biomech. 1991; 24(2):117-26. DOI: 10.1016/0021-9290(91)90356-r. View

Scannell J, McGill S . Lumbar posture--should it, and can it, be modified? A study of passive tissue stiffness and lumbar position during activities of daily living. Phys Ther. 2003; 83(10):907-17. View

Jackson R, McManus A . Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study. Spine (Phila Pa 1976). 1994; 19(14):1611-8. DOI: 10.1097/00007632-199407001-00010. View

van Dieen J, Toussaint H, Maurice C, Mientjes M . Fatigue-related changes in the coordination of lifting and their effect on low back load. J Mot Behav. 1996; 28(4):304-14. DOI: 10.1080/00222895.1996.10544600. View

10.

OSullivan P, Mitchell T, Bulich P, Waller R, Holte J . The relationship beween posture and back muscle endurance in industrial workers with flexion-related low back pain. Man Ther. 2005; 11(4):264-71. DOI: 10.1016/j.math.2005.04.004. View

11.

Burton A . The ratio of upper lumbar to lower lumbar sagittal mobility related to age, sex, and low back trouble. Eng Med. 1987; 16(4):233-6. DOI: 10.1243/emed_jour_1987_016_052_02. View

12.

Smith A, OSullivan P, Straker L . Classification of sagittal thoraco-lumbo-pelvic alignment of the adolescent spine in standing and its relationship to low back pain. Spine (Phila Pa 1976). 2008; 33(19):2101-7. DOI: 10.1097/BRS.0b013e31817ec3b0. View

13.

Hodges P, Moseley G, Gabrielsson A, Gandevia S . Experimental muscle pain changes feedforward postural responses of the trunk muscles. Exp Brain Res. 2003; 151(2):262-71. DOI: 10.1007/s00221-003-1457-x. View

14.

Dankaerts W, OSullivan P, Burnett A, Straker L . Differences in sitting postures are associated with nonspecific chronic low back pain disorders when patients are subclassified. Spine (Phila Pa 1976). 2006; 31(6):698-704. DOI: 10.1097/01.brs.0000202532.76925.d2. View

15.

OSullivan P, Dankaerts W, Burnett A, Straker L, Bargon G, Moloney N . Lumbopelvic kinematics and trunk muscle activity during sitting on stable and unstable surfaces. J Orthop Sports Phys Ther. 2006; 36(1):19-25. DOI: 10.2519/jospt.2006.36.1.19. View

16.

Adams M, Mannion A, Dolan P . Personal risk factors for first-time low back pain. Spine (Phila Pa 1976). 2000; 24(23):2497-505. DOI: 10.1097/00007632-199912010-00012. View

17.

Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G . Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987; 18(3):233-7. DOI: 10.1016/0003-6870(87)90010-x. View

18.

Naidoo R, Coopoo Y . The health and fitness profiles of nurses in KwaZulu-Natal. Curationis. 2007; 30(2):66-73. DOI: 10.4102/curationis.v30i2.1076. View

19.

OSullivan P . Lumbar segmental 'instability': clinical presentation and specific stabilizing exercise management. Man Ther. 2000; 5(1):2-12. DOI: 10.1054/math.1999.0213. View

20.

Biering-Sorensen F . A prospective study of low back pain in a general population. II. Location, character, aggravating and relieving factors. Scand J Rehabil Med. 1983; 15(2):81-8. View