Segmental lumbar mobility in individuals with low back pain: in vivo assessment during manual and self-imposed motion using dynamic MRI.
BACKGROUND
Altered spinal mobility is thought to be related to current or past episodes of low back pain; however evidence of that relationship in younger subjects has not been established. The purpose of this study was to compare lumbar segmental mobility in asymptomatic and symptomatic subjects during posterior to anterior (PA) manual spinal mobilization and a self-initiated prone press-up (PU) maneuver. We hypothesized that persons with central low back pain would have an altered lumbar segmental mobility pattern compared to those without pain.


METHODS
Forty-five individuals (age 32.1 +/- 8.5) with non-specific low back pain and 20 persons (age 31.1 +/- 7.0) without low back pain participated. Each subject underwent dynamic imaging of the lumbar spine during a PA mobilization procedure and while performing a PU. Segmental motion was quantified as the change in the intervertebral angle between the resting and end-range vertebral positions.


RESULTS
The symptomatic group had a larger percentage of subjects with evidence of single level segmental hypermobility than the asymptomatic group during the PA (40.0% vs. 5%) and PU (26.7% vs. 15%) procedures. Single lumbar motion-segment analysis revealed hyper-mobility in symptomatic subjects at L5 - S1 (Chi-square = 10.0, p < or = 0.01) and L4 - L5 (Chi-square = 4.18, p < or = 0.05) during the PA test.


CONCLUSIONS
Persons with non-specific low back pain have a tendency to demonstrate single level lumbar segmental hypermobility when compared to age specific asymptomatic subjects.
Kulig
Kornelia
K
Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA 90089, USA. kulig@usc.edu
Powers
Christopher M
CM
Landel
Robert F
RF
Chen
Hungwen
H
Fredericson
Michael
M
Guillet
Marc
M
Butts
Kim
K
D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000502:physiology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D010147:Pain Measurement / Q000379:methods; D011187:Posture / Q000502:physiology*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology