Three-dimensional kinetics of the lumbar spine and hips in low back pain patients during sit-to-stand and stand-to-sit.
METHODS
Experimental, biomechanical study to determine the kinetics of the lumbar spine and hips during sit-to-stand and stand-to-sit.


OBJECTIVE
To investigate the effects of back pain, with and without limitation in straight leg raise, on the joint moment and power of the lumbar and hips during sit-to-stand and stand-to-sit.


BACKGROUND
Movements of the lumbar spine and hips, and their coordination have been reported to be affected by the presence of low back pain (LBP), especially in those with a positive straight leg raise. However, the literature has no information concerning moment and power characteristics of the lumbar spine and hips during sit-to-stand and stand-to-sit in such patients.


METHODS
Twenty asymptomatic subjects, 20 LBP patients, and 20 patients with LBP and a positive straight leg raise sign were requested to perform the sit-to-stand and stand-to-sit activities. Electromagnetic sensors were attached to the body segments to measure their kinematics while 2 nonconductive force plates gathered ground reaction force data. Biomechanical models were used to determine the muscle moments and power at the lumbosacral (L5/S1) joint and hips.


RESULTS
Muscle moments acting at the lumbar spine and hip in the sagittal plane were found to decrease in subjects with LBP, but there were significant increases in moments in other planes of motion. The power patterns of the spine and hips were also significantly altered, particularly in subjects with a positive straight leg raise sign.


CONCLUSIONS
Back pain subjects exhibit compensatory movements and altered load sharing strategies during the sit-to-stand and stand-to-sit activities. Exercise therapy should take account of these changes so that the normal kinematic and kinetic characteristics of the spine and hips can be restored.
Shum
Gary L K
GL
School of Physiotherapy, the University of Sydney, Sydney, Australia.
Crosbie
Jack
J
Lee
Raymond Y W
RY
D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D007866:Leg / Q000503:physiopathology; D017116:Low Back Pain / Q000503:physiopathology*; D008159:Lumbar Vertebrae / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009068:Movement / Q000502:physiology; D018482:Muscle, Skeletal / Q000503:physiopathology; D011187:Posture / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology