Lumbopelvic rhythm during forward and backward sagittal trunk rotations: combined in vivo measurement with inertial tracking device and biomechanical modeling.
BACKGROUND
The ratio of total lumbar rotation over pelvic rotation (lumbopelvic rhythm) during trunk sagittal movement is essential to evaluate spinal loads and discriminate between low back pain and asymptomatic population.


METHODS
Angular rotations of the pelvis and lumbar spine as well as their sagittal rhythm during forward flexion and backward extension in upright standing of eight asymptomatic males are measured using an inertial tracking device. The effect of variations in the lumbopelvic ratio during trunk flexion on spinal loads is quantified using a detailed musculoskeletal model.


RESULTS
The mean of peak voluntary flexion rotations of the thorax, pelvis, and lumbar was 121° (SD 9.9), 53.0° (SD 5.2), and 60.2° (SD 8.6), respectively. The mean lumbopelvic ratios decreased from 2.51 in 0-30° of trunk flexion to 1.34 in 90-120° range during forward bending while it increased from 1.23 in 90-120° range to 2.86 in 0-30° range during backward extension. Variations in the lumbopelvic ratio from 0.5 to 3 (with an interval of 0.25) at any trunk flexion angle generally reduced the L5-S1 compression and shear forces by up to 21 and 45%, respectively. The measured lumbopelvic ratios resulted overall in near-optimal (minimal) L5-S1 compression forces.


CONCLUSIONS
A simultaneous rhythm between the lumbar and pelvis movements was found during both forward and backward trunk movements. While the lumbar spine contributed more to the trunk rotation during early and final stages of forward flexion and backward extension, respectively, the pelvis contributed more during final and early stages of forward flexion and backward extension, respectively. Our healthy subjects adapted a lumbopelvic coordination that diminished L5-S1 compression force.
Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.
A
A
Tafazzol
Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran. Electronic address: arjmand@sharif.edu.
N
N
Arjmand
Division of Applied Mechanics, Department of Mechanical Engineering, École Polytechnique, Montréal, Québec, Canada.
A
A
Shirazi-Adl
Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.
M
M
Parnianpour
D000328:Adult; D001696:Biomechanical Phenomena / Q000502:physiology; D006801:Humans; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae / Q000502:physiology*; D008161:Lumbosacral Region / Q000502:physiology; D008297:Male; D009068:Movement / Q000502:physiology*; D010384:Pelvic Bones / Q000502:physiology*; D011187:Posture; D016059:Range of Motion, Articular; D012399:Rotation; D013131:Spine / Q000502:physiology; D013909:Thorax / Q000502:physiology
Backward extension; Biomechanical model; Forward flexion; Inertial tracking sensors; Lumbopelvic rhythm