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Patterns of Lumbar Region Movement During Trunk Lateral Bending in 2 Subgroups of People With Low Back Pain

SP Gombatto, PT, MS, is a doctoral candidate in the Program in Physical Therapy, Washington University School of Medicine, Campus Box #8502, 4444 Forest Park Blvd, St Louis, MO 63110 (USA).
DR Collins, PhD, is Independent Consultant to the Musculoskeletal Analysis Laboratory, Program in Physical Therapy, Washington University School of Medicine.
SA Sahrmann, PT, PhD, FAPTA, is Professor of Physical Therapy/Neurology/Cell Biology & Physiology, Program in Physical Therapy, Washington University School of Medicine.
JR Engsberg, PhD, is Associate Professor, Department of Physical Therapy, Doisy College of Health Sciences, Saint Louis University, St Louis, Mo.
LR Van Dillen, PT, PhD, is Assistant Professor, Program in Physical Therapy, Washington University School of Medicine.

spgombat{at}artsci.wustl.edu

Background and Purpose: The movement system impairment (MSI) system is one proposed system for classifying low back pain (LBP) problems. Prior clinical data and observations for the MSI system suggest that different LBP subgroups demonstrate different patterns of movement during clinical tests, such as trunk lateral bending (TLB). The purpose of this study, therefore, was to examine the validity of the observation that lumbar region (LR) movement patterns during TLB are different between 2 subgroups of people with LBP: lumbar rotation with extension (RotExt) and lumbar rotation (Rot).

Subjects: Participants were 44 people (28 men and 16 women; age [±SD], 28.5±8.4 years) with chronic or recurrent LBP.

Methods: Each participant's LBP problem was classified with the MSI system. Kinematic variables were measured, and LBP symptoms were recorded during the TLB test.

Results: People in the 2 LBP subgroups demonstrated different patterns of LR movement during TLB. People in the Rotation With Extension subgroup displayed an asymmetric (right versus left) pattern of LR movement across the TLB movement, whereas people in the Rotation subgroup displayed a symmetric pattern of LR movement. Equal proportions of people in the 2 subgroups reported an increase in symptoms with the TLB test.

Discussion and Conclusion: The patterns of LR movement across the TLB movement were different in 2 subgroups of people with LBP. The difference in the LR movement patterns between subgroups may be an important factor to consider in specifying the details of the interventions for these 2 LBP problems.