Lumbopelvic Stability in Non-specific Low Back Pain: Exploring the Relationships between Hip Strengthening, Lumbopelvic Mechanics, and Pain
Date
2013-04-29
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Abstract
Low back pain (LBP) is among the most common chronic conditions in Canada and upwards of 85% of low back pain cases become classified as non-specific low back pain (NSLBP) meaning that a definitive diagnosis cannot be found. This represents a significant problem for clinical practitioners treating these individuals. The objective of this research is to address in part two major challenges facing clinical researchers, understanding the mechanisms that contribute to NSLBP and identifying treatment strategies that yield optimal clinical outcomes for individuals with chronic NSLBP. With this research we aimed to contribute new knowledge in two areas for which gaps in the literature exist; the clinical assessment of lumbopelvic stability and the value of specific hip strengthening exercise within exercise therapy programs designed to treat NSLBP. Three studies involving cross-sectional, experimental, and quasi-experimental designs were used to investigate the validity of the Trendelenburg test (TT) as a functional measure of hip abductor muscle (HABD) strength and lumbopelvic stability. A fourth study, a randomized controlled trial was used to compare the efficacy of two exercise therapy programs for the reduction of pain and disability in individuals with NSLBP. The first study revealed non-significant negative correlations between HABD strength and contralateral pelvic drop (cPD) measured during the TT. The second study demonstrated that significant reductions in HABD strength did not result in the compensatory frontal plane motion at the hip pelvis and trunk described by the Trendelenburg’s theory. The third study showed that despite an average reduction in pain of 48%, and significant increases in HABD strength, no changes in cPD were measured during the TT following a specific HABD strengthening program. The randomized controlled trial determined that the addition of hip strengthening to a motor control-focused lumbopelvic exercise program did not result in changes in lumbopelvic mechanics or greater reductions in pain and disability in individuals with NSLBP. In conclusion, the validity of the TT as measure of HABD strength is not supported and suggests that it has limited use as a measure of lumbopelvic stability. Further research to develop optimal exercise therapies for the treatment of NSLBP is needed.
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Rehabilitation and Therapy
Citation
Kendall, K. D. (2013). Lumbopelvic Stability in Non-specific Low Back Pain: Exploring the Relationships between Hip Strengthening, Lumbopelvic Mechanics, and Pain (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/26803