Association Between Hamstring Shortness and Asymmetry, Pain Intensity, Disability Index, and Compensatory Lumbar Movement in 60 Patients with Nonspecific Chronic Low Back Pain

Abstract

Background The correlation between hamstring muscle shortening and nonspecific low back pain and compensatory lumbar movements is still controversial. The purpose of this study was to evaluate the association between hamstring shortness and asymmetry, pain intensity, the disability index, and compensatory lumbar movement in 60 patients with nonspecific chronic low back pain. Material/Methods Sixty patients with nonspecific low back pain participated in this study. The hamstring shortness and asymmetry, pain intensity, the disability index, and compensatory lumbar movement of the patients were assessed. The pain intensity was evaluated using a numeric pain rating scale (NPRS), active knee extension testing was performed to measure the length of the hamstring, and compensatory lumbar movement was assessed using a digital dual inclinometer. Correlation analysis was used for analysis of the obtained data. Results The hamstring length showed a negative correlation with hamstring length asymmetry, NPRS, and disability index ( P <0.05). The asymmetry of the hamstring length was positively correlated with NPRS, disability index, and compensatory lumbar rotation ( P <0.05). Lumbar flexion was positively correlated with the hamstring muscle length ( P <0.05). However, there was a negative correlation between the hamstring length asymmetry, NPRS, and disability index ( P <0.05). There was no correlation between the compensatory lumbar rotation, hamstring length, or disability index. Conclusions Compensatory flexion movements, NPRS, and disability index in patients with nonspecific chronic low back pain were associated with hamstring shortness and asymmetry. These factors should be considered when planning physical therapy for patients with nonspecific low back pain.

Effects of hamstring stretching using pressure bio feedback unit in patients with low back pain

“…In the current study, there is also improvement in the overall Oswestry disability index score as well as individual items including pain intensity, personal care, lifting, walking, sitting, standing, social life, and traveling this might be due to the reason that stretching helps to decrease pain in muscles, enhance flexibility, boost bodily performance as well as avoids injury chances [2,17,18]. No improvement in sleeping was noted which may be since sleep might not be affected at baseline, so no improvement was seen after the intervention in patients with chronic low back pain.…”

“…The results of this study showed that hamstring stretching using a pressure biofeedback unit in patients with low back pain causes an improvement in the flexibility of the hamstring muscles. An active knee extension test position for hamstring stretching using a pressure biofeedback unit is more effective for stretching as compared to using the same position without using a pressure bio feedback unit because a pressure biofeedback unit aims to put the pelvis in the anteriorly tilted position [9,18] and evidence has shown that hamstring stretching is more effective in the anterior pelvic tilt position as compared to posterior pelvic tilt position [19]. The focus of this study to use the anterior pelvic tilt position is because hamstring tightness might exist as a potential causative element of low back pain and anterior pelvic rotation might get limited when there is a decrease in the hamstring elasticity [6].…”

A relação entre a lombalgia e os isquiotibias na literatura atual

“…Esta hiperativação desencadeia um ciclo de piora, uma vez que desestimula a ativação de outros músculos como: Glúteo máximo, oblíquo interno, transverso do abdome e multífidos (KIM & YIM, 2020). Pacientes com lombalgia inespecífica crônica associada à enfraquecimento muscular dos estabilizadores centrais tendem a apresentar encurtamento exacerbado dos isquiotibiais (MOON et al, 2023).…”

“…Neste sentido, há uma correlação positiva entre a gravidade da lombalgia e a rigidez dos músculos isquiotibiais (ALLAM et al, 2022), sendo o comprimento também relacionado ao grau de incapacidade apresentado pelos pacientes (MOON et al, 2023).…”

“…Em estudo realizado com 65 pacientes entre a faixa etária de 25 a 45 anos que possuíam dor lombar inespecífica, foi demonstrada correlação positiva entre a assimetria do comprimento dos isquiotibiais e a elevação da escala numérica da dor, do índice de incapacidade, da rotação lombar compensatória e da redução da flexão lombar. Evidenciou-se que a compensação da assimetria do comprimento dos isquiotibiais gera um desequilíbrio entra as vértebras lombares, sendo fator relevante no desencadeamento de lombalgia (MOON et al, 2023).…”