Lumbopelvic rhythm during trunk motion in the sagittal plane: A review of the kinematic measurement methods and characterization approaches

Abstract

Lumbopelvic rhythm during trunk forward bending and backward return has been widely investigated to have a better understanding of the pattern of trunk motion, as used in research on low back disorders. Considerable differences in the methods used to measure, and approaches used to characterize the lumbopelvic rhythm hinder the integration of findings of those studies for further research in the future. Thus, the purpose of this review was to summarize the methods for kinematic measurement as well as their characterization approaches for the lumbopelvic rhythm. PUBMED and CINAHL databases were searched for relevant studies. Several types of instruments were found to be used in the reviewed studies, mostly using markers or sensors, which were placed on different parts of spine, with different definitions to measure the lumbar and pelvic motion. Also, various characterization approaches were found to be used, of which some related to the magnitude, while the others to the timing aspects of lumbopelvic rhythm. Such a characterization was either qualitative or quantitative. In addition, the specified characterization approaches were applied on a sample of trunk kinematics data from our lab to demonstrate differences in the outcomes of these approaches.

Timing and magnitude of lumbar spine contribution to trunk forward bending and backward return in patients with acute low back pain

“…Such inconsistency in the results between the current study and the study by Wong and Lee (2004) could be due to the differences in the personal characteristics of participants (e.g., females ~ 57 years old in the current study vs. males ~ 40 years old in the study by Wong and Lee (2004)), different methods of data analysis (CRP method in the current study vs. Cross-correlation method in the study by Wong and Lee (2004); see Vazirian et al (2016b) for differences between the two methods) and potential differences in LBP subtypes. In studies including patients with chronic LBP, there are reports of a more in-phase lumbo-pelvic coordination in patients vs. asymptomatic controls during forward bending and backward return (Asgari et al, 2015; Mokhtarinia et al, 2016) as well as during walking and running (Seay et al, 2011; Selles et al, 2001).…”

“…In asymptomatic individuals, the lumbar contribution to forward bending has been reported to be dominant in the early stage of trunk motion, whereas pelvis contribution increases toward the end of motion and is dominant at the late stage of motion (Esola et al, 1996; Lee and Wong, 2002; Pal et al, 2007; Tafazzol et al, 2014; Vazirian et al, 2016a; Vazirian et al, 2017; Vazirian et al, 2016b). Conversely, backward return starts with a small lumbar contribution that gradually increases toward the end of motion (Granata and Sanford, 2000; Lee and Wong, 2002; McClure et al, 1997; Pal et al, 2007).…”

“…There are, however, some exceptions to such general trend of observed differences in the literature which could be due to heterogeneity of LBP (e.g., different subtypes of LBP), differences in patient’s personal characteristics, and difference in performing forward bending and backward return (e.g., pace of task, presence of load, etc.) (Granata and Sanford, 2000; Kim et al, 2013; Silfies et al, 2009; Van Wingerden et al, 2008; Vazirian et al, 2016b). Kim et al (2013), for instance, observed larger lumbar contribution to the trunk motion in a subgroup of patient with LBP who were identified to have “lumbar flexion with rotation syndrome”.…”

“…These results clearly distinguished patients from asymptomatic controls in discrete end points, however, they don’t offer any information related to potential differences in lumbo-pelvic coordination throughout the trunk forward bending and backward motion. Further characterization of lumbo-pelvic coordination throughout the entire task cycle could provide more in-depth information about the impact of acute LBP on timing and magnitude aspects of lumbo-pelvic coordination (Mokhtarinia et al, 2016; Pal et al, 2007; Selles et al, 2001; Thomas and Gibson, 2007; Vazirian et al, 2016b). In other words, potential biomechanical abnormalities in the lower back of patients with LBP, particularly due to neuromuscular impairments, could be better identified by assessment of lumbo-pelvic coordination throughout the entire task.…”

Lumbopelvic rhythm in the sagittal plane: A review of the effects of participants and task characteristics

“…This study comes as a continuation of a previous review where we summarized the methods used for kinematic measurement, and characterization approaches for LPR. 10 It is expected therefore, that these reviews help in establishing a platform for future study of this concept in LBP research.…”