Predictors of dysfunction and health-related quality of life in the flexion pattern subgroup of patients with chronic lower back pain

Abstract

Findings about predictors of chronic lower-back pain (CLBP) were inconsistent and inconclusive in previous studies because patients with CLBP are heterogeneous. Subgrouping patients with CLBP, according to a CLBP classification system, might thus clarify the research findings. CLBP in the direction of lumbar flexion movement, that is, the flexion pattern, is common in clinical situations. Therefore, the purpose of this study was to determine the predictors of dysfunction (pain, disability) and health-related quality of life in the flexion pattern subgroup of patients with CLBP.A cross-sectional study of prospectively collected data. One hundred eight subjects in the flexion pattern subgroup of CLBP. Thirteen variables were measured: the visual analog scale (VAS), the Oswestry Disability Index (ODI), the Short Form-36 (SF-36), the Beck Depression Inventory (BDI), hip internal rotation range of motion, hip flexion range of motion, knee extension range of motion, knee extension with dorsiflexion range of motion, ratio forward flexion, knee extension strength, hip extension strength, hip flexion strength, and lumbopelvic stability.The models for predictors of lower-back pain in the CLBP flexion pattern subgroup included knee extension and the BDI as predictor variables that accounted for 8.1% of the variance in the VAS (P < .05); predictors for disability included the BDI, age, and hip flexion strength, which accounted for 21.2% of the variance in the ODI (P < .05); predictors for health-related quality of life included the BDI, sex, knee extension with dorsiflexion range of motion, and age, which accounted for 38.8% of the variance in the SF-36 (P < .05) in multiple regression models with a stepwise selection procedure.The current results suggest that knee extension, the BDI, age, hip flexion strength, knee extension with dorsiflexion, and sex should be considered when determining appropriate prediction, prevention, and intervention in the flexion pattern subgroup of patients with CLBP.

Lumbopelvic motor control function between patients with chronic low back pain and healthy controls: a useful distinguishing tool

“…However, it is difficult to accurately quantify the value of lumbopelvic stability because these methods evaluate the lumbopelvic stability using an ordinal scale of whether the test was successfully performed. Therefore, this study measured the hip extension angle while maintaining lumbopelvic during leg lowering by using the method of Jung et al, [8] which was a modification of the method by Sahrmann [7] method. This method was advantageous in this comparison study because it accurately quantifies the value of lumbopelvic stability measuring the ratio using the hip extension angle instead of the success of the test performed.…”

“…The lumbopelvic stability of CLBP was 43.33° ± 24.76° in this study. The lumbopelvic stability of CLBP with lumbar flexion syndrome was 46.30° ± 24.41° in the study by Jung et al [8] Our study recruited patients with CLBP without subgrouping and would have included patients with CLBP and lumbar extension and rotation syndrome. These factors may have produced a difference in lumbopelvic motor control function compared with those in previous studies, which is the first limitation of the present study.…”

“…Lumbopelvic motor control function was assessed using the lumbopelvic stability test described by Jung et al [8] ; it has a high intra-rater reliability. To measure lumbopelvic motor control function, the participants flexed their hip and knee to 90° in the supine position (Fig.…”

“… 5 6 Lumbopelvic stability is commonly assessed by the ability to control the lumbar curve during leg lowering in various measurement methods, [7] and a recent study suggested a method of evaluating the ratio scale using hip flexion angles. 8 9 Muscles that maintain lumbopelvic stability are local muscles of postural, tonic, and segmental stabilizers, such as the lumbar multifidus, pelvic floor, transversus abdominis, and diaphragm. 10 11 In addition, global muscles of dynamic, phasic, and torque-producing capabilities, such as the rectus abdominis and external oblique, contribute to lumbopelvic stability.…”

Reliability of Hamstring Flexibility Test with Hip Inferior Glide Mobilization in Patients with Low Back Pain

“…A motion sensor was strapped above the lateral malleolus line. 13 Inferior gliding of the passive hip was achieved using two non-elastic belts, one of which was fastened at the inguinal line of the test leg. The second belt was fastened to the hook of a hardwood plate ( Figure 1A).…”