The association between pelvic asymmetry and non-specific chronic low back pain as assessed by the Global Postural System.

Abstract

Background: Empirical evidence that demonstrates the relationship between pelvic asymmetry and non-specific chronic low back pain (NCLBP) is currently lacking. Objective: To establish the reliability of the Global Postural System (GPS) in assessing pelvic asymmetry and identify the association between pelvic asymmetry parameters and the occurrence of NCLBP in young adults. Design: A cross-sectional, regression study. Methods: People who aged between 18 and 30 and were diagnosed with NCLBP were recruited. Healthy individuals who were matched for age, gender, and education level were recruited as controls. Global Postural System (GPS) was employed to assess pelvic asymmetry. Prior to explore the association, the reliability of GPS was assessed by the ICC (2, k) for interrater reliability, ICC (3, k) for intra-rater reliability, standard error and minimal detectable difference. Bivariate correlation analysis and logistic regression analysis were used to determine the relationship between pelvic asymmetry and the occurrence of NCLBP. Results: Twenty-eight healthy participants and 28 people with NCLBP were recruited. Moderate to excellent ICCs were observed for the inter-rater and intra-rater reliability of most postural parameters. The bivariate correlation analysis indicated that age, body mass index and pelvic asymmetry parameters were related to the occurrence of NCLBP. Pelvic angle asymmetry (odd ratio=1.17), and asymmetry of the distance between the posterior superior iliac spine and the floor (odd ratio=1.21) were significant factors associated with NCLBP. Limitation: This study did not explore the causal relationship between pelvic asymmetry in the sagittal plane/pelvic asymmetry in the transverse plane and the occurrence of NCLBP. The interpretation of the results may not be generalized beyond the sample population. Conclusions: The GPS is a reliable method to assess pelvic asymmetry in a clinical setting. The pelvic asymmetry parameters obtained from the GPS are likely to assist in the early identification of the potential occurrence of NCLBP.

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