The Effect of Limb Movement on the Lumbopelvic Region in People with Low Back Pain

Low back pain: LBP) affects up to 80% of the population at some point in their lifetime. Several models have been proposed to explain the persistent and recurrent course of LBP. In particular, the Movement System Impairment model proposes that lumbopelvic motion that begins soon after the start of an active movement is important to LBP because of its potential contribution to increased frequency of lumbopelvic motion across the day. The purpose of this dissertation is to examine aspects of this model, focusing specifically on lumbopelvic motion during limb movements. In Chapter 2, we examine whether men and women with LBP differ in the prevalence of movement impairments during standardized clinical tests. We report that a larger proportion of men than women demonstrate early lumbopelvic motion during limb movement tests and movement tests potentially affected by limb tissue stiffness, but not during a movement test unaffected by limb tissue stiffness. In Chapter 3, we examine differences in lumbopelvic motion between people with and people without LBP during two active limb movement tests. We report that, compared to people without LBP, people with LBP demonstrate a greater magnitude of and earlier lumbopelvic rotation during knee flexion and hip lateral rotation. In Chapter 4, we examine the relationship between lumbopelvic motion during passive and active hip lateral rotation in people with and people without LBP. We report that people with LBP, but not people without LBP, demonstrate a relationship between lumbopelvic motion during passive and active hip lateral rotation. In Chapter 5, we examine how effectively people with and people without LBP modify lumbopelvic motion during active hip lateral rotation following within-session instruction. We report that all people are able to modify lumbopelvic motion during hip lateral rotation, but that people with LBP are less effective at modifying lumbopelvic motion than people without LBP. The results of this dissertation suggest that lumbopelvic motion during limb movements is important to the course of a LBP problem. Further studies could investigate the factors contributing to lumbopelvic motion during limb movements and intervention strategies to address lumbopelvic motion during limb movements