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7. The Effect of an Overhead External Load Lifting and Lowering on Dynamic Postural Control in Subgroups of Low Back Pain.

Author

Shahbazi, Majid, Sarrafzadeh, Javad, Ebrahimi Takamjani, Ismail, and Negahban, Hossein

Subjects
LUMBAR pain, WEIGHT lifting
Abstract

Background: Understanding postural control in low back pain (LBP) subgroups can help develop targeted interventions to improve postural control. The studies on this topic are limited. Therefore, the primary purpose of this study was to compare the postural control of LBP subgroups with healthy individuals during overhead load lifting and lowering. Methods: In this cross-sectional study, the participants were 52 with LBP and 20 healthy. The LBP patients were classified based on the O'Sullivan classification system into 21 flexion patterns and 31 active extension patterns. The participants lifted the box from their waists to their overheads and lowered it to their waists. Changes in postural control parameters were measured with a force plate system. Results: The results of the analysis of variance showed that during load lifting, the mediolateral phase plane (p =.044) and the mean total velocity (p =.029) had significant differences between flexion patterns and healthy. Also, the load-lowering results showed that active extension patterns, compared with healthy, had significant differences in the anteroposterior–mediolateral phase plane (p =.042). The patients showed less postural sway than the healthy. Conclusions: The results in this work highlight the importance of identifying the homogenous subgroups in LBP and support the classification of heterogeneous LBP. Different subgroups exhibit different postural control behaviors. These behaviors can be due to the loading of various tissues during different tasks. [ABSTRACT FROM AUTHOR]

Published
2024
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20. The effect of dual-task conditions on postural control in adults with low back pain:a systematic review and meta-analysis

Author

Pourahmadi, Mohammadreza, Negahban, Hossein, Koes, Bart Willem, Fernández-de-Las-Peñas, César, Ebrahimi Takamjani, Ismail, Bahramian, Mehrdad, Pourahmadi, Mohammadreza, Negahban, Hossein, Koes, Bart Willem, Fernández-de-Las-Peñas, César, Ebrahimi Takamjani, Ismail, and Bahramian, Mehrdad

Abstract

BACKGROUND: Dual-task conditions, which involve performing two tasks simultaneously, may exacerbate pain and further impair daily functioning in individuals with low back pain (LBP). Understanding the effects of dual-task conditions on postural control in patients with LBP is crucial for the development of effective rehabilitation programs. Our objective was to investigate the impact of dual-task conditions on postural control in individuals with LBP compared to those without LBP. METHODS: We conducted a comprehensive search of Medline via PubMed, Scopus, the Cochrane Central Register of Controlled Trials, Web of Science, and EMBASE databases, with no language restrictions, from inception to January 1, 2023. The primary outcome measures of the study were velocity, area, amplitude, phase plane portrait, and path/sway length of the center of pressure (CoP). Standardized mean difference (SMD) effect sizes were calculated, and the quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: From 196 studies, five involving 242 adults (≥ 18 years) met the inclusion criteria. Three studies were rated as high quality, while two were deemed moderate. In the included studies, 140 participants had non-specific LBP, while 102 participants did not report any symptoms, with mean ages of 36.68 (± 14.21) and 36.35 (± 15.39) years, respectively. Three studies had both genders, one exclusively included females, and one did not specify gender. Meta-analyses of primary outcomes revealed no significant differences in postural control between patients with LBP and pain-free controls during both easy and difficult postural tasks and cognitive load for velocity (easy: SMD - 0.09, 95% CI - 0.91 to 0.74; difficult: SMD 0.12, 95% CI - 0.67 to 0.91), area (easy: SMD 0.82, 95% CI - 2.99 to 4.62; difficult: SMD 0.14, 95% CI - 2.62 to 2.89), phase plane (easy: SMD - 0.59, 95% CI - 1.19 to 0.02; difficult: SMD - 0.18, 95% CI - 0.77 to 0.42), path/sway length (easy: SMD

Published
2023

24. Anterior tibial muscle function assessment using acoustic myography and electromyography

Author

Ebrahimi-Takamjani, Ismail

Subjects
610
Abstract

This thesis describes a series of experiments comparing the electrical and acoustic signals recorded from the human tibialis anterior muscle. Electromyography (EMG) is a widely used method of monitoring muscle activity. In many muscles its amplitude increases linearly with force and changes in the EMG/force ratio or shifts of the median frequency provide evidence of fatigue. However, in some circumstances it is difficult or impossible to record the EMG satisfactorily e.g. if there is sweat on the skin or in strong electrical fields or during electrical stimulation. Acoustic myography (AMG) is a more recent development. It is a non- invasive technique which may also be used as an indicator of skeletal muscle activity. Transverse oscillations of the muscle surface are detected with microphones or accelerometers. Their performance is not affected by sweating or electrical stimulation artefacts. The AMG is a much simpler signal than EMG and because it has a very narrow bandwidth it is easy to filter out noise. Like EMG, it has been found that the AMG increases with force but it is also known that, contrary to the EMG, the amplitude of AMG declines with force during fatiguing activity. The experiments described here investigate the relationships between the EMG, AMG amplitude and force in normal muscles and during muscle fatigue. In addition, the characteristics of the frequency spectra of EMG and AMG were investigated. The effect of muscle length on EMG and AMG characteristics were also studied. The contribution of blood flow to the AMG was studied by comparing the signals recorded with and without blood flow in the lower limb. A linear relationship was found between rectified integrated EMG (IEMG) and force in fresh and fatigued muscle. The slope of the relationship increased with fatigue. A similar relationship was found between the IAMG and force in the range 0-75% of maximum voluntary contraction in control conditions. However, the slope of the relationship between IAMG and force declined after fatiguing exercise. The EMG spectra from the tibialis anterior contained frequencies between 0 and 400 Hz. The median frequency increased linearly as the force of muscle contraction increased. The EMG median frequency decreased during sustained contractions as fatigue developed. However, the AMG contained a range of frequencies between 0 and 45 Hz. The median frequencies of the AMG also increased linearly with increasing force. However, the AMG frequency content was not significantly changed if fatigue developed at low forces such as 40% of maximum voluntary contraction but the median frequency declined significantly when the muscle was fatigued at forces above 60% of maximum. Changes in the length of tibialis anterior affected the force development, EMG and AMG characteristics. At shorter muscle lengths, the maximal voluntary force is reduced compared to the intermediate and longer lengths and the slope of the relationships between force and IEMG and IAMG increases. There were no significant differences in force or the relationships between force and IAMG and force and IEMG between the intermediate and longer lengths. There were no significant changes in the median frequencies of EMG and AMG at different muscle lengths. There were no significant changes in the characteristics of AMG and EMG when the blood flow to the lower limb was stopped by inflating an pressure cuff. It can be concluded that the contribution of blood flow to the AMG and EMG was insignificant. In conclusion, the AMG represents a mechanical counterpart of the electrical activity in muscle fibres. The IAMG and the AMG median frequency may be used to provide indirect information about force. Analysis of changes in the IAMG/force ratio or AMG median frequency might be used to identify the development of fatigue during contractions above 60% of maximum voluntary force.

Published
1995

26. Using e-learning methods for physiotherapy students learning – a systematic review and meta-analysis of the impact on knowledge, skills, satisfaction and attitudes.

Author

ShahAli, Shabnam, Shahabi, Saeed, Kohan, Noushin, Ebrahimi Takamjani, Ismail, and Ebrahimi, Reyhane

Subjects
PHYSICAL therapy students, ONLINE education, SCHOOL environment, ONLINE information services, MEDICAL databases, META-analysis, MEDICAL information storage & retrieval systems, CONFIDENCE intervals, HEALTH occupations students, SYSTEMATIC reviews, SATISFACTION, PHYSICAL therapy education, CLINICAL competence, STUDENTS, DESCRIPTIVE statistics, STUDENT attitudes, MEDLINE, DATA analysis software
Abstract

To assess the effectiveness of e-learning methods in comparison with traditional learning on physiotherapy students' knowledge, skills and satisfaction/attitude. Seven databases including PubMed, Web of Science, Embase, Scopus, ProQuest, Ovid SP and Cochrane were searched until October 2021. Randomised controlled trials (RCTs) that compared e-learning with traditional learning or another form of digital education among physiotherapy students and assessed knowledge, skills and satisfaction/attitude were included. Cochrane effective practice and organisation of care tool was used to assess risk of bias. Nineteen RCTs were included. The results suggested that blended learning approach is better than traditional methods for improving skills and satisfaction/attitude in physiotherapy students, with moderate to low level of evidence. There was no difference between blended learning and traditional learning for knowledge acquisition. Pure e-learning revealed an equal result with traditional learning in all measured outcomes. Due to limited number of studies that compared one e-learning method with another form of digital education, the findings were inconclusive. e-Learning methods made changes in knowledge, skills, satisfaction/attitude. Based on moderate to low evidence, blended learning method may be more effective than traditional learning in terms of skill acquisition and satisfaction/attitude. [ABSTRACT FROM AUTHOR]

Published
2023
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28. Reliability of Ultrasound Findings in Patients with Lumbar Multifidus Myofascial Pain Syndrome

Author

Ebrahimi Takamjani, Ismail, Ezzati, Kamran, Khani, Saemeh, Sarrafzadeh, Javad, and Tabatabaiee, Abbas

Subjects
Research Article
Abstract

BACKGROUND: Lumbar multifidus muscle provides stability to the spine. The present study aimed to evaluate the reliability of ultrasound findings in patients with lumbar multifidus myofascial pain syndrome (MPS). METHODS: A total of 24 cases (7 females, 17 males, mean age: 40.13± 5.69, BMI: 26.48±4.96) with multifidus MPS were assessed. The variables were muscle thickness in rest and contraction, thickness changes, and cross-sectional area (CSA) in rest and contraction. Two examiners performed the test and retest sessions. RESULTS: The active trigger points of lumbar multifidus on the right and left side of the cases were 45.8 % and 54.2%, respectively. The intraclass correlation coefficient (ICC) values for muscle thickness and thickness changes showed moderate to very high reliability for both within and between intra-examiner measurements. (ICC, 1st examiner: 0.78-0.96; ICC, 2nd examiner: 0.86-0.95). In addition, the ICC values of within and between-session intra-examiner for CSA were high. (ICC, 1st examiner: 0.83-0.88; ICC, 2nd examiner: 0.84-0.89). The ICC and standard error of measurement (SEM) of inter-examiner reliability ranged between 0.75 to 0.93 and 0.19 to 0.88 for multifidus muscle thickness and thickness changes. The ICC and SEM of inter-examiner reliability ranged between 0.78 to 0.88 and 0.33 to 0.90 for CSA of the multifidus muscle. CONCLUSION: The within and between-session reliability of multifidus thickness, thickness changes, and CSA was moderate to very high in patients with lumbar MPS when taken by two examiners. Furthermore, the inter-examiner reliability of these sonographic findings was high.

Published
2023

30. Trunk–Pelvis Kinematics Variability During Gait and Its Association With Trunk Muscle Endurance in Patients With Chronic Low Back Pain.

Author

Bagheri, Rasool, Ebrahimi Takamjani, Ismail, Pourahmadi, Mohammad R., Jannati, Elham, Fazeli, Sayyed H., Hedayati, Rozita, and Akbari, Mahmood

Subjects
PHYSIOLOGY of abdominal muscles, CHRONIC diseases, CONFIDENCE intervals, STATISTICAL correlation, GAIT in humans, KINEMATICS, SCIENTIFIC observation, PELVIS, PHYSICAL fitness, PROBABILITY theory, STATISTICAL sampling, T-test (Statistics), TORSO, CROSS-sectional method, MOTION capture (Human mechanics), DATA analysis software, DESCRIPTIVE statistics, ERECTOR spinae muscles, LUMBAR pain, INTRACLASS correlation
Abstract

The first purpose was to investigate the trunk muscle endurance, the second aim was to evaluate the trunk–pelvis kinematics during gait, and the third was to evaluate the relationship between trunk–pelvis kinematics and the trunk muscle endurance. Thirty participants (15 nonspecific chronic low back pain [NCLBP] and 15 healthy) were included. The authors first assessed trunk muscle endurance on endurance testing protocols. The authors next measured the trunk–pelvis kinematics during gait using a 3-dimensional motion capture system. Angular displacement, waveform pattern (CVp), and offset variability (CVo) were also examined. Statistical analysis revealed a significant difference in (1) the trunk muscle endurance and (2) sagittal, frontal, and transverse planes CVp between groups (P <.05). A significant moderate correlation was found between supine double straight-leg raise and frontal CVp (r =.521, P =.03) and transverse planes CVp (r =.442, P =.05). However, a significant moderate correlation was observed between prone double straight-leg raise and sagittal plane CVp (r =.528, P =.03) and transverse plane CVp (r =.678, P =.001). The relationship between (1) lower trunk extensor endurance with transverse and sagittal planes CVp and (2) lower abdominal muscle endurance with transverse and frontal planes CVp suggests that gait variability in these planes may result because of trunk muscle deconditioning accompanying NCLBP. [ABSTRACT FROM AUTHOR]

Published
2020
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31. The Amount and Temporal Structure of Center of Pressure Fluctuations During Quiet Standing in Patients With Chronic Low Back Pain.

Author

Azadinia, Fatemeh, Ebrahimi-Takamjani, Ismail, Kamyab, Mojtaba, Asgari, Morteza, and Parnianpour, Mohamad

Subjects
LUMBAR pain, LYAPUNOV exponents, PRESSURE, POSTURAL balance, CHRONIC diseases
Abstract

The characteristics of postural sway were assessed in quiet standing under three different postural task conditions in 14 patients with nonspecific chronic low back pain and 12 healthy subjects using linear and nonlinear center of pressure parameters. The linear parameters consisted of area, the mean total velocity, sway amplitude, the SD of velocity, and the phase plane portrait. The nonlinear parameters included the Lyapunov exponent, sample entropy, and the correlation dimension. The results showed that the amount of postural sway was higher in the patients with low back pain compared with the healthy subjects. Assessing the nonlinear parameters of the center of pressure showed a lower sample entropy and a higher correlation dimension in the patients with low back pain compared with the healthy subjects. The results of this study demonstrate the greater regularity and higher dimensionality of the center of pressure fluctuations in patients with nonspecific chronic low back pain, which suggests that these patients adopt different postural control strategies to maintain an upright stance. [ABSTRACT FROM AUTHOR]

Published
2020
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38. Kinematics of the Spine During Sit-to-Stand Movement Using Motion Analysis Systems: A Systematic Review of Literature.

Author

Pourahmadi, Mohammad Reza, Ebrahimi Takamjani, Ismail, Jaberzadeh, Shapour, Sarrafzadeh, Javad, Sanjari, Mohammad Ali, Bagheri, Rasool, and Taghipour, Morteza

Subjects
*HEALTH, *RANGE of motion of joints, *KINEMATICS, *MEDLINE, *ONLINE information services, *SPINE, *INFORMATION resources, *SYSTEMATIC reviews, *TORSO, *BODY movement, *RESEARCH bias, *MOTION capture (Human mechanics), *DATA analysis software, *LUMBAR pain
Abstract

Context: Clinical evaluation of the spine is commonplace in musculoskeletal therapies, such as physiotherapy, physical medicine/rehabilitation, osteopathic, and chiropractic clinics. Sit-to-stand (STS) is one of the most mechanically demanding daily activities and crucial to independence. Difficulty or inability to perform STS is common in individuals with a variety of motor disabilities, such as low back pain (LBP). Objective: The purpose of this systematic review was to evaluate available evidence in literature to determine 2-dimensional and 3-dimensional kinematics of the spine during STS in patients with LBP and healthy young adult participants using motion analysis systems (electromagnetic and marker based). Methods: Electronic databases (PubMed/MEDLINE [National Library of Medicine], Scopus, ScienceDirect, and Google Scholar) were searched between January 2002 and February 2017. Additionally, the reference lists of the articles that met the inclusion criteria were also searched. Prospective studies published in peer-reviewed journals, with full text available in English, investigating the kinematics of the spine during STS in healthy subjects (mean age between 18 and 50 y) or in patients with LBP using motion analysis systems, were included. Sixteen studies fulfilled the eligibility criteria. All information relating to methodology and kinematic modeling of the spine segments along with the outcome measures was extracted from the studies identified for synthesis. Results: The results indicated that the kinematics of the spine are greatly changed in patients with LBP. In order to develop a better understanding of spine kinematics, studies recommended that the trunk should be analyzed as a multisegment. It has been shown that there is no difference between the kinematics of patients with LBP and healthy population when the spine is analyzed as a single segment. Furthermore, between-gender differences are present during STS movement. Conclusion: This review provided a valuable summary of the research to date examining the kinematics of the spine during STS. [ABSTRACT FROM AUTHOR]

Published
2019
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42. Immediate Effects of Lumbosacral Orthosis on Postural Stability in Patients with Low Back Pain: A Preliminary Study

Author

Azadinia, Fatemeh, Ebrahimi-Takamjani, Ismail, Mojtaba Kamyab, Asgari, Morteza, and Parnianpour, Mohamad

Subjects
lcsh:RD701-811, lcsh:Orthopedic surgery, LBP, Postural balance, orthotic device, Research Article
Abstract

Background: Lumbosacral orthosis (LSO) is commonly used for the treatment of back pain. The clinical andmechanical effectiveness of this device has been repeatedly investigated in several studies; however, its sensorimotoreffectiveness has been rarely considered. Regarding this, the aim of the current study was to investigate the effect ofa non-extensible LSO on postural stability (as a construct of sensorimotor function) in patients with nonspecific chroniclow back pain (LBP).Methods: This preliminary study was conducted on 17 patients with nonspecific chronic LBP using a single-groupquasi-experimental design. Postural stability was measured while the participants were placed in a quiet standingposition, under the combined conditions of base of support (rigid and foam surface), visual input (open eyes and closedeyes), and LSO (with and without orthosis).Results: The findings demonstrated that wearing orthosis during the most challenging postural task (i.e., blindfoldedwhile standing on a foam surface) significantly reduced postural sway parameters related to the position anddisplacement of the center of pressure (COP; the sway area and sway amplitude in the anteroposterior direction;PConclusion: As the findings of the present study indicated, the use of a non-extensible LSO decreased the COPdisplacement; however, it did not affect the COP velocity. Therefore, our data could not utterly support the effectivenessof non-extensible LSO on postural stability as a construct of sensorimotor function. Postural control is an appropriateindicator for assessing the global functioning of the sensorimotor system due to its dependence upon the interactionbetween the neural and musculoskeletal systems. Consequently, further studies are needed to elucidate the positiveeffects of LSO on the aspects of sensorimotor function.Level of evidence: III

Published
2019

43. Comparison of Postural Balance between Subgroups of Nonspecific Low-back Pain Patients Based on O’Sullivan Classification System and Normal Subjects during Lifting

Author

Shahbazi Moheb Seraj, Majid, Sarrafzadeh, Javad, Maroufi, Nader, Ebrahimi Takamjani, Ismail, Ahmadi, Amir, and Negahban, Hossein

Subjects
lcsh:RD701-811, Lifting, classification, lcsh:Orthopedic surgery, Postural balance, Low back pain, Research Article
Abstract

BACKGROUND: Balance disorder is one of the most-studied fields in low-back pain patients (LBP). However, there is insufficient information regarding the effect of LBP subgrouping on postural control. The purpose of the present study was to compare postural control between subgroups of chronic nonspecific LBP and healthy subjects during lifting. METHODS: A total of 35 men with chronic LBP (19 active extension pattern [AEP] and 16 flexion pattern [FP]) and 15 healthy controls were enrolled in this cross-sectional study. Pooled LBP was subdivided based on the O’Sullivan’s classification system (OCS). The participants were asked to lift a box from the ground to the waist level and hold it for 20 seconds. The load was 10% of the subject’s weight. Force plate system was used to record balance parameters, including standard deviations (SDs) of center of pressure (COP) amplitude and COP velocity in anterior-posterior and medial-lateral directions and mean total velocity. The test was divided into two static and dynamic phases. Data were analyzed using one-way analysis of variance and independent t-test. RESULTS: There were no significant differences between pooled LBP and control groups in any of the variables, except for the SD of the anterior-posterior direction velocity in the X-plane in the static phase (P=0.017). After classifying LBP, the results showed that the healthy and AEP groups were significantly different in SD of COP velocity in the frontal plane (P=0.021), mean total velocity (P=0.010), and SD of COP velocity in the sagittal plane (P=0.039). CONCLUSION: The present study showed that postural control was not different between the pooled LBP and normal groups. After classifying pooled LBP based on OCS, we found that the AEP showed different postural control as compared to healthy controls in the dynamic phase. The FP and AEP exhibited different postural control relative to the healthy controls in the static phase, and COP velocity was lower in those groups compared to the control group. The results of this study support the concept of LBP classification.

Published
2019

44. Effect of Gastrocnemius Kinesio Taping on Countermovement Jump Performance and Vertical Stiffness Following Muscle Fatigue.

Author

Boozari, Sahar, Sanjari, Mohammad Ali, Amiri, Ali, and Ebrahimi Takamjani, Ismail

Subjects
LEG physiology, CALF muscle physiology, ANALYSIS of variance, CLINICAL trials, GROUND reaction forces (Biomechanics), JUMPING, KINEMATICS, PROBABILITY theory, RESEARCH funding, STATISTICAL sampling, EFFECT sizes (Statistics), RANDOMIZED controlled trials, PRE-tests & post-tests, REPEATED measures design, DESCRIPTIVE statistics, MUSCLE fatigue, PLANTARFLEXION, TAPING & strapping, EQUIPMENT & supplies
Abstract

Context: Kinesio tape (KT) is a widely used intervention in the fields of sports and rehabilitation. However, its effects on lower-extremity behavior during functional activities are not entirely known. Objective: To test the hypothesis that application of KT can change performance and vertical stiffness (VS) during the countermovement jump (CMJ) before and after a fatigue protocol. Design: A predesign and postdesign to study the effect of KT in 2 situations, prefatigue and postfatigue. In each fatiguing condition, there were 2 conditions with and without KT application on the gastrocnemius muscle. Setting: Biomechanics laboratory. Participants: Fifty healthy, nonathlete participants (26 females and 24 males). Interventions: KT application on the gastrocnemius muscle and a fatigue protocol to induce fatigue in plantar flexor muscles. Main Outcome Measures: Various jumping parameters, including jump height, maximum force, maximum power, rate of force development, eccentric lower-limb stiffness, and VS, were calculated using the vertical ground reaction force data. Eccentric lower-limb stiffness and VS were calculated using a mass-spring model. The studied variables can present lower-extremity elastic behavior and performance during CMJ. Results: The results of a 2-way repeated-measures analysis of variance showed no significant effect for KT application. Fatigue resulted in lower values of jump height, maximum power, and VS. Moreover, male subjects showed greater values of jump height, maximum force, and maximum power than did females. Conclusions: The main finding of this study was that gastrocnemius KT has no effect on performance or elastic behavior of the lower-extremity during CMJ. Moreover, KT cannot reduce the adverse effect of fatigue in a functional activity such as CMJ. It seems that gastrocnemius KT is not effective for demanding activities. [ABSTRACT FROM AUTHOR]

Published
2018
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47. Gait analysis of patients with piriformis muscle syndrome compared to healthy controls

Author

Ebrahimi Takamjani Ismail, Tabatabaiee Abbas, Sarrafzadeh Javad, and Salehi Reza

Subjects
musculoskeletal diseases, medicine.medical_specialty, Physical Therapy, Sports Therapy and Rehabilitation, Walking, Knee Joint, Piriformis Muscle Syndrome, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, medicine, Humans, 030212 general & internal medicine, Range of Motion, Articular, Gait, business.industry, Buttock Pain, Sagittal plane, Tenderness, medicine.anatomical_structure, Gait analysis, medicine.symptom, Range of motion, business, Gait Analysis, 030217 neurology & neurosurgery
Abstract

Background Piriformis muscle syndrome (PMS) is a condition that can causes local buttock pain and tenderness. The symptoms of PMS are related to the hip joint position and may affect repetitive daily tasks such as walking. Objectives What is the difference between the gait characteristics of patients with PMS and those of matched-healthy controls? Design Observational study. Methods Thirty patients with PMS and 30 age-, sex-, and height-matched healthy participants underwent three-dimensional walking analysis. Results The results showed no significant differences in the spatiotemporal characteristics of gait between the groups (p > 0.1). The PMS group flexed the hip joint significantly more (−7.2 [–11.9 to −2.2], p = 0.003) and extended the hip joint to a lesser degree (−2.48 [–4.91 to −0.5], p = 0.04) than the control group. Patients with PMS needed a statistically significantly longer time to reach the peak angles of hip internal (1.3 [1 to 1.9], p = 0.003) and external (5.5 [0.9 to 10.1], p = 0.01) rotations during the gait cycle. Further, the results showed that the sagittal range of motion of the knee joint was significantly lesser in patients with PMS than in controls (3.45 [0.4 to 6.4], p = 0.02). Conclusions Patients with PMS seem to have different kinematic changes during level walking. Changing the peak flexion and extension of the hip joint is considered a strategy to enable pain-free gait in patients with PMS. Further, the knee kinematics are modified consequent to the change of hip joint kinematics.

Published
2020

48. The Ratio of Lumbar to Hip Motion during the Trunk Flexion in Patients with Mechanical Chronic Low Back Pain According to O’Sullivan Classification System: A Cross-sectional Study

Author

Shahbazi Moheb Seraj, Majid, Sarrafzadeh, Javad, Maroufi, Nader, Ebrahimi Takamjani, Ismail, Ahmadi, Amir, and Negahban, Hossein

Subjects
body regions, musculoskeletal diseases, lcsh:RD701-811, Kinematics, Lumbar spine, lcsh:Orthopedic surgery, Posture, Original Article, Low back pain, Forward flexion, Classification
Abstract

Static and dynamic postures of lumbopelvic in low back pain (LBP) are considered as two important aspects of clinical assessment and management of LBP. Thus, the focus of the current study was to compare the posture and compensatory strategy of hip and lumbar region during trunk flexion between LBP subgroupsand health subjects. LBP cases are subdivided into active extension pattern (AEP) and flexion pattern (FP) based on O'Sullivan's classification system (OCS).This work was a cross-sectional study involving 72 men, 21 low back pain patients with FP and 31 low back pain patients with AEP and 20 healthy groups. Lumbar and hip angles during trunk flexion were measured by a 3D motion analysis system in neutral standing posture and end-range of trunk flexion. The participants were asked to full bend without any flexion of the knees. The bending speed was preferential. Hip and lumbar ranges of motion were divided into four quartiles (Q). The quartiles were compared between groups. Data analysis was performed using one-way analysis of variance (ANOVA) and independent t-test.There was no statistically significant difference in lumbar lordosis in standing and full trunk flexion positions between the healthy groups and heterogeneous LBP groups. In addition, there was not any statistically significant difference between the healthy group and the homogenous LBP group (FP and AEP). Moreover, no statistically significant difference was observed in hip angles during standing between the healthy group and the heterogeneous LBP group, and between the healthy group and the homogenous LBP group (FP and AEP). In full trunk flexion position, there was statistically significant difference in hip angles between the healthy group and the heterogeneous LBP group (P=0.026). In this position, the difference in hip angles between the healthy group and FP group was statistically significant (This study supported the subgrouping of LBP and showed that the difference between subgroups could be determined effectively through subdividing the total range of lumbar and hip motions into smaller portions. It is possible that the neuromuscular system selects different strategies to compensate and prevent further injury of the chain components (muscle, joint, nerve and etc.).IV.

Published
2018

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