A new clinical test to differentiate lumbopelvic control
Individuals with persistent low back pain (LBP) exhibit changes in motor behaviour which include posture, muscle activation and movement. Individuals with LBP have been divided into subgroups and have been indentified to have: poor ability to dissociate movement of the lumbopelvic region spine from that of the thorax (poor intersegmental coordination), poor capacity to voluntarily maintain a lumbar lordosis, a compromised control of the multifidus muscle and smudging of the separate regions of the motor cortex involved in the activation of short/deep and long/superficial muscles of the back which are responsible for coordinated motions of these segments.
The aim of this study was to develop a clinical test to assess the ability to dissociate lumbopelvic motion from that of the thoracolumbar junction and evaluate the reliability of the test in individuals with and without LBP.
The test-development phase involved development and refinement of criteria to quantify movement performance and design of a standardized video to instruct participation.
The clinical test of thoracolumbar dissociation was devised into assess a patient’s ability to perform anterior/posterior pelvic tilt in sitting while attempting to maintain a constant position of the thoracolumbar junction.
The results demonstrate that the clinical test of thoracolumbar dissociation has acceptable inter-rater reliability when used by trained physiotherapists. This test described here is the first to assess the ability to dissociate movement of the lumbopelvic region from that of the thoracolumbar region.
> From: Elgueta-Cancino et al., Manual therapy (2015) 418-424(Epub ahead of print). All rights reserved to Elsevier Ltd. Click here for the Pubmed summary