Does the evidence support the existence of lumbar spine coupled motion? A critical review of the literature.

STUDY DESIGN

Literature review.

OBJECTIVES

To synthesize the current literature addressing coupled motion between side bending and rotation in the lumbar spine to determine if a consistent pattern exists across articles.

BACKGROUND

[corrected] Low back pain is one of the most common conditions seen in outpatient physical therapy clinics. This condition is often treated with manual therapy techniques. Many approaches to manual therapy incorporate the concept of coupled motion.

METHODS AND MEASURES

Using OVID databases, we reviewed and categorized articles published between 1982 and 2006 that addressed coupled motion between side bending and rotation in the lumbar spine. We identified 24 articles in which 32 analyses addressed our clinical question. RESULTS Seventeen of the 24 articles identified concluded that some form of coupled motion exists; however, there was little agreement across articles as to the specific characteristics of coupled motion.

CONCLUSIONS

The inconsistency in reported patterns of coupled motion suggests that physical therapists should use caution when applying concepts of coupled motion to the evaluation and treatment of patients with low back pain.