Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Hiroshima, Japan; Major in Medical Engineering and Technology, Graduate School of Medical Technology and Health Welfare Science, Hiroshima International University, Hiroshima, Japan.
Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Hiroshima, Japan.
Gait Posture. 2022 Oct;98:121-127. doi: 10.1016/j.gaitpost.2022.08.021. Epub 2022 Sep 5.
Lumbopelvic region rotation relative flexibility (LRRF), which is defined as lumbopelvic region that is relatively less stiffness than the hip region, is associated with low back pain (LBP) symptoms. However, how LRRF is influenced by lumbopelvic region motion during walking is unclear.
What is the influence of LBP and LRRF on coordination patterns of the thorax, pelvis, and femur during walking?
The presence of LRRF was determined based on whether the lumbopelvic rotation occurred in the first 50% of knee flexion or hip external rotation movement. Participants with LBP and LRRF were classified into the LBP group. Participants with LRRF but without LBP were classified into the early pelvis rotation (ROT) group, and those without LBP and relative flexibility were classified as controls. The thorax-pelvis coordination and pelvis-femur coordination during the stance cycles were calculated from the segmental angles obtained by three-dimensional motion analysis using a modified vector coding technique.
In the sagittal plane, the thorax-pelvis coordination of the LBP group showed more anti-phase patterns at both the early stance and midstance compared with controls and the ROT group. In the sagittal and horizontal planes, pelvis-femur coordination of the LBP and ROT groups showed more in-phase patterns during the early stance and midstance compared with controls.
Regardless of LBP, the presence of LRRF alters the intersegmental coordination during walking. In individuals with LRRF, stiffness of the hip may increase during walking. People who have LRRF without LBP may develop LBP in the future, and it is important for prevention to identify these differences in kinematics during walking.
腰骶区旋转相对灵活性（LRRF）定义为腰骶区相对于髋区的刚性较低，与下腰痛（LBP）症状有关。然而，LRRF 在行走时如何影响腰骶区运动尚不清楚。
LBP 和 LRRF 对行走时胸、骨盆和股骨协调模式的影响是什么？
根据腰骶部旋转是否发生在膝关节屈曲的前 50%或髋关节外旋运动中，确定 LRRF 的存在。存在 LBP 和 LRRF 的参与者被归类为 LBP 组。存在 LRRF 但无 LBP 的参与者被归类为早期骨盆旋转（ROT）组，无 LBP 且相对灵活的参与者被归类为对照组。使用三维运动分析从节段角度计算站立周期中的胸-骨盆协调和骨盆-股骨协调，使用改良矢量编码技术。
在矢状面，与对照组和 ROT 组相比，LBP 组在早期和中期站立时的胸-骨盆协调表现出更多的反相模式。在矢状面和水平面，LBP 和 ROT 组在早期和中期站立时的骨盆-股骨协调表现出更多的同相模式。
无论是否存在 LBP，LRRF 的存在都会改变行走时的节段间协调。在存在 LRRF 的个体中，行走时髋关节的刚性可能会增加。没有 LBP 但存在 LRRF 的人可能会在未来患上 LBP，因此，在行走时识别这些运动学差异对于预防很重要。
