Effect of pelvic tilt on standing posture.

Low back dysfunction is associated in many cases with lumbar lordosis, and tilting the pelvis posteriorly is often recommended for therapeutic purposes. The influence of pelvic tilt on the spinal curves has not been studied. The purpose of this study was to use an objective noninvasive method to determine the effect of the pelvic tilt on the spinal curves in the sagittal plane. Thirty-two healthy subjects and 15 patients with chronic low back dysfunction (CLBD) were studied. Patients with CLBD and healthy subjects were instructed in performing active anterior and posterior pelvic tilt maneuvers, first in the supine and then in the standing position. Comparisons between the Patient Group and the Healthy Group were made for several variables representing the severity of spinal curves, pelvic orientation, hip orientation, and knee orientation. A computerized system, the Iowa Anatomical Position System, was used to obtain coordinates of external body surface landmarks from which pelvic tilt measurements were determined. The results showed that the voluntary pelvic tilt did not alter the thoracic spinal curve. For both the Healthy Group and the Patient Group, the lumbar curve was altered by the pelvic tilt: anterior tilt increased the depth of the lumbar curve and posterior tilt decreased the depth of the lumbar curve. The amount of pelvic tilt was the same whether knees were extended or flexed approximately 10 degrees. Pelvic tilt also tended to influence the orientation of the head and other parts of the body.