The association of hip muscle strength and flexibility, hip mobility, and asymmetry with dysfunction and pain in individuals with chronic low back pain
Year: 2023
Type: article
Abstract: Background: Chronic low back pain (CLBP) is difficult to diagnose and treat due to ill-defined pathological causes, resulting in suboptimal outcomes for individuals and substantial cost to the healthcare system. Previous studies have indicated targeting the hip muscles in CLBP treatment may optimize outcomes, but there has been very scarce investigation on whether specific weakness of hip muscles, limited hamstrings flexibility and hip mobility, and asymmetry of these impairments are associated with physical dysfunction and pain in CLBP. Purpose and Methods: The present study uses data from a large cohort study for a secondary analysis (n=515) to determine whether hip extension, abduction, and flexion strength, hamstrings flexibility, hip internal rotation mobility, and asymmetry in these measures associate with performance-based tests of walking, sit-to-stand, and lifting motions, and patient reported outcomes (PROs) of LBP-related disability, pain interference, and physical dysfunction in CLBP. Results: In stepwise selection adjusted for age, sex, and body mass index (BMI), hip muscle weakness was associated with poor functional performance, heightened LBP-related disability, heightened pain interference, and perceived physical dysfunction. Specifically, hip extension weakness associated with all performance-based tests and PROs, hip abduction weakness associated with slow walking and the sit-to-stand test, and hip flexion weakness associated with slow walking and high LBP-related disability and physical dysfunction assessed by PROs. Limited and asymmetrical hamstrings flexibility and asymmetry in hip internal rotation were also associated with poor functional performance, heightened LBP-related disability, heightened pain interference, and perceived physical dysfunction. Specifically, hamstrings flexibility associated with all performance-based tests and PROs, asymmetry in hip internal rotation associated with slow walking tests and high disability, pain interference, and physical dysfunction assessed by PROs, and asymmetrical hamstrings flexibility associated with heightened disability assessed by PROs. Conclusion: The weakness of hip muscles, tightness and asymmetry of the hamstrings, and asymmetric hip internal rotation mobility may be modifiable factors of physical dysfunction, pain interference, and LBP-related disability in CLBP. Further longitudinal investigation is necessary to determine if these associations persist as hip muscle strength and flexibility, hip mobility, and side-to-side asymmetry change over time along with physical dysfunction, pain interference, and LBP-related disability.
Author: Hartoyo, Mara A.
Institution: University of Pittsburgh
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W6998778345