The association of hip range of movement, and its side-to-side asymmetries, and non-specific lower back pain in adults aged 40 years and older

ABSTRACT: Background: The hip joint's close association and coupling with the lumbar spine may influence its axes of rotation during closed-chain movement. Consequently, altered hip range of movement (ROM) may potentially foment the symptoms of non-specific lower back pain (NSLBP), warranting...

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Main Authors: Kevin Ermann, PT, Benita Olivier, PT PhD
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:North American Spine Society Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666548425000010
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author Kevin Ermann, PT
Benita Olivier, PT PhD
author_facet Kevin Ermann, PT
Benita Olivier, PT PhD
author_sort Kevin Ermann, PT
collection DOAJ
description ABSTRACT: Background: The hip joint's close association and coupling with the lumbar spine may influence its axes of rotation during closed-chain movement. Consequently, altered hip range of movement (ROM) may potentially foment the symptoms of non-specific lower back pain (NSLBP), warranting its investigation. A quantitative, cross-sectional, analytical design was employed to determine whether NSLBP has an association with altered hip ROM and dominance-aligned hip side-to-side asymmetries. Methods: Ninety-three convenience sampled participants with and without NSLBP were enrolled. These were assigned to the Lumbar Pain Group (LPG), comprising 61 individuals, 32 males and 29 females or the Control Group (CG), consisting of 32 pain-free volunteers, 18 males and 14 females. Individuals with hip conditions were excluded from the study. Participants completed a Baecke questionnaire and their BMI, Beighton score and leg dominance was established. The following asymptomatic, dominance aligned hip ROM was measured with an Inertial Measurement Unit (IMU): hip flexion ROM in supine; hip extension ROM in prone; Modified Thomas Test (MTT) with knee extension; straight leg raise (SLR); abduction in supine; adduction in supine and hip internal (IR) and external rotation (ER) in prone, sitting and supine in 30° flexion using a framework. Results: The LPG and CG showed similar hip ROM. However, significant hip side-to-side asymmetries presented in the LPG's sagittal, frontal and transverse planes but only presented in the CG's transverse plane hip ranges. The dominant side usually displayed the smaller range. Conclusions: Without further evidence, it is unlikely that symmetrically atypical coupled hip ranges should be ignored in the treatment of NSLBP, but a stronger case exists for attention to the hip ROM side-to-side asymmetries. Compounded, multi-planar hip ROM side asymmetries may be one of the causes of NSLBP.
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spelling doaj-art-e6a300ec6a5d4fc190f9ed7ed9457f5c2025-08-20T03:44:11ZengElsevierNorth American Spine Society Journal2666-54842025-03-012110058110.1016/j.xnsj.2025.100581The association of hip range of movement, and its side-to-side asymmetries, and non-specific lower back pain in adults aged 40 years and olderKevin Ermann, PT0Benita Olivier, PT PhD1Corresponding author. 44 Ashford Road, Parkwood, Johannesburg, South Africa, 2193.; Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, South AfricaDepartment of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, South AfricaABSTRACT: Background: The hip joint's close association and coupling with the lumbar spine may influence its axes of rotation during closed-chain movement. Consequently, altered hip range of movement (ROM) may potentially foment the symptoms of non-specific lower back pain (NSLBP), warranting its investigation. A quantitative, cross-sectional, analytical design was employed to determine whether NSLBP has an association with altered hip ROM and dominance-aligned hip side-to-side asymmetries. Methods: Ninety-three convenience sampled participants with and without NSLBP were enrolled. These were assigned to the Lumbar Pain Group (LPG), comprising 61 individuals, 32 males and 29 females or the Control Group (CG), consisting of 32 pain-free volunteers, 18 males and 14 females. Individuals with hip conditions were excluded from the study. Participants completed a Baecke questionnaire and their BMI, Beighton score and leg dominance was established. The following asymptomatic, dominance aligned hip ROM was measured with an Inertial Measurement Unit (IMU): hip flexion ROM in supine; hip extension ROM in prone; Modified Thomas Test (MTT) with knee extension; straight leg raise (SLR); abduction in supine; adduction in supine and hip internal (IR) and external rotation (ER) in prone, sitting and supine in 30° flexion using a framework. Results: The LPG and CG showed similar hip ROM. However, significant hip side-to-side asymmetries presented in the LPG's sagittal, frontal and transverse planes but only presented in the CG's transverse plane hip ranges. The dominant side usually displayed the smaller range. Conclusions: Without further evidence, it is unlikely that symmetrically atypical coupled hip ranges should be ignored in the treatment of NSLBP, but a stronger case exists for attention to the hip ROM side-to-side asymmetries. Compounded, multi-planar hip ROM side asymmetries may be one of the causes of NSLBP.http://www.sciencedirect.com/science/article/pii/S2666548425000010Non-specific lower back painLumbopelvic-hip complexHip range of movementHip range of movement side-to-side asymmetriesLeg dominanceHip rotation in prone
spellingShingle Kevin Ermann, PT
Benita Olivier, PT PhD
The association of hip range of movement, and its side-to-side asymmetries, and non-specific lower back pain in adults aged 40 years and older
North American Spine Society Journal
Non-specific lower back pain
Lumbopelvic-hip complex
Hip range of movement
Hip range of movement side-to-side asymmetries
Leg dominance
Hip rotation in prone
title The association of hip range of movement, and its side-to-side asymmetries, and non-specific lower back pain in adults aged 40 years and older
title_full The association of hip range of movement, and its side-to-side asymmetries, and non-specific lower back pain in adults aged 40 years and older
title_fullStr The association of hip range of movement, and its side-to-side asymmetries, and non-specific lower back pain in adults aged 40 years and older
title_full_unstemmed The association of hip range of movement, and its side-to-side asymmetries, and non-specific lower back pain in adults aged 40 years and older
title_short The association of hip range of movement, and its side-to-side asymmetries, and non-specific lower back pain in adults aged 40 years and older
title_sort association of hip range of movement and its side to side asymmetries and non specific lower back pain in adults aged 40 years and older
topic Non-specific lower back pain
Lumbopelvic-hip complex
Hip range of movement
Hip range of movement side-to-side asymmetries
Leg dominance
Hip rotation in prone
url http://www.sciencedirect.com/science/article/pii/S2666548425000010
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