Hip Flexors Shortening among Patients with Low Back Pain
DOI:
https://doi.org/10.47672/ajhmn.1598Keywords:
Hip Flexors, Hip Flexors Tightness, Low Back Pain, Muscle Shortening, Nonspecific Low Back PainAbstract
Purpose: Determine the hip flexors shortening in individuals with low back pain.
Methodology: It was descriptive cross-sectional study. A total of 255 participants were included according to the selection criteria. Non-probability sampling technique was used to select participants. Inclusion criteria of the study were the patients of age between 18 to 65 years having low back pain from a period of 3 months or more. Exclusion criteria were the individuals with history of spinal trauma, joint dysfunction in past 3 months, any congenital deformity in hip or lumbar region, any history of fracture in related joints in previous 6 months and history of abdominal, hip or lumbar surgery in previous 3 months. Study settings include OPD of DHQ hospital, Gujranwala and Physical therapy department of Gondal hospital, Gujranwala. Study was completed within 4 month. Thomas test was used to assess hip flexors shortening. A structured questionnaire was used to collect participants' relevant data. Data was analysed by SPSS version 20.
Findings: Mean age of the patients was 40.10±12.31 and mean body mass index was 27.44±6.10. Out of 255 patients, 35.7% were male and 64.3% were females. 64.3% participants were housewife, 20.8% were labour and 14.9% were worker. Thomas test was found to be positive in 63.5% patients of low back pain and negative in 36.5% patients. Chi square shows that (p>0.05) there was no significant association between participants' gender and the results of Thomas test. But a statistically significant association was found between gender and occupation (p<0.05).
Recommendations: In conclusion, hip flexor shortening was prevalent in patients of low back pain. The prevalence of hip flexor muscles shortening was found to be 63.5%. There was no statistical significant association of participants' gender with hip flexor shortening. However, statistical significant association was found between gender and occupation of the participant with low back pain. The relationship of hip flexor shortening with various conditions should be evaluated in future research with a bigger sample size, diverse populations, and different age groups. It is suggested that future research look at the prevalence of hip flexor shortening in those without LBP. To stop people's muscles from shortening in general, several awareness programmes for posture advice and muscle stretching practices should be set up.
Downloads
References
Du S, Liu W, Cai S, Hu Y, Dong J. The efficacy of e-health in the self-management of chronic low back pain: a meta analysis. International journal of nursing studies 2020; 106: 103507.
Bento TPF, dos Santos Genebra CV, Maciel NM, Cornelio GP, Simeão SFAP, de Vitta A. Low back pain and some associated factors: is there any difference between genders? Brazilian journal of physical therapy 2020; 24(1): 79-87.
Popescu A, Lee H. Neck pain and lower back pain. Medical Clinics 2020; 104(2): 279-92.
DePalma MG. Red flags of low back pain. Jaapa 2020; 33(8): 8-11.
Solomon CG, Chiarotto A, Koes BW. Nonspecific low back pain. The New England journal of medicine 2022; 386(18): 1732-40.
Traeger AC, Buchbinder R, Elshaug AG, Croft PR, Maher CG. Care for low back pain: can health systems deliver? Bulletin of the World Health Organization 2019; 97(6): 423.
de Souza IMB, Merini LR, Ramos LAV, Passaro AdC, França JID, Marques AP. Prevalence of low back pain and associated factors in older adults: Amazonia Brazilian community study. Healthcare; 2021: MDPI; 2021. p. 539.
Konrad A, MoÄnik R, Titze S, Nakamura M, Tilp M. The influence of stretching the hip flexor muscles on performance parameters. a systematic review with meta-analysis. International journal of environmental research and public health 2021; 18(4): 1936.
Li W, Gong Y, Liu J, et al. Peripheral and central pathological mechanisms of chronic low back pain: a narrative review. Journal of Pain Research 2021: 1483-94.
Rahyussalim AJ, Zufar MLL, Kurniawati T. Significance of the association between disc degeneration changes on imaging and low back pain: a review article. Asian spine journal 2020; 14(2): 245.
Teodorczyk-Injeyan JA, Triano JJ, Injeyan HS. Nonspecific low back pain: inflammatory profiles of patients with acute and chronic pain. The Clinical journal of pain 2019; 35(10): 818.
Nischal P, Agarwal S, Kumar D. Effect of Hip Flexor Muscles Strengthening and Femoral Nerve Sliding on Lumber Lordosis and Low Back Pain.
Kim B, Kang T, Kim D. Effect of proprioceptive neuromuscular facilitation stretching on pain, hip joint range of motion, and functional disability in patients with chronic low back pain. Physical Therapy Rehabilitation Science 2021; 10(2): 225-34.
Shamsi M, Mirzaei M, Shahsavari S, Safari A, Saeb M. Modeling the effect of static stretching and strengthening exercise in lengthened position on balance in low back pain subject with shortened hamstring: a randomized controlled clinical trial. BMC musculoskeletal disorders 2020; 21(1): 1-9.
Herzog W. The problem with skeletal muscle series elasticity. BMC biomedical engineering 2019; 1(1): 1-14.
Vigotsky AD, Lehman GJ, Beardsley C, Contreras B, Chung B, Feser EH. The modified Thomas test is not a valid measure of hip extension unless pelvic tilt is controlled. PeerJ 2016; 4: e2325.
Kiseljak D, BolÄević F, Ćurko D, et al. The Modified Thomas Test realized by optoelectronic kinematic measurement. Functional Neurology, Rehabilitation, and Ergonomics 2017; 7(3): 39-44.
Kale SS, Gijare S. Prevalence of lower crossed syndrome in school going children of age 11 to 15 years. Indian J Physiother Occup Ther 2019; 13(2): 176-9.
Wu A, March L, Zheng X, et al. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Annals of translational medicine 2020; 8(6).
Aleku M, Nelson K, Abio A, Lowery Wilson M, Lule H. Lower back pain as an occupational hazard among Ugandan health workers. Frontiers in public health 2021; 9: 761765.
Shiri R, Falah"Hassani K, Heliövaara M, et al. Risk factors for low back pain: a Population"Based longitudinal study. Arthritis care & research 2019; 71(2): 290-9.
Gilmartin-Thomas JF, Cicuttini FM, Owen AJ, et al. Moderate or severe low back pain is associated with body mass index amongst community-dwelling older Australians. Archives of gerontology and geriatrics 2020; 91: 104231.
Roach SM, San Juan JG, Suprak DN, Lyda M, Bies AJ, Boydston CR. Passive hip range of motion is reduced in active subjects with chronic low back pain compared to controls. International journal of sports physical therapy 2015; 10(1): 13.
Paatelma M, Karvonen E, Heiskanen J. Clinical perspective: how do clinical test results differentiate chronic and subacute low back pain patients from" non-patients"? Journal of Manual & Manipulative Therapy 2009; 17(1): 11-9.
Evans K, Refshauge KM, Adams R, Aliprandi L. Predictors of low back pain in young elite golfers: A preliminary study. Physical Therapy in Sport 2005; 6(3): 122-30.
Serranheira F, Sousa-Uva M, Heranz F, Kovacs F, Sousa-Uva A. Low Back Pain (LBP), work and absenteeism. Work 2020; 65(2): 463-9.
Aslan HIY, Buddhadev HH, Suprak DN, San Juan JG. Acute effects of two hip flexor stretching techniques on knee joint position sense and balance. International journal of sports physical therapy 2018; 13(5): 846.
Kim W-d, Shin D. Correlations between hip extension range of motion, hip extension asymmetry, and compensatory lumbar movement in patients with nonspecific chronic low back pain. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research 2020; 26: e925080-1.
Mine K, Ishiguro K, Nakayama T. Immediate effects of stretching for iliopsoas muscles on lumbopelvic-hip kinematics during gait: a randomised controlled trial using subjects with non-specific low back pain. Int J Sports Exerc Med 2017; 3: 62.
Cejudo A, Moreno-Alcaraz VJ, Izzo R, Santonja-Medina F, Sainz de Baranda P. External and total hip rotation ranges of motion predispose to low back pain in elite Spanish inline hockey players. International journal of environmental research and public health 2020; 17(13): 4858.
Kitamura G, Tateuchi H, Ichihashi N. Greater lumbar extension during dolphin kick and psoas major tightness in swimmers with low back pain. Journal of Sport Rehabilitation 2019; 29(6): 716-22.
Mahdian R, Tabatabaei Molazi F, Rajabi R, Karimi Zadeh Ardakani M. Evaluating the Prevalence of Hamstrings and Hip Flexors Tightness in Male Transient Low Back Pain Developers During Prolonged Standing. International Journal of Musculoskeletal Pain Prevention 2022; 7(4): 803-8.
Mahishale A, Bhattarai A. Prevalence of pelvic crossed syndrome in females with primary dysmenorrhea and its impact on physical activity: An observational study. Indian Journal of Physical Therapy and Research 2023; 5(1): 60-5.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Amen Shahid, Faryal Kashif, Faiza Asghar, Farooq Islam, Asim Raza
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
