Energy Transfer Across the Lumbosacral and Lower-Extremity Joints in Patients With Low Back Pain During Sit-to-Stand

Abstract 

Shum GL, Crosbie J, Lee RY. Energy transfer across the lumbosacral and lower-extremity joints in patients with low back pain during sit-to-stand.

Objective

To examine the transfer of energy through the pelvis and the lower limb during sit-to-stand (STS) in low back pain (LBP) subjects with or without a straight-leg raise sign.

Design

Cross-sectional.

Setting

Biomechanics laboratory.

Participants

Three groups, each of 20 subjects, participated. The first group consisted of asymptomatic subjects, and the other 2 groups of consisted of LBP subjects (duration between 7 days and 12 weeks) with and without a straight-leg raise sign.

Interventions

Not applicable.

Main Outcome Measures

The work done and the power of the pelvis, thigh, and leg segments during STS were determined.

Results

Energy was transferred from the pelvis to the thigh segment and then to the leg segment, and this was achieved mainly by passive mechanisms. The power flow of the pelvis segment was significantly decreased in subjects with LBP. Although the power of the lower-limb segments was decreased, the total work done of these segments was increased.

Conclusions

STS is a more energy-demanding and less efficient task for subjects with LBP, either with or without a positive straight-leg raise sign. Such increases in energy demand may further exacerbate back pain, and treatment should be developed to restore a more efficient energy transfer pattern.

Key Words: Back pain, Energy transfer, Hip, Kinetics, Rehabilitation, Spine

List of Abbreviations: CMC, coefficient of multiple correlation, ICC, intraclass correlation coefficient, LBP, low back pain, STS, sit-to-stand, 3D, 3-dimensional, VAS, visual analog scale