Lumbopelvic Rhythm: Difference between revisions

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'''According to Cailliet'''<ref name=":0" />, the first part of '''bending forward consists of lumbosacral flexion''' '''followed by anterior [https://www.physio-pedia.com/Pelvic_Tilt tilting of pelvis] at hip joints''' '''.''' The muscles in the lower back namely erector spinae, [https://courses.lumenlearning.com/suny-fitness/chapter/types-of-muscle-contractions-isotonic-and-isometric/ contract] eccentrically to control the movement against gravity while trunk flexes and pelvis tilts anteriorly. The muscles that flex the hip contract concentrically and this motion is balanced by eccentric contraction of muscles that extend the hip.
'''According to Cailliet'''<ref name=":0" />, the first part of '''bending forward consists of lumbosacral flexion''' '''followed by anterior [https://www.physio-pedia.com/Pelvic_Tilt tilting of pelvis] at hip joints''' '''.''' The muscles in the lower back namely erector spinae, [https://courses.lumenlearning.com/suny-fitness/chapter/types-of-muscle-contractions-isotonic-and-isometric/ contract] eccentrically to control the movement against gravity while trunk flexes and pelvis tilts anteriorly. The muscles that flex the hip contract concentrically and this motion is balanced by eccentric contraction of muscles that extend the hip.


When '''return to the erect posture, this rhythm is reversed. It is initiated by posterior tilting of pelvis at the hip, followed by extension of lumbar spine'''.<ref name=":1" /> The hip extensors initiate the posterior rotation of the pelvis until it is in a better position for [https://www.physio-pedia.com/Erector_Spinae#:~:text=0%25%20Complete%20%E2%80%A2-,Introduction,serratus%20posterior%20superior%20and%20inferior). spinal extensors] to concentrically contract without too much stress being put on them. As these muscles contract concentrically, the hip flexors contract eccentrically to [https://www.youtube.com/watch?v=A4gU0YD6HS4&list=PLqabsnGcY9_IiCNr0f_mkEs9SFFNzGTCc&index=3&t=0s help control the movement].
When '''return to the erect posture, this rhythm is reversed. It is initiated by posterior tilting of pelvis at the hip, followed by extension of lumbar spine'''.<ref name=":1" /> The hip extensors initiate the posterior rotation of the pelvis until it is in a better position for [https://www.physio-pedia.com/Erector_Spinae#:~:text=0%25%20Complete%20%E2%80%A2-,Introduction,serratus%20posterior%20superior%20and%20inferior). spinal extensors] to concentrically contract without too much stress being put on them. As these muscles contract concentrically, the hip flexors contract eccentrically to [https://www.youtube.com/watch?v=A4gU0YD6HS4&list=PLqabsnGcY9_IiCNr0f_mkEs9SFFNzGTCc&index=3&t=0s help control the movement].The aspect of motion of interest include timing, as well as magnitude related characteristics.<ref>Zhou J, Ning X, Fathallah F. [[Difference in lumbopelvic rhythm between trunk flexion and extension. Clinical Biomechanics]]. 2016;32:274-279. doi:10.1016/j.clinbiomech.2015.10.012.</ref>
The aspect of motion of interest include timing, as well as magnitude related characteristics.


{{#ev:youtube|https://youtu.be/KQgp_dtXm7Q|300}} <ref>Vanessa Yingling . PelvicLumbarMotion . Available from : https://youtu.be/KQgp_dtXm7Q [last accessed 15/9/2020]</ref>
{{#ev:youtube|https://youtu.be/KQgp_dtXm7Q|300}} <ref>Vanessa Yingling . PelvicLumbarMotion . Available from : https://youtu.be/KQgp_dtXm7Q [last accessed 15/9/2020]</ref>
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==  Lumbopelvic rhythm contribution to low back pain ==
==  Lumbopelvic rhythm contribution to low back pain ==
Lumbopelvic rhythm while bending forward and returning to initial position has been investigated and better understanding of trunk motion pattern was achieved as used on research on low back disorders<ref>Vazirian M, Van Dillen L, Bazrgari B. [https://scholar.google.com/scholar_url?url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639918/&hl=en&sa=T&oi=gsb-ggp&ct=res&cd=0&d=49963495382477579&ei=WjhgX-rcJ4apywSo65KACA&scisig=AAGBfm0bw1fhLAWOymkU2-WYE5f8Rcnw8A Lumbopelvic rhythm during trunk motion in the sagittal plane]: A review of the kinematic measurement methods and characterization approaches. Physical therapy and rehabilitation. 2016;3.</ref>. During forward bending, the eccentric contractions of the lumbar and hip extensors help to lower the body in a controlled motion against gravity. If the muscles are weak or fatigued, the weight of the body is enough to overload the muscles and this causes strain. When the body is returning to the erect position, if the hip flexors are tight or the extensors are too weak to initiate posterior pelvic rotation, the spinal extensors can get overloaded, causing injury and pain.<ref>Lowe W:[https://www.academyofclinicalmassage.com/the-lumbopelvic-rhythm/ The lumbopelvic rhythm. Academy of clinical massage], published july 1,2015</ref>(fig.4)
Lumbopelvic rhythm while bending forward and returning to initial position has been investigated and better understanding of trunk motion pattern was achieved as used on research on low back disorders<ref>Vazirian M, Van Dillen L, Bazrgari B. [https://scholar.google.com/scholar_url?url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639918/&hl=en&sa=T&oi=gsb-ggp&ct=res&cd=0&d=49963495382477579&ei=WjhgX-rcJ4apywSo65KACA&scisig=AAGBfm0bw1fhLAWOymkU2-WYE5f8Rcnw8A Lumbopelvic rhythm during trunk motion in the sagittal plane]: A review of the kinematic measurement methods and characterization approaches. Physical therapy and rehabilitation. 2016;3.</ref>. During forward bending, the eccentric contractions of the lumbar and hip extensors help to lower the body in a controlled motion against gravity. If the muscles are weak or fatigued, the weight of the body is enough to overload the muscles and this causes strain. When the body is returning to the erect position, if the hip flexors are tight or the extensors are too weak to initiate posterior pelvic rotation, the spinal extensors can get overloaded, causing injury and pain.<ref>Lowe W:[https://www.academyofclinicalmassage.com/the-lumbopelvic-rhythm/ The lumbopelvic rhythm. Academy of clinical massage], published july 1,2015. Accessed Sept 2020</ref>(fig.4)
== Improvement of lumbopelvic rhythm by correction of forward head posture ==
== Improvement of lumbopelvic rhythm by correction of forward head posture ==
Research<ref>Dass B, Shinde D, Kala S et.al. [https://www.ijhsr.org/IJHSR_Vol.10_Issue.9_Sep2020/11.pdf Improvement in the lumbo-pelvic rhythm by correction of forward head posture]. Int J Health Sci Res. 2020; 10(9):69-75.</ref> was done on the improvement of lumbopelvic rhythm by correction of forward head posture which concluded that the study showed clinical significance in the improvement of lumbopelvic rhythm by [https://www.physio-pedia.com/Forward_Head_Posture forward head] correction given for 4 weeks of treatment.
Research<ref>Dass B, Shinde D, Kala S et.al. [https://www.ijhsr.org/IJHSR_Vol.10_Issue.9_Sep2020/11.pdf Improvement in the lumbo-pelvic rhythm by correction of forward head posture]. Int J Health Sci Res. 2020; 10(9):69-75.</ref> was done on the improvement of lumbopelvic rhythm by correction of forward head posture which concluded that the study showed clinical significance in the improvement of lumbopelvic rhythm by [https://www.physio-pedia.com/Forward_Head_Posture forward head] correction given for 4 weeks of treatment.
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== Implications  ==
== Implications  ==
# It is used to identify '[http://www.hanslindgren.com/blog/self-assessment-and-treatment-of-the-pelvic-cross-syndrome/#:~:text=The%20Pelvic%20Cross%20Syndrome%20is,bottom%20of%20the%20lower%20back. Pelvic cross syndrome]' in gymnasts.
# It is used to identify '[http://www.hanslindgren.com/blog/self-assessment-and-treatment-of-the-pelvic-cross-syndrome/#:~:text=The%20Pelvic%20Cross%20Syndrome%20is,bottom%20of%20the%20lower%20back. Pelvic cross syndrome]' in gymnasts.<ref>Kruse D, Lemmen B. [https://pubmed.ncbi.nlm.nih.gov/19142076/ Spine Injuries in sport of Gymnastics. Current Sports Medicine Reports.] 2009;8(1):20-28</ref>
# It is used to identify weakness, inflexibilities or muscles imbalance which contribute to low back pain.
# It is used to identify weakness, inflexibilities or muscles imbalance which contribute to low back pain.


Revision as of 18:32, 15 September 2020

Original Editor - Chelsea Mclene

Top Contributors - Chelsea Mclene, Fatma ElZahraa, Kim Jackson and Sehriban Ozmen  

Introduction[edit | edit source]

Lumbar joint is formed by wedge shaped intervertebral disc anteriorly and posteriorly by L5-S1 facet.

Cailliet described a specific instance of coordinated, simultaneous activity of lumbar flexion and anterior tilting of pelvis in sagittal plane during trunk flexion and extension. He combined lumbar and pelvic motion.[1]When femur, pelvis and spine move in combined coordinated manner, it produces a larger ROM than what might be available to one segment alone. It is an open kinematic chain and is analogous to Scapulo-Humeral Rhythm.

What is lumbopelvic rhythm?[edit | edit source]

The activity of bending over to touch one's toes with knees straight depends on lumbopelvic rhythm.[2]

Lumbopelvic rhythm or the hip-spine coordination[3] refers to the way in which the lumbar spine, moves in combination with the pelvis. It is the kinematic relationship between lumbar spine and hip joints during sagittal plane movement.

[4]

According to Cailliet[1], the first part of bending forward consists of lumbosacral flexion followed by anterior tilting of pelvis at hip joints . The muscles in the lower back namely erector spinae, contract eccentrically to control the movement against gravity while trunk flexes and pelvis tilts anteriorly. The muscles that flex the hip contract concentrically and this motion is balanced by eccentric contraction of muscles that extend the hip.

When return to the erect posture, this rhythm is reversed. It is initiated by posterior tilting of pelvis at the hip, followed by extension of lumbar spine.[2] The hip extensors initiate the posterior rotation of the pelvis until it is in a better position for spinal extensors to concentrically contract without too much stress being put on them. As these muscles contract concentrically, the hip flexors contract eccentrically to help control the movement.The aspect of motion of interest include timing, as well as magnitude related characteristics.[5]

[6]


Lumbopelvic rhythm contribution to low back pain[edit | edit source]

Lumbopelvic rhythm while bending forward and returning to initial position has been investigated and better understanding of trunk motion pattern was achieved as used on research on low back disorders[7]. During forward bending, the eccentric contractions of the lumbar and hip extensors help to lower the body in a controlled motion against gravity. If the muscles are weak or fatigued, the weight of the body is enough to overload the muscles and this causes strain. When the body is returning to the erect position, if the hip flexors are tight or the extensors are too weak to initiate posterior pelvic rotation, the spinal extensors can get overloaded, causing injury and pain.[8](fig.4)

Improvement of lumbopelvic rhythm by correction of forward head posture[edit | edit source]

Research[9] was done on the improvement of lumbopelvic rhythm by correction of forward head posture which concluded that the study showed clinical significance in the improvement of lumbopelvic rhythm by forward head correction given for 4 weeks of treatment.

This included cervicothoracic fascia release, Maitland mobilisation, stretching of trapezius, pectorals, levator scapulae and neck exercise like chin tuck and chin drop.

Implications[edit | edit source]

  1. It is used to identify 'Pelvic cross syndrome' in gymnasts.[10]
  2. It is used to identify weakness, inflexibilities or muscles imbalance which contribute to low back pain.

[11]

Further Reading[edit | edit source]

Lumbosacral Biomechanics

Lumbo-Pelvic Stability

Pelvic tilt

References[edit | edit source]

  1. ↑ 1.0 1.1 Cailliet R: Soft Tissue Pain and Disability(ed. 3) ,Philadelphia F.A. Davis,1996
  2. ↑ 2.0 2.1 Norkin, C. C., Levangie, P. K. Joint Structure and Function: A Comprehensive Analysis. United States: F.A. Davis Company,2011
  3. ↑ Tojima M, Ogata N, Nakahara Y, Haga n. Three-dimensional motion analysis of lumbopelvic rhythm during trunk extension. Journal of Human Kinetics 2016 Apr 1;50(1):53-62.
  4. ↑ Alexandra Kopelovich . Lumbopelvic rhythm . Available from : http://youtu.be/yvVbwcv_sVQ [last accessed 15/9/2020]
  5. ↑ Zhou J, Ning X, Fathallah F. Difference in lumbopelvic rhythm between trunk flexion and extension. Clinical Biomechanics. 2016;32:274-279. doi:10.1016/j.clinbiomech.2015.10.012.
  6. ↑ Vanessa Yingling . PelvicLumbarMotion . Available from : https://youtu.be/KQgp_dtXm7Q [last accessed 15/9/2020]
  7. ↑ Vazirian M, Van Dillen L, Bazrgari B. Lumbopelvic rhythm during trunk motion in the sagittal plane: A review of the kinematic measurement methods and characterization approaches. Physical therapy and rehabilitation. 2016;3.
  8. ↑ Lowe W:The lumbopelvic rhythm. Academy of clinical massage, published july 1,2015. Accessed Sept 2020
  9. ↑ Dass B, Shinde D, Kala S et.al. Improvement in the lumbo-pelvic rhythm by correction of forward head posture. Int J Health Sci Res. 2020; 10(9):69-75.
  10. ↑ Kruse D, Lemmen B. Spine Injuries in sport of Gymnastics. Current Sports Medicine Reports. 2009;8(1):20-28
  11. ↑ NESTA & Spencer Institute . Integrated motion of lumbar spine . Available from : https://youtu.be/qbjiXos89Dc [last accessed 15/9/2020]
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