Lumbopelvic Rhythm: Difference between revisions
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[[Lumbar Anatomy|Lumbar joint]] is formed by wedge shaped [[intervertebral disc]] anteriorly and posteriorly by [https://www.physio-pedia.com/Lumbosacral_Biomechanics L5-S1 facet]. | [[Lumbar Anatomy|Lumbar joint]] is formed by wedge shaped [[intervertebral disc]] anteriorly and posteriorly by [https://www.physio-pedia.com/Lumbosacral_Biomechanics L5-S1 facet]. | ||
Cailliet described a specific instance of coordinated | Cailliet described a specific instance of coordinated simultaneous activity of lumbar flexion and anterior tilting of the pelvis in sagittal plane during trunk flexion and extension. He combined [[Lumbar Spine Range Of Motion|lumbar]] and [[Pelvic Tilt|pelvic motions]].<ref name=":0">Cailliet R: Soft Tissue Pain and Disability(ed. 3) ,Philadelphia F.A. Davis,1996</ref>When the femur, pelvis, and spine move in a 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 [https://www.physio-pedia.com/Scapulohumeral_Rhythm Scapulo-Humeral Rhythm.] | ||
[[File:Basics of lumbar spine.jpg|center|thumb|<ref>basics of lumbar spine. source: pixy.org.CCO public domain, No attribution required. Available from https://pixy.org/1364428/ [last accessed 23/9/2020]</ref>]] | [[File:Basics of lumbar spine.jpg|center|thumb|<ref>basics of lumbar spine. source: pixy.org.CCO public domain, No attribution required. Available from https://pixy.org/1364428/ [last accessed 23/9/2020]</ref>]] | ||
== What Is Lumbopelvic Rhythm? == | == What Is Lumbopelvic Rhythm? == | ||
[[File:Toe touching.png|thumb|<ref>[https://thenounproject.com/benjamin_erich/ Bob holzer]. Uttanasana yoga icon. [https://creativecommons.org/licenses/by/3.0 Lisensed under creative common]. Available from https://thenounproject.com/term/uttanasana/107998/ , [last accessed 23/9/2020]</ref>]] | [[File:Toe touching.png|thumb|<ref>[https://thenounproject.com/benjamin_erich/ Bob holzer]. Uttanasana yoga icon. [https://creativecommons.org/licenses/by/3.0 Lisensed under creative common]. Available from https://thenounproject.com/term/uttanasana/107998/ , [last accessed 23/9/2020]</ref>]] | ||
The activity of bending over to touch one's toes with knees straight depends on lumbopelvic rhythm. | The activity of bending over to touch one's toes with knees straight depends on the lumbopelvic rhythm. Lumbopelvic rhythm or the hip-spine coordination<ref>Tojima M, Ogata N, Nakahara Y, Haga n. [https://waseda.pure.elsevier.com/en/publications/three-dimensional-motion-analysis-of-lumbopelvic-rhythm-during-tr Three-dimensional motion analysis of lumbopelvic rhythm during trunk extension]. Journal of Human Kinetics 2016 Apr 1;50(1):53-62.</ref> refers to the way in which the lumbar spine, moves in combination with the pelvis. '''It is the kinematic relationship between the lumbar spine and hip joints during sagittal plane movement.''' | ||
'''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 '''returning to the erect posture, this rhythm is reversed. It is initiated by posterior tilting of the pelvis at the hip, followed by extension of the lumbar spine'''.<ref name=":1">Norkin, C. C., Levangie, P. K. [https://www.google.co.in/books/edition/Joint_Structure_and_Function/JXb2AAAAQBAJ?hl=en&gbpv=0 Joint Structure and Function: A Comprehensive Analysis]. United States: F.A. Davis Company,2011</ref> 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 includes timing, as well as magnitude-related characteristics.<ref>Zhou J, Ning X, Fathallah F. [https://pubmed.ncbi.nlm.nih.gov/26577865/ Difference in lumbopelvic rhythm between trunk flexion and extension. Clinical Biomechanics]. 2016;32:274-279. doi:10.1016/j.clinbiomech.2015.10.012.</ref> | |||
When ''' | |||
{{#ev:youtube|https://youtu.be/yvVbwcv_sVQ|300}}<ref>Alexandra Kopelovich . Lumbopelvic rhythm . Available from : http://youtu.be/yvVbwcv_sVQ [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> | {{#ev:youtube|https://youtu.be/yvVbwcv_sVQ|300}}<ref>Alexandra Kopelovich . Lumbopelvic rhythm . Available from : http://youtu.be/yvVbwcv_sVQ [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> | ||
== Lumbopelvic Rhythm Contribution | == 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 | Lumbopelvic rhythm while bending forward and returning to the initial position has been investigated and a better understanding of trunk motion pattern was achieved as used in 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)[[File:Lumbar vertebra 5 posterior.png|thumb|<ref>lumbar joint - anterior. sorce: anatomography. Available from https://commons.wikimedia.org/wiki/File:Lumbar_vertebrae_anterior.png [last accessed 23/9/2020]</ref>|225x225px|center]][[File:Anterior-lumbar joint.jpg|thumb|<ref>lumbar joint - anterior. sorce: anatomography. Available from https://commons.wikimedia.org/wiki/File:Lumbar_vertebrae_anterior.png [last accessed 23/9/2020]</ref>|center]] | ||
== 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. | ||
This included [https://www.youtube.com/watch?v=-gfwdRTdV8U cervicothoracic fascia release], [https://www.physio-pedia.com/Maitland%27s_Mobilisations Maitland mobilisation], [https://www.healthline.com/health/fitness-exercise/trapezius-stretches stretching of trapezius], [https://www.verywellfit.com/how-to-pectoral-stretch-exercise-2696346 pectorals][https://www.spine-health.com/wellness/exercise/easy-levator-scapulae-stretch-neck-pain#:~:text=Tilt%20the%20chin%20downward%20until,Repeat%20on%20other%20side. , levator scapulae] and neck | This included [https://www.youtube.com/watch?v=-gfwdRTdV8U cervicothoracic fascia release], [https://www.physio-pedia.com/Maitland%27s_Mobilisations Maitland mobilisation], [https://www.healthline.com/health/fitness-exercise/trapezius-stretches stretching of trapezius], [https://www.verywellfit.com/how-to-pectoral-stretch-exercise-2696346 pectorals][https://www.spine-health.com/wellness/exercise/easy-levator-scapulae-stretch-neck-pain#:~:text=Tilt%20the%20chin%20downward%20until,Repeat%20on%20other%20side. , levator scapulae] , and neck exercises like [https://www.youtube.com/watch?v=gIBoxQ6AlS0 chin tuck] and chin drop. | ||
== 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.<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 '[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 | # It is used to identify weakness, inflexibilities, or muscle imbalances that contribute to low back pain. | ||
{{#ev:youtube|https://youtu.be/qbjiXos89Dc|300}}<ref>NESTA & Spencer Institute . Integrated motion of lumbar spine . Available from : https://youtu.be/qbjiXos89Dc [last accessed 15/9/2020]</ref> | {{#ev:youtube|https://youtu.be/qbjiXos89Dc|300}}<ref>NESTA & Spencer Institute . Integrated motion of lumbar spine . Available from : https://youtu.be/qbjiXos89Dc [last accessed 15/9/2020]</ref> | ||
Revision as of 23:26, 19 November 2023
<div class="noeditbox"> ==Page Under Review== This article is currently under review and may not be up to date. Please come back soon to see the finished work! ({{REVISIONDAY}}/{{REVISIONMONTH}}/{{REVISIONYEAR}}) </div>
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 the pelvis in sagittal plane during trunk flexion and extension. He combined lumbar and pelvic motions.[1]When the femur, pelvis, and spine move in a 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 the lumbopelvic rhythm. Lumbopelvic rhythm or the hip-spine coordination[4] refers to the way in which the lumbar spine, moves in combination with the pelvis. It is the kinematic relationship between the lumbar spine and hip joints during sagittal plane movement.
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 returning to the erect posture, this rhythm is reversed. It is initiated by posterior tilting of the pelvis at the hip, followed by extension of the lumbar spine.[5] 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 includes timing, as well as magnitude-related characteristics.[6]
Lumbopelvic Rhythm Contribution to Low Back Pain[edit | edit source]
Lumbopelvic rhythm while bending forward and returning to the initial position has been investigated and a better understanding of trunk motion pattern was achieved as used in research on low back disorders.[9]. 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.[10](fig.4)
Improvement Of Lumbopelvic Rhythm By Correction Of Forward Head Posture[edit | edit source]
Research[13] 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 exercises like chin tuck and chin drop.
Implications[edit | edit source]
- It is used to identify 'Pelvic cross syndrome' in gymnasts.[14]
- It is used to identify weakness, inflexibilities, or muscle imbalances that contribute to low back pain.
Further Reading[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 Cailliet R: Soft Tissue Pain and Disability(ed. 3) ,Philadelphia F.A. Davis,1996
- ↑ basics of lumbar spine. source: pixy.org.CCO public domain, No attribution required. Available from https://pixy.org/1364428/ [last accessed 23/9/2020]
- ↑ Bob holzer. Uttanasana yoga icon. Lisensed under creative common. Available from https://thenounproject.com/term/uttanasana/107998/ , [last accessed 23/9/2020]
- ↑ 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.
- ↑ Norkin, C. C., Levangie, P. K. Joint Structure and Function: A Comprehensive Analysis. United States: F.A. Davis Company,2011
- ↑ 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.
- ↑ Alexandra Kopelovich . Lumbopelvic rhythm . Available from : http://youtu.be/yvVbwcv_sVQ [last accessed 15/9/2020]
- ↑ Vanessa Yingling . PelvicLumbarMotion . Available from : https://youtu.be/KQgp_dtXm7Q [last accessed 15/9/2020]
- ↑ 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.
- ↑ Lowe W:The lumbopelvic rhythm. Academy of clinical massage, published july 1,2015. Accessed Sept 2020
- ↑ lumbar joint - anterior. sorce: anatomography. Available from https://commons.wikimedia.org/wiki/File:Lumbar_vertebrae_anterior.png [last accessed 23/9/2020]
- ↑ lumbar joint - anterior. sorce: anatomography. Available from https://commons.wikimedia.org/wiki/File:Lumbar_vertebrae_anterior.png [last accessed 23/9/2020]
- ↑ 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.
- ↑ Kruse D, Lemmen B. Spine Injuries in sport of Gymnastics. Current Sports Medicine Reports. 2009;8(1):20-28
- ↑ NESTA & Spencer Institute . Integrated motion of lumbar spine . Available from : https://youtu.be/qbjiXos89Dc [last accessed 15/9/2020]
