PDF(Pubmed)
Abstract：
BACKGROUND: Biomechanical alterations in patients with low back pain (LBP), as reduced range of motion or strength, do not appear to be exclusively related to the trunk. Thus, studies have investigated biomechanical changes in the hip, due to the proximity of this joint to the low back region. However, the relationship between hip biomechanical changes in patients with LBP is still controversial and needs to be summarized. Therefore, the aim of this study was to systematically review observational studies that used biomechanical assessments in patients with non-specific LBP.
METHODS: The search for observational studies that evaluated hip biomechanical variables (i.e., range of motion, kinematic, strength, and electromyography) in adults with non-specific acute, subacute, and chronic LBP was performed in the PubMed, Embase, Cinahl and Sportdiscus databases on February 22nd, 2024. Four blocks of descriptors were used: 1) type of study, 2) LBP, 3) hip and 4) biomechanical assessment. Two independent assessors selected eligible studies and extracted the following data: author, year of publication, country, study objective, participant characteristics, outcomes, and results. The methodological quality of the studies was assessed using the Epidemiological Appraisal Instrument and classified as low, moderate, and high. Due to the heterogeneity of the biomechanical assessment and, consequently, of the results among eligible studies, a descriptive analysis was performed.
RESULTS: The search strategy returned 338 articles of which 54 were included: nine articles evaluating range of motion, 16 evaluating kinematic, four strength, seven electromyography and 18 evaluating more than one outcome. The studies presented moderate and high methodological quality. Patients with LBP, regardless of symptoms, showed a significant reduction in hip range of motion, especially hip internal rotation, reduction in the time to perform functional activities such as sit-to-stance-to-sit, sit-to-stand or walking, greater activation of the hamstrings and gluteus maximus muscles and weakness of the hip abductor and extensor muscles during specific tests and functional activities compared to healthy individuals.
CONCLUSIONS: Patients with LBP present changes in range of motion, task execution, activation, and hip muscle strength when compared to healthy individuals. Therefore, clinicians must pay greater attention to the assessment and management of the hip during the treatment of these patients.
BACKGROUND: International Prospective Register of Systematic Reviews (PROSPERO) (CRD42020213599).
METHODS: The search for observational studies that evaluated hip biomechanical variables (i.e., range of motion, kinematic, strength, and electromyography) in adults with non-specific acute, subacute, and chronic LBP was performed in the PubMed, Embase, Cinahl and Sportdiscus databases on February 22nd, 2024. Four blocks of descriptors were used: 1) type of study, 2) LBP, 3) hip and 4) biomechanical assessment. Two independent assessors selected eligible studies and extracted the following data: author, year of publication, country, study objective, participant characteristics, outcomes, and results. The methodological quality of the studies was assessed using the Epidemiological Appraisal Instrument and classified as low, moderate, and high. Due to the heterogeneity of the biomechanical assessment and, consequently, of the results among eligible studies, a descriptive analysis was performed.
RESULTS: The search strategy returned 338 articles of which 54 were included: nine articles evaluating range of motion, 16 evaluating kinematic, four strength, seven electromyography and 18 evaluating more than one outcome. The studies presented moderate and high methodological quality. Patients with LBP, regardless of symptoms, showed a significant reduction in hip range of motion, especially hip internal rotation, reduction in the time to perform functional activities such as sit-to-stance-to-sit, sit-to-stand or walking, greater activation of the hamstrings and gluteus maximus muscles and weakness of the hip abductor and extensor muscles during specific tests and functional activities compared to healthy individuals.
CONCLUSIONS: Patients with LBP present changes in range of motion, task execution, activation, and hip muscle strength when compared to healthy individuals. Therefore, clinicians must pay greater attention to the assessment and management of the hip during the treatment of these patients.
BACKGROUND: International Prospective Register of Systematic Reviews (PROSPERO) (CRD42020213599).
摘要：
背景：下背痛（LBP）患者的生物力学改变，作为减小的运动范围或力量，似乎并不完全与树干有关。因此，研究调查了髋关节的生物力学变化，由于这个关节靠近低背部区域。然而,LBP患者髋关节生物力学改变之间的关系仍存在争议，需要总结。因此,本研究的目的是系统回顾在非特异性LBP患者中使用生物力学评估的观察性研究.
方法：寻找评估髋关节生物力学变量的观察性研究(即，运动范围,运动学,力量,和肌电图）在非特异性急性成人中，亚急性，慢性LBP在PubMed进行，Embase,2月22日的Cinahl和Sportdiscus数据库，2024.使用了四组描述符：1)研究类型，2)LBP,3)髋关节和4)生物力学评价。两名独立评估人员选择了符合条件的研究，并提取了以下数据：作者，出版年份,国家,研究目标,参与者特征，结果，和结果。使用流行病学评估工具评估研究的方法学质量，中度,和高。由于生物力学评估的异质性，因此,在符合条件的研究中，进行了描述性分析.
结果：搜索策略返回了338篇文章，其中包括54篇文章：9篇文章评估活动范围，16评估运动学，四个力量,7个肌电图和18个评估一个以上的结果。这些研究具有中等和较高的方法学质量。LBP患者,不管症状如何,显示髋部活动范围显著减少，尤其是髋部内旋,减少进行功能性活动的时间，例如坐到站到坐，坐着站着或走路，与健康个体相比，在特定测试和功能活动期间，腿筋和臀大肌的更大激活以及髋关节外展肌和伸肌的无力。
结论：患有LBP的患者存在活动范围的变化，任务执行,激活,与健康人相比，臀部肌肉力量。因此,在这些患者的治疗过程中，临床医生必须更加重视髋关节的评估和管理。
背景：国际前瞻性系统审查注册（PROSPERO）（CRD42020213599）。
方法：寻找评估髋关节生物力学变量的观察性研究(即，运动范围,运动学,力量,和肌电图）在非特异性急性成人中，亚急性，慢性LBP在PubMed进行，Embase,2月22日的Cinahl和Sportdiscus数据库，2024.使用了四组描述符：1)研究类型，2)LBP,3)髋关节和4)生物力学评价。两名独立评估人员选择了符合条件的研究，并提取了以下数据：作者，出版年份,国家,研究目标,参与者特征，结果，和结果。使用流行病学评估工具评估研究的方法学质量，中度,和高。由于生物力学评估的异质性，因此,在符合条件的研究中，进行了描述性分析.
结果：搜索策略返回了338篇文章，其中包括54篇文章：9篇文章评估活动范围，16评估运动学，四个力量,7个肌电图和18个评估一个以上的结果。这些研究具有中等和较高的方法学质量。LBP患者,不管症状如何,显示髋部活动范围显著减少，尤其是髋部内旋,减少进行功能性活动的时间，例如坐到站到坐，坐着站着或走路，与健康个体相比，在特定测试和功能活动期间，腿筋和臀大肌的更大激活以及髋关节外展肌和伸肌的无力。
结论：患有LBP的患者存在活动范围的变化，任务执行,激活,与健康人相比，臀部肌肉力量。因此,在这些患者的治疗过程中，临床医生必须更加重视髋关节的评估和管理。
背景：国际前瞻性系统审查注册（PROSPERO）（CRD42020213599）。
