Poster Presentation 51st International Society for the Study of the Lumbar Spine Annual Meeting 2025

Introduction: Recurrent low back pain (LBP) is characterized by episodic pain that can interfere with daily activities and often results in compensatory movement patterns. Understanding shoulder and pelvis coordination during axial trunk rotation is essential, as these regions contribute significantly to trunk mobility and overall spinal health. This study aims to investigate shoulder-pelvis coordination differences between individuals with recurrent LBP and those without, focusing on a range of motion (ROM), angular velocity, and relative phase (RP) to understand how recurrent LBP alters these parameters. The research fills a critical gap in understanding the underlying kinematic restrictions and adaptations that may influence movement patterns and stability in recurrent LBP populations.

Methods: Nineteen subjects with recurrent low back pain (LBP) and 19 age-matched control subjects who are all right limb dominant participated in this study. All participants were asked to perform axial trunk rotation activities at a self-selected speed to the end of the maximum range in a standing position. The outcome measures included ROM, angular velocity, and RP on the shoulder and pelvis in the transverse plane and were analyzed based on the demographic characteristics between groups (Figure1).

Results: The LBP group demonstrated decreased ROM (p = 0.02) and angular velocity (p = 0.02) for the pelvis; however, there was no group difference for the shoulder girdle (Figure2). The ROM difference between the shoulder and pelvic transverse planes significantly interacted with age (F = 14.75, p = 0.001). The LBP group demonstrated a higher negative correlation between the shoulder (r = -0.74, p = 0.001) and pelvis (r = -0.72, p = 0.001) as age increased, while no significant correlations were found in the control group (Figure3).

Discussion: The findings suggest that recurrent LBP is associated with reduced pelvic ROM and angular velocity during axial trunk rotation, likely due to neuromuscular constraints and increased pelvic stiffness. This limited pelvic mobility contrasts with relatively unchanged shoulder movement, leading to a compensatory reliance on the shoulder girdle to achieve trunk rotation. The age-related decline in pelvic rotation observed in the LBP group underscores the potential impact of recurrent LBP on functional trunk movement over time. Given the decreased pelvic mobility in individuals with recurrent LBP, rehabilitation strategies that promote pelvic flexibility and coordinated movement patterns may be beneficial. Enhancing pelvic rotation capacity could improve the integration of spinal motion, reduce the frequency of LBP episodes, and improve postural control in this population.