Hip biomechanics in patients with low back pain, what do we know? A systematic review.
Level 3 - non-randomized controlled study
Systematic review of observational studies
PubMed 38807086 · doi:10.1186/s12891-024-07463-5
What was done
This systematic review (PROSPERO CRD42020213599) searched PubMed, Embase, CINAHL, and SPORTDiscus through February 22, 2024, for observational studies evaluating hip biomechanical parameters (range of motion, kinematics, strength, and electromyography) in adults with non-specific acute, subacute, or chronic low back pain (LBP). Two independent assessors selected studies and evaluated methodological quality using the Epidemiological Appraisal Instrument. Due to substantial heterogeneity across biomechanical assessments, a descriptive synthesis was conducted without meta-analysis.
What was found
Fifty-four studies of moderate and high methodological quality were included (9 range of motion, 16 kinematics, 4 strength, 7 electromyography, and 18 evaluating multiple outcomes). The abstract provides no quantitative effect sizes or p-values. Qualitatively, individuals with LBP demonstrated reduced hip range of motion (especially internal rotation), reduced time to execute functional tasks such as sit-to-stand and walking, greater activation of the hamstrings and gluteus maximus, and weakness in the hip abductor and extensor muscles relative to healthy controls.
Why it matters
This review demonstrates consistent hip-level biomechanical impairments across patients with non-specific low back pain, reinforcing the need to assess and address the hip complex in clinical LBP management.
Limits
The abstract reports no numerical values, effect sizes, confidence intervals, or total participant sample size. Because all included papers were observational designs, causal relationships between hip biomechanical deficits and low back pain cannot be established.