Sex Differences in Lumbopelvic Movement Patterns During Hip Medial Rotation in People With Chronic Low Back Pain

Hoffman SL, Johnson MB, Zou D, Van Dillen LR. Sex differences in lumbopelvic movement patterns during hip medial rotation in people with chronic low back pain. Arch Phys Med Rehabil 2011;92:1053-9. Objective: To examine sex differences in lumbopelvic motion and symptom behavior during hip medial rotation in people with low back pain (LBP). We hypothesized that men would demonstrate greater and earlier lumbopelvic motion and would be more likely to report increased symptoms compared with women. Design: Cross-sectional observational study. Setting: University musculoskeletal analysis laboratory. Participants: Persons with chronic LBP (N=59; 30 men, 29 women) were recruited from the community and a university-based physical therapy clinic. Interventions: Not applicable. Main Outcome Measures: Lumbopelvic rotation range of motion, amount of hip rotation completed before the start of lumbopelvic motion, and provocation of LBP symptoms during the test of prone hip medial rotation were measured. Results: Men demonstrated significantly more lumbopelvic rotation (men, 10.0 degrees +/- 5.1 degrees; women, 4.5 degrees +/- 3.9 degrees; P<.001) and completed less hip rotation before the start of lumbopelvic motion (men, 5.4 degrees +/- 3.8 degrees; women, 16.0 degrees +/- 13.2 degrees; P<.001) compared with women. Additionally, a significantly greater percentage of men (60.0%) than women (34.5%; P=.050) reported increased symptoms with hip medial rotation. Conclusions: Men could be at greater risk than women for experiencing LBP symptoms related to hip medial rotation as a result of greater and earlier lumbopelvic motion.