The association between pelvic asymmetry and non-specific chronic low back pain as assessed by the global postural syste
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RESEARCH ARTICLE
Open Access
The association between pelvic asymmetry and non-specific chronic low back pain as assessed by the global postural system Qiuhua Yu1†, Huanjie Huang1†, Zhou Zhang1, Xiaoqian Hu1,2, Wenfeng Li1, Le Li1,3, Min Chen1, Zhenwen Liang4, Wai Leung Ambrose Lo1,3* and Chuhuai Wang1*
Abstract Background: Empirical evidence that demonstrates the relationship between pelvic asymmetry and non-specific chronic low back pain (NCLBP) is currently lacking. Objective: To establish the reliability of the Global Postural System (GPS) in assessing pelvic asymmetry and identify the association between pelvic asymmetry parameters and the occurrence of NCLBP in young adults. Design: A cross-sectional, regression study. Methods: People who were aged between 18 and 30 and were diagnosed with NCLBP were recruited. Healthy individuals who were matched for age, sex, and education level were recruited as controls. Global Postural System (GPS) was employed to assess pelvic asymmetry. Prior to exploring the association, the reliability of GPS was assessed by the ICC (2, k) for interrater reliability, ICC (3, k) for intra-rater reliability, standard error and minimal detectable difference. Bivariate correlation analysis and logistic regression analysis were used to determine the relationship between pelvic asymmetry and the occurrence of NCLBP. Results: Twenty-eight healthy participants and 28 people with NCLBP were recruited. Moderate to excellent ICCs were observed for the inter-rater and intra-rater reliability of most postural parameters. The bivariate correlation analysis indicated that age, body mass index and pelvic asymmetry parameters were related to the occurrence of NCLBP. Pelvic angle asymmetry (odds ratio = 1.17), and asymmetry of the distance between the posterior superior iliac spine and the floor (odds ratio = 1.21) were associated with NCLBP. Limitations: This study did not explore the causal relationship between pelvic asymmetry in the sagittal plane/ pelvic asymmetry in the transverse plane and the occurrence of NCLBP. The interpretation of the results may not be generalized beyond the sample population. Conclusions: The GPS is a reliable method to assess pelvic asymmetry in a clinical setting. Two pelvic parameters were associated with the presence of NLBP. Measurement of pelvic asymmetry may assist in the early identification of potential occurrence of NCLBP but further work is required. Keywords: Pelvic asymmetry, Low back pain, Photographic assessment, Pelvic posture
* Correspondence: [email protected]; [email protected] † Qiuhua Yu and Huanjie Huang contributed equally to this work. 1 Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhong Shan Er Lu, Guangzhou 5100800, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reprod
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