Effect of Posterior Pelvic Tilt on Balance and Sensory Integration in Patients With Non-specific Low Back Pain

Study Overview
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Brief Summary
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There is a debate in the literature about the effect of NSLBP on pelvic tilt and its effect on balance, sensory integration and functional disability so we need this study to fill the aforementioned gap in literature in this field. So the purpose of the study is to evaluate posterior pelvic tilt effect on overall dynamic balance, sensory integration and functional disability in patients with non-specific low back pain.

Detailed Description
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The LBP became one of the biggest problems for public health systems in the world during the second half of the 20th century. The lifetime prevalence of LBP is reported to be as high as 84%, and the prevalence of chronic LBP is about 23%, with 11-12% of the population being disabled by LBP. Prevalence of LBP was 53.2%. It was more among female patients (62.8%) than among male patients (38.3%) among attendants to a Family Health Center in Egypt. Additionally, studies have observed relationships between chronic non-specific LBP and a posteriorly shifted center of gravity, impaired proprioception, and decreased muscular strength, activation and endurance of the trunk and hips. Balance is impaired in individuals with chronic low back pain when compared to healthy individuals. Most of these studies supposed that postural mal-alignment involves deviations in only one direction which is toward lordosis and anterior pelvic tilt. However, clinical experience suggests that some patients with back pain have the opposite problem which is a much reduced lordotic curve and a posterior pelvic tilt. If the true relationship between posture and low back pain disability is curvilinear instead, this could explain why the studies so far have shown weak or no relationships.

Official Title
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Effect of Posterior Pelvic Tilt on Balance, Sensory Integration and Risk of Fall in Patients With Non-specific Low Back Pain

Conditions
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Biochemical Lesions Lumbar Region, Orthopedic Disorder of Spine, Back Disorder

Intervention / Treatment
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* Other: pelvic tilt effect on balance, sensory integration and risk of fall


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Fifty patients with chronic low back pain or repeated non-specific back pain for more than three months. Both sex with posterior pelvic tilt (-0.7 ± 6.5°)and decreased lumbar lordosis, for (Group A) and normal anterior pelvic tilt angle between 5° and 13° for (Group B) Their ages were ranged from 20-35 years. Body Mass Index from 18-25 Kg/m² . Exclusion Criteria: Previous back surgery. Signs and symptoms of gross spinal instability. Radiological diagnosis of spondylolysis or spondylolisthesis. Acute low back pain. Disc prolapse or herniation. Any neurological, orthopedic, and vestibular disorders affecting the balance system. Flexion and extension restriction of the lumbar region. Other conditions that affected the normal functioning of the central and peripheral nervous system such as alcohol abuse, addiction, dementia, and cognitive disorders.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Posterior pelvic tilt group<br>patients with chronic low back pain or repeated non-specific back pain for more than three months. Both sex with posterior pelvic tilt (-0.7 ± 6.5°) and decreased lumbar lordosis Their ages were ranged from 20-35 years Body Mass Index from 18-25 Kg/m² | Other: pelvic tilt effect on balance, sensory integration and risk of fall<br>* BIODEX balance system, Limits of stability test, Risk of Fall test, m-CTSIB test<br>|
| Normal anterior pelvic tilt group<br>patients with chronic low back pain or repeated non-specific back pain for more than three months. Both sex with anterior pelvic tilt (5° and 13°) and normal lumbar lordosis Their ages were ranged from 20-35 years Body Mass Index from 18-25 Kg/m² | Other: pelvic tilt effect on balance, sensory integration and risk of fall<br>* BIODEX balance system, Limits of stability test, Risk of Fall test, m-CTSIB test<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Biodex balance system Limits of stability test | A test measures dynamic postural stability in percentage | 10 minuets | 
| Biodex balance system m-CTSIB test | A test measures postural sway control to assess sensory integration. | 10 minuets | 
| Biodex balance system Fall risk test (FR) | A test to assess risk of fall according to mean age | 10 minuets | 
| Oswestry Disability Index (ODI) | An index to assess physical functioning in percentage. | 10 minuets | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Global Posture System (GPS) 600 | A device to assess degree of pelvic tilt angle in degrees. | 10 minuets | 
| Body Mass Index (weight in kilograms, height in meters) | kg/m^2 | 10 minuets | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pelvic tilt, sensory integration, balance, back pain, biodex