Passive elastic contribution of hip extensors to joint moments during walking in people with low back pain

Background: It has been found that alterations in passive muscle properties may be associated with low back pain, and these may be responsible for the altered gait parameters often observed in subjects with back pain. The purpose of the present study was to assess total hip and passive hip extensor moments in people with or without low back pain during the hip flexion component of walking. Methods: 52 subjects volunteered for this study (low back pain group, n = 25 (male n = 13, female n = 12), control group, n = 27 (male n = 15, female n = 12)). Passive hip moments were calculated using an adapted force transducer during supine testing. A biomechanical model and predictive equation were used to calculate passive hip moments during walking. Total hip moments were calculated with the use of a 9 camera, 3-D motion-capture system. Findings: Independent samples t-tests demonstrated no significant differences between groups for gait parameters or hip or knee angles. Results of the ANOVAs demonstrated significant differences in passive hip flexor moments during the second half of hip flexion (P < 0.05).There were also significant differences in hip power and work done during peaks of power absorption and the second peak of power generation (P < 0.05). Interpretation: The present data demonstrates that subjects with low back pain have altered passive hip extensor and total power and work done during walking compared with healthy controls. Biomechanical models should include individual measurements of passive joint moments.