Lumbopelvic biomechanics in patients with lumbar disc herniation—prospective cohort study

Abstract

Low back pain (LBP) is the most frequent cause of adult disability. One of the main reasons can be a herniated disc (lumbar disc herniation—LDH), potentially disturbing spinal movement patterns. Its influence on gait and lumbopelvic biomechanics still remains unclear. Little to no evidence was found on lumbopelvic kinematics and gait in young LDH adults. The purpose of this study was to analyze the lumbopelvic biomechanics in young adult individuals with lumbar disc herniation diagnosed by MRI. Forty-three participants (18–35 years) were divided into two groups: an LDH group (n = 19) and a control group (n = 24). All participants underwent dynamic lumbopelvic and gait measures by a G-Walk wearable device in a 6-m walking test (6MWT). The Oswestry Disability Index (ODI) questionnaire was used for subjective disability assessment. The LDH group showed higher speed (p = 0.02), lower symmetry of pelvis tilt (p = 0.01), and lower pelvis rotation (p = 0.04) compared to the healthy controls. Correlation calculations showed significance between pelvis obliquity and pelvis rotation (r = 0.53) but only in healthy controls. The lumbopelvic biomechanics shows differences in pelvis tilt and symmetry index of rotation parameters between LDH and healthy controls. In conclusion, LDH affects the gait kinematics, causing three-dimensional disorders and lack of synergy. This is probably due to pain avoidance behaviors and the compensation mechanisms of the adjacent body region.