Association between lumbar extremes of motion and musculoskeletal injury of the low back and hip in adult women
Borman, Nicole Patrice
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The purpose of this study was to quantify the association between baseline measurements of lumbar extremes of motion, body mass index, self-reported histories of physical activity, and stiffness for musculoskeletal injuries of the low back and hip among women of different ages and racial groups. Participants in the WIN study at the Cooper Institute in Dallas, TX completed Web-based questionnaires on demographics, orthopedic history of symptoms, injuries, and weekly minutes of moderate and/or vigorous physical activity. Data from self-reported orthopedic history of 911 women were analyzed along with measures of lumbar spine motion. The self-reported data consisted of age, race, physical activity level, history of stiffness, and history of musculoskeletal injury (MSI). Four-hundred and sixty-three (50.8%) of 911 women reported having a history of MSI of the low back and hip. Univariate logistic regression models suggest that lumbar flexion in the middle or third quintile (OR = 0.66, 95% CI = [0.44 to .99], p = .05) and history of stiffness (OR = 5.99, 95% CI = [4.5 to 8.0], p = .001) relate to increased likelihood of MSI. Further analysis using multivariate logistic regression revealed that although the women in the third quintile for lumbar flexion were still less likely to report an MSI (OR = 0.68, 95% CI = [0.43 to 1.1], p = .11), it did not reach statistical significance. However, women with reported history of stiffness in the low back and hip at baseline had increased likelihood of MSI regardless of baseline quintile of lumbar motion. Further, the multivariate logistic regression model for MSI controlling for lumbar flexion and extension motion, race, age, body mass index, and physical activity demonstrated that women with history of stiffness (OR = 6.2, 95% CI = [4.6 to 8.3], p = .001) have increased likelihood of MSI of the low back and hip. Women with self-reported history of stiffness at baseline are 6 times more likely to report MSI of the low back and hip. Therapeutic interventions to address low back and hip stiffness early may aid in decreasing MSI of these regions for other women with comparable characteristics.