11-1-067 ”Abductory twist” – an element of observational gait analysis in low back pain – a case study - Prabu Raja Gopala Krishnan et al

Streszczenie

The objective of this case study is to explain the influence of the altered lower limb kinematics in subject with non-specific low back pain using simple video analysis and to emphasise the relationship between the altered lower limb kinematics and low back pain. Low back pain management is one of the most challenging tasks encountered by the therapist. Altered lower limb kinematics has been hypothesized to influence low back pain. A thorough biomechanical evaluation of the lower limbs and the pelvic girdle along with the spine is important in successful rehabilitation of non-specific low back pain.An 18 year old cricket player with the chief complaint of low back pain presented to the department of physiotherapy. Routine physiotherapy evaluation was carried out and the patient was diagnosed with non specific chronic low back pain. He had undergone specific low back rehabilitation protocol elsewhere. On observation it was found that there was a collapse of medial longitudinal arch during midstance. Following this, a through video analysis was done to identify the abnormalities in kinematics. There was a rapid medial movement of the heel at the instant of heel off which was coined as abductory twist in the literature.Abductory twist is an abnormal finding in which there is an excess and prolonged foot pronation beyond midstance. This alters the kinematics proximally leading to back pain. Observational gait analysis is mandatory in recurrent non-specific low back pain. This case study explains the pathomechanical relationship between the foot and low back pain.

 

Słowa kluczowe

abductory twist, observational gait analysis, dynamic foot function, medial longitudinal arch