Does the Evidence Support the Existence of Lumbar Spine Coupled Motion? A Critical Review of the Literature

Susan L. Edmond, Owen Legaspi

DOI: 10.2519/jospt.2007.2300

STUDY DESIGN: Literature review. OBJECTIVES: To synthesize the current literature addressing coupled motion between side bending and rotation in the lumbar spine to deter­mine if a consistent pattern exists across articles. BACKGROUND: Low back pain is one of the most common conditions seen in outpatient physi­cal therapy clinics. This condition is often treated with manual therapy techniques. Many approaches to manual therapy incorporate the concept of coupled motion. METHODS AND MEASURES: Using OVID databases, we reviewed and categorized articles published between 1982 and 2006 that addressed coupled motion between side bending and rotation in the lumbar spine. We identified 24 articles in which 32 analyses addressed our clinical question. RESULTS: Seventeen of the 24 articles identified concluded that some form of coupled motion exists; however, there was little agreement across articles as to the specific characteristics of coupled motion. CONCLUSIONS: The inconsistency in reported patterns of coupled motion suggests that physical therapists should use caution when applying concepts of coupled motion to the evaluation and treatment of patients with low back pain.

J Orthop Sports Phys Ther. 2007;37(4):169-178. doi:10.2519/jospt.2007.2300

KEY WORDS: coupled movements, lumbar biomechanics, lumbar motion

This review synthesizes the current literature addressing coupled motion between side bending and rotation in the lumbar spine and finds little agreement across articles as to the specific characteristics of coupled motion. This inconsistency in reported patterns suggests that physical therapists should use caution when applying these concepts to the evaluation and treatment of patients with low back pain.

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