2022-2023 Grant in Aid of Research

Exploring the association between novel clinical tests for psoas major dysfunction, sacroiliac joint dysfunction, and limb length discrepancy in lumbar disc herniation -A case series analysis.

Parthasaranthy Eappakkam Kumaraswamy

Currently, 24 to 80% of people experience recurrent low back pain (LBP), and 10% develop chronic low back pain (CLBP). In particular, individuals with Magnetic Resonance Imaging (MRI) confirmed lumbar disc herniation (LDH) characterized by psoas major muscle dysfunction (PMD), Sacroiliac joint dysfunction (SIJD), and limb length discrepancy (LLD) have a greater likelihood to develop CLBP. In view of the fact that there is a significant risk for progression to CLBP after the first onset of LBP in individuals with LDH, there is an indispensable need to develop specific clinical tests for assessment, models of chronicity mechanisms, treatment guidelines, and strategies to minimize the need for healthcare and societal, the economic burden of LDH. Therefore, the overarching aim of this research is to implement a case series analysis to determine the association between a costless cluster of clinical tests for psoas major muscle dysfunction, sacroiliac joint dysfunction, and limb length discrepancy in people with imaging proven LDH. The proposed novel cluster of clinical tests includes an axial rotation test (PMD), peak muscle force of psoas major (PM) using Hand-Held Dynamometer (HHD), sacral spring test, sacral kinetic test of ipsilateral Gillet, ipsilateral lumbar flexion test (SIJD), and apparent limb length (LLD) measurement using a tape measure.