Efectos de la utilización del soporte lumbar Lumbosant, junto a un explorador auxiliar sobre el resultado final del test de elevación de la pierna recta

Resum

Objetives: 1st, to understand how the posterior pelvic tilt and the degree of reduction in lumbar lordosis influence the standard straight leg raise test (SLR), as well as if these associated movements are proportionate to the level of hamstring extensibility. 2nd, to analyse the effects on the posterior pelvic tilt and lumbar lordosis reduction when using a rigid and curved lumbar support (Lumbosant), and an assessor assistant during the SLR test, as well as in the final quantification of the test. 3rd. To analyse the effects of a curved adjustable lumbar and pelvis support during SLR test with an assessor assistant. Methods: Transversal descriptive design was used on both studies. The first study included a sample of 23 voluntary adults. All the participants had unspecific lower back pain at least once. Hamstring extensibility was assessed with SLR test and Lumbo-Horizontal angle (L-H fx). Three lumbar spine X-rays were also carried out in supine with three different postures: " Position-0" at the starting positioning of the SLR test, "position-1" at the end of the SLR test, and "position-2" using Lumbosant and an assistant assessor during the SLT test. In the second study, 34 voluntary participants were included. Two lumbar X-rays were carried out in supine at the ending position of SLR one during the standard text, and the other when using the Lumbosant-2 support and an assistant assessor. Results: In the first study, clinical assessment of the hamstrings extensibility during SLR with Lumbosant support and one assistant assessor was 13.9º lower in comparison to the standard assessment (75.30±14.40º vs. 89.2±20.8º; t=7.06;p<0.0005). L-H fx angle was quantified as 87+15.65º, and lower in women (78.9+15º) than in men (97.50+9.0º) (t=3.45;p<.002). In the second study, average values of the standard SLR was 81.41+18.8º, and in contrast, 68.59+14.7º (R=0.958***) when using LumboSant-2. The average value of the lumbar curve at the end of the standard SLR was 30.79+11.7º, in contrast with 47.91º+12.8º (t=10.39;p<0.0005) when using LumboSant-2. A difference of 10º was observed in the posterior pelvic tilt, more using the lumbar support than without. Conclusions: 1st, During the SLR test, an inevitable posterior pelvic tilt is always observed, which differs between subjects (6º to 36º). Similar associated movements are observed in the lumbar spine, reducing its lordosis between 10º and 57º. 2nd, diagnostic sensibility of the SLR test improves using Lumbarsant support and an assistant assessor, because posterior pelvic tilt is reduced 55.7% and the flattening of the lumbar lordosis is reduced 53.8%. 3rd, SLR test can no quantify the hamstring extensibility unless the lumbo-pelvic movement is monitored, and therefore Lumbarsant support and an assistant assessor is recommended to improve its reliability. 4th, the improved LumboSant-2 supports better the lumbar lordosis during SLR test, because it can be adapted to the specific curve angle of each assessed subject.