ASSESSING THE PREVALENCE AND RISK FACTORS OF LOWER CROSS SYNDROME IN OUTPATIENT DEPARTMENT PRESENTING WITH LOWER BACK PAIN

Abstract

BACKGROUND: Lower cross syndrome is a muscular imbalance which is defined by tightness of the hip flexors and lumbar extensors, accompanied by the weakness of gluteal and abdominal muscles. This muscular imbalance alters the postural alignment and increases lumbar curvature, causing hyper lordosis, which increases the risk of developing lower back pain. OBJECTIVE: 1) Assessing the prevalence of Lower Cross Syndrome in outpatient department present with lower back pain. 2) To identify the risk factors associated with lower cross syndrome among patients with lower back pain in outpatient department. By using Owestry low back disability questionnaire (ODQ), testing muscle strength, joint ROM and postural assessment.11 METHODS: This cross-sectional study was done to identify the prevalence and risk factors related with lower cross syndrome among individuals presenting with complaints of nonspecific low back pain. Through convenience-based sampling of 250 participants were enrolled according to the inclusion criteria of age from 25 to 40 years, BMI ranged from 18 to 25 kg/m², with mechanical low back pain complain. Data collection tools included ODI to determine functional disability, visual analogue scale (VAS) for pain intensity, test to determine hip flexor muscle tightness and double lowering test to determine abdominal muscle weakness. Data were calculated using SPSS software with descriptive statistics and inferential tests to identify associations between demographic, muscular, and postural factors and the presence of LCS. Ethical approval was granted by the Institutional Review board (IRB) of Liaquat National School of Physiotherapy, and informed consent was obtained from all participants. RESULT: This study involved 250 participants complaining of non-specific low back pain, to assess the prevalence and risk factors of lower cross syndrome. According to the ODI questionnaire most participants showed mild to moderate functional disability (ODI 18.62 ± 9.04) about 90.8% tested positive for lower cross syndrome. According to the physical assessment it was revealed that the Double Leg Lowering Test (p = 0.009) confirmed the weakness of core abdominal muscles and Thomas Test (positive in 90.8%) confirmed tightness of hip flexor muscles. CONCLUSION: This study concluded that 90.8% of individuals are positive with lower cross syndrome with low back pain, mainly young adults aged between 25 to 40 years. Participants experienced moderate intensity of pain with mild to moderate functional disability. The study also found tight hip flexor muscles and weak abdominal muscles which contribute to LCS.