Search

Background Empirical evidence that demonstrates the relationship between pelvic asymmetry and non-specific chronic low back pain (NCLBP) is currently lacking. Objective To establish the reliability of the Global Postural System (GPS) in assessing pelvic asymmetry and identify the association between pelvic asymmetry parameters and the occurrence of NCLBP in young adults. Design A cross-sectional, regression study. Methods People who were aged between 18 and 30 and were diagnosed with NCLBP were recruited. Healthy individuals who were matched for age, sex, and education level were recruited as controls. Global Postural System (GPS) was employed to assess pelvic asymmetry. Prior to exploring the association, the reliability of GPS was assessed by the ICC (2, k) for interrater reliability, ICC (3, k) for intra-rater reliability, standard error and minimal detectable difference. Bivariate correlation analysis and logistic regression analysis were used to determine the relationship between pelvic asymmetry and the occurrence of NCLBP. Results Twenty-eight healthy participants and 28 people with NCLBP were recruited. Moderate to excellent ICCs were observed for the inter-rater and intra-rater reliability of most postural parameters. The bivariate correlation analysis indicated that age, body mass index and pelvic asymmetry parameters were related to the occurrence of NCLBP. Pelvic angle asymmetry (odds ratio = 1.17), and asymmetry of the distance between the posterior superior iliac spine and the floor (odds ratio = 1.21) were associated with NCLBP. Limitations This study did not explore the causal relationship between pelvic asymmetry in the sagittal plane/pelvic asymmetry in the transverse plane and the occurrence of NCLBP. The interpretation of the results may not be generalized beyond the sample population. Conclusions The GPS is a reliable method to assess pelvic asymmetry in a clinical setting. Two pelvic parameters were associated with the presence of NLBP. Measurement of pelvic asymmetry may assist in the early identification of potential occurrence of NCLBP but further work is required.

Cull dairy cows are typically transported to slaughter by road. Across different types of cattle, road transport is recognized as stressful. Cull dairy cows may have different injuries or weaknesses and may thus be more vulnerable to transport stress than other types of cattle. The aim of this study was to investigate whether the clinical condition of cull dairy cows deteriorates during transport ( < 8 h), and to evaluate risk factors for potential deterioration of the clinical condition. A total of 411 dairy cows were clinically examined on farm before loading and again after unloading at the slaughter plant. The clinical examination included locomotion, presence of wounds, milk leakage, and general condition. One-fifth of the cows either became lame or more lame during transport, and there was a significant increase in the proportion of lame cows after transport (41% after vs. 31% before, P < 0.0001). A significant increase in the proportion of cows with milk leakage (17% vs. 1%, P < 0.0001) and wounds (34% after vs. 22% before, P < 0.0001) after transport were also found. Low body condition score (BCS) ( < 2.75) (P = 0.001), early or late lactation [ < 100 days in milk (DIM) or > 300 DIM] (P = 0.01), digital dermatitis in the hind feet (P = 0.01), and pelvic asymmetry (P = 0.001) were identified as risk factors for the deterioration in lameness during transport. Early lactation ( < 100 DIM) (P = 0.04) and transport distance ( > 100 km) (P = 0.006) were identified as risk factors for milk leakage. For wounds, no significant risk factors were found. The results demonstrate that cull dairy cows are vulnerable to the strains of transport, even journeys shorter than 8 h, to the extent that the occurrence of clinical findings were increased after transport in cows legally considered fit for transport. These results call for further research into the animal welfare implications and optimization of cattle transport.

In single event multilevel surgery, femoral derotation is commonly performed. When the kinematic deviations are asymmetrical its indication is frequently one-sided. What are the effects of this procedure on the transverse kinematics of the pelvis and on the contralateral hip rotation and foot progression angles? Among 170 children with CP, operated, with at least a clinical gait analysis before and after surgery, 42 having had a unilateral femoral derotation are included. Patients with tibial derotation are excluded. This study focuses on "remote" effects on the pelvis and the contralateral side. Unilateral hip derotation in asymmetric patients is effective in reducing pelvic asymmetry without altering contralateral hip kinematics, thus affecting the angle of progression of the contralateral foot.

Gait is one of the most common and important factor of human movements in daily life. Pelvis is closely connected with the gait due to it allows maintain stable posture by supporting the spine and lower extremities against the gravity. Therefore, pelvic asymmetry, which is caused by biomechanical stress and muscle imbalance, has been associated with postural imbalance and abnormal walking pattern. The purpose of this study was to manufacture customized foot orthotics for improving gait balance and evaluate the effectiveness of customized foot orthotics during walking by measuring lower extremity muscle activity and plantar pressure distribution. All subjects with pelvic asymmetry were asked to walk on a treadmill under three conditions: walking without foot orthotics, walking with customized foot orthotics and walking with non-customized foot orthotics. Root mean square (RMS) value of the electromyography signals, force and peak pressure of the plantar pressure distribution was analyzed based on the gait cycle. The results showed that excessive tension of the muscles and high pressure of the foot that was induced by pelvic asymmetry were more reduced when walking with custom-made foot orthotics than walking without foot orthotics and walking with non-customized foot orthotics. This paper suggest that custom-made orthotics for patients with pelvic asymmetry could be helpful to relieve the excessive loading of the foot and maintain balanced gait pattern.

Objective: To compare the pelvic alignment among never-pregnant women, pregnant women, and postpartum women. Methods: A total of 177 nulliparous women (mean age, 18.9 ± 1.0 years), 45 pregnant women between the third and tenth month of pregnancy (mean age, 29.4 ± 3.8 years), and 124 primiparous women between the first and sixth months after delivery (mean age, 30.1 ± 4.4 years) were enrolled in this study. Pelvic alignment was measured by using the anterior superior iliac spine (ASIS) and posterior superior iliac spines (PSIS) as landmarks. The bilateral difference of pelvic tilt was defined as pelvic asymmetry (PA), the distance between bilateral ASIS was defined as the anterior width of the pelvis (AWP), and the distance between the bilateral PSIS was defined as the posterior width of the pelvis (PWP). Results: PA of the pregnant group and postpartum group were significantly greater than the never-pregnant group (2.8 ± 2.4°, 4.2 ± 3.0°, and 3.7 ± 3.2°, respectively, p < 0.001). AWP of the pregnant and postpartum group was wider than the never-pregnant group (24.9 ± 0.3 cm, 24.1 ± 0.1 cm, and 23.6 ± 0.2 cm, respectively, p < 0.001). PWP of the pregnant and postpartum group was narrower than the never-pregnant group (8.2 ± 0.3 cm, 8.6 ± 0.1 cm, and 9.2 ± 0.1 cm, respectively, p = 0.008). In the multivariate regression analysis using never-pregnant women as the reference, pregnant and postpartum women were significantly more likely to have greater PA (β = 0.156, 0.156), wider AWP (β = 0.116, 0.202), and narrower PWP (β = -0.132, -0.147) than never-pregnant women. Conclusions: We found that the alignment of the pelvis was different among never-pregnant, pregnant, and postpartum women.

Does Pelvic Asymmetry always Mean Pathology? Analysis of Mechanical Factors Leading to the Asymmetry Pelvic asymmetry is a phenomenon of dual character. Some describe it in terms of pathology, whereas others report that pelvic asymmetry also occurs in healthy subjects. A group of 321 subjects showing symmetrical alignment of the pelvis were involved in the study. Different forms of mechanical loads (jumps, resistance exercises of selected muscle groups) were tested for their ability to alter the configuration of the lower girdle. A hand inclinometer was used to measure pelvic asymmetry in standing. Asymmetrical configuration of the pelvis appears frequently as a consequence of mechanical loading of the lower girdle. It was registered in 25.08% of our study group. The greatest capacity to introduce pelvic asymmetry appeared in cases of asymmetrical loads that were applied in a form of so-called ‘mechanical shock’ (i.e., a force with great impulse). From this viewpoint, pelvic asymmetry should be regarded as a physiologic adaptative alteration of the locomotory system to transmission of asymmetrical mechanical loads.

We report a very rare injury of a 8-year-old girl with sacroiliac fracture dislocation and triradiate cartilage separation. After the restoration of the sacroiliac joint by open means, reduction of the separated cartilage was seen. At 20 months follow-up, an osseous bridging at the triradiate cartilage and mild coxa valga deformity developed. We think that every child with serious sacroiliac joint injury should be evaluated for associated triradiate cartilage injury and followed to skeletal maturity for late complications such as acetabular dysplasia, hip subluxation and pelvic asymmetry.

Fluctuating asymmetry (FA), a pattern of bilateral variation that is normally distributed around a mean of zero, appears to correlate inversely with fitness and health. In this study, we compared the FA of asymptomatic control subjects (n=51) and patients with low back pain (n=44). We measured eight traits, from the upper and lower limbs, and used them to obtain asymmetry indices for each subject. We also measured pelvic asymmetry in standing subjects. The low back pain (LBP) group showed significantly higher asymmetry in the pelvis, and in ulnar length and bistyloid breadth. Our results demonstrate a link between LBP and asymmetry not only in a weight-bearing trait (i.e., pelvic configuration), but in two traits that are not functionally related to the back (i.e., ulnar length and bistyloid breadth). We can now consider LBP as another health and fitness measure correlated with FA.

Objectives Asymmetry within the pelvic structure can lead to a cascade of postural compensations throughout the spine, predisposing people to recurrent somatic dysfunction and decreased functionality. As a basic structural element, the pelvis should be fully symmetric with respect to the sagittal plane. However, many studies conducted by different researchers showed, that the asymmetry of the pelvis is a very common case. This asymmetry was recorded as a result of various types of measurements made on the basis of X-rays, TK as well as sectional preparations. The reason for this was seen in the shortened one of the lower limbs or the lumbar spine pathology. The aim of this paper is to answer the question: If there is any relationship between pelvic asymmetry in children and pelvic asymmetry of their parents?

Background:Assessment of the pelvis is a complex integration with spine and lower extremities and is prone to multiple dysfunctions. Physiotherapists in routine rarely assess pelvis associated musculoskeletal abnormalities. This study was aimed at finding the frequency of pelvic-asymmetry in medical students of Karachi. Methodology:An observational cross-sectional study was conducted from 28th November 2017 to 6th February 2018 to measure asymmetry of the pelvis manually. A sample of 154 medical students was calculated through Open Source Epidemiologic Statistics for Public Health (Open Epi) version 3.0 with a confidence level of 95%. Non-probability purposive sampling technique was used. An informed consent was taken and data was collected from participants aged between 18-25 years through a self-generated questionnaire. Participants with Congenital abnormalities or fracture of lower limb or complain of nerve root pain, any spinal pathology/tumor/surgery of lower limb were excluded from the study sample. Data was analyzed using Statistical Project of Social Science (SPSS) version 20. Results:According to the results 43.5% of the study subjects were observed having pelvic asymmetry. Furthermore, 41.0% participants were spending 3 hours standing constantly. Only 41.5% of participants with low back pain were observed having an asymmetrical pelvis. Conclusion:It can be concluded from the study results that there is a high prevalence of pelvic asymmetry observed among medical students of Karachi. Moreover, knee and ankle joint pain due to constant standing is highly associated with asymmetrical pelvis as compared to hip pain. Link: http://aeirc-edu.com/ojs14/index.php/IJEHSR/article/view/293/475

The objective of this study was to investigate the occurrence of pelvic asymmetry in neurologic patients with symptoms not explained by their neurologic diagnosis.We analyzed 150 consecutive neurologic patients referred to physiatric consultation based on their clinical examination findings.We observed pelvic asymmetry associated with either C-type or S-type scoliosis and apparent leg-length difference in 87% of the patients. Symmetry could be reestablished by all patients, although 15% showed immediate or imminent relapse. Maintenance of symmetry showed a highly significant (P.001) correlation with improvement in functional ability and reduction of pain as evaluated during the last visit to the physiatrist. In the follow-up questionnaire, 78% of the patients reported improvement in functional ability and reduced pain.Our results support the view that leg-length difference and scoliosis may be more often of reversible nature than previously considered. Acquired postural asymmetry of the sacroiliac joint may be a neglected cause of several neurologic and other pain-related symptoms that can be relieved by a simple and safe treatment.

Introduction Asymmetry of the horse and rider partnership is a challenging and complex area. There is limited scientific research regarding the occurrence of misalignments in the horse and rider, and if there is any relationship between the two. This study investigated asymmetry of single horse and rider combinations focusing on pelvis asymmetry. Methods 14 single horse/rider combinations (minimum 6 month partnership) on the same daily routine were assessed. Horses and riders were assessed for misalignments of the pelvis, spine, and neck by a fully qualified human and animal (McTimoney) practitioner on the same day. Triplicate measurements of rider dorsal iliac crest (IC) distance (nearest 0.2 cm) and degree of tilt (0d.p) were recorded, sitting and standing, using a PALM palpation meter to calculate IC height discrepancy. Triplicate horse tuber coxae (TC) heights (nearest 0.5 cm) were measured using a plumb line. Difference between means indicated direction and value of asymmetry relative to symmetry of zero. Student's t-test and Pearson's Product Moment correlation examined asymmetry relationships. Results Mean rider IC height discrepancy, standing, was 0.89 ± 0.64 cm and sitting, 1.00 ± 0.66 cm. Mean TC height discrepancy was 1.3 ± 1.6 cm. Asymmetry of the pelvis was a feature of 93% of horse/rider combinations, 85% occurring in the same direction. There was a significant positive correlation between horse TC and rider IC height discrepancies (r2 = 0.4, F = 8.24, P = 0.014). Conclusions This study provides positive evidence of a relationship between the direction of horse pelvic rotation and rider pelvic tilt and also between the degree of tilt and rotation. This has implications for physical therapy treatment of horse and rider. Further research of causal effect relationships of the asymmetries is recommended. Ethical Animal Research Procedures were reviewed by the McTimoney Chiropractic College Ethical Review Committee. Sources of funding: none. Competing interests: none.

Summary A review of forty-nine pregnancies in thirty-seven patients who had previously suffered from poliomyelitis found that obstetric complications were proportional to the clinical disabilities of the patient. A simple test of unilateral weight-bearing gives a good clue as to whether pelvic asymmetry is present.