BioMed Central Page 1 of 10 (page number not for citation purposes) BMC Musculoskeletal Disorders Open Access Research article Segmental lumbar mobility in individuals with low back pain: in vivo assessment during manual and self-imposed motion using dynamic MRI Kornelia Kulig* 1 , Christopher M Powers 1 , Robert F Landel 1 , Hungwen Chen 1 , Michael Fredericson 2 , Marc Guillet 2 and Kim Butts 3 Address: 1 Department of Biokinesiology and Physical Therapy, University of Southern California, 1540 East Alcazar St., CHP-155, Los Angeles, CA 90089, USA, 2 Department of Functional Restoration, Division of Sports Medicine, Stanford University, Stanford, CA 94305, USA and 3 Department of Radiology, Stanford University, Stanford, CA 94305, USA Email: Kornelia Kulig* - kulig@usc.edu; Christopher M Powers - powers@usc.edu; Robert F Landel - rlandel@usc.edu; Hungwen Chen - hungwenchen@hotmail.com; Michael Fredericson - mfred2@stanford.edu; Marc Guillet - marc@agilept.com; Kim Butts - kimbutts@stanford.edu * Corresponding author Abstract Background: Altered spinal mobility is thought to be related to current or past episodes of low back pain; however evidence of that relationship in younger subjects has not been established. The purpose of this study was to compare lumbar segmental mobility in asymptomatic and symptomatic subjects during posterior to anterior (PA) manual spinal mobilization and a self-initiated prone press-up (PU) maneuver. We hypothesized that persons with central low back pain would have an altered lumbar segmental mobility pattern compared to those without pain. Method: Forty-five individuals (age 32.1 ± 8.5) with non-specific low back pain and 20 persons (age 31.1 ± 7.0) without low back pain participated. Each subject underwent dynamic imaging of the lumbar spine during a PA mobilization procedure and while performing a PU. Segmental motion was quantified as the change in the intervertebral angle between the resting and end-range vertebral positions. Results: The symptomatic group had a larger percentage of subjects with evidence of single level segmental hypermobility than the asymptomatic group during the PA (40.0% vs. 5%) and PU (26.7% vs. 15%) procedures. Single lumbar motion-segment analysis revealed hyper-mobility in symptomatic subjects at L5 – S1 (Chi-square = 10.0, p ≤ 0.01) and L4 – L5 (Chi-square = 4.18, p ≤ 0.05) during the PA test. Conclusion: Persons with non-specific low back pain have a tendency to demonstrate single level lumbar segmental hypermobility when compared to age specific asymptomatic subjects. Background Back pain and its association with altered functional abil- ity can significantly affect an individual's quality of life [1,2]. Prevalence of low back pain throughout the lifespan has been reported to be between 13 and 85% [3-7]. The point prevalence of back pain varies with age [7]. Back Published: 29 January 2007 BMC Musculoskeletal Disorders 2007, 8:8 doi:10.1186/1471-2474-8-8 Received: 7 June 2006 Accepted: 29 January 2007 This article is available from: http://www.biomedcentral.com/1471-2474/8/8 © 2007 Kulig et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.