Objective: Lower back pain is most prevalent during our young and middle adult lives. Eighty percent of the population will experience an episode of pain during their lifetime. Recently some exercises are prescribed by physical therapists based on the patient's lordosis. Therefore, the aim of this study is to investigate the relationship between LBP and lumbar lordosis in the students (21±2.3 years old).

Materials & Methods: Lumbar lordosis with adjustable ruler, pelvic tilt with tilt-meter and scoliosis, flat foot and shoulder drop with clinical examination have been studied. For determining the reproducibility, each test has been repeated after 5 minutes.

Results: The results have been shown that there were 21.5% scoliosis, 34% shoulder drop, 25% flat foot and 12.5% lateral pelvic tilt. Also, 15.6% of subjects have been suffering from LBP. In addition, correlation between lumbar lordosis and pelvic tilt was 43% that supported the results of previous studies. The results of this study have not shown any significant differences of lumbar lordosis between normal and LBP subjects.

Conclusion: On the other hand, mean of lumber lordosis in subjects with scoliosis was more than able-bodied subjects. Otherwise, in back pain subjects with shoulder drop and flat foot, hypolordosis has seen. Therefore, we concluded that to describe the exercise program based on lumbar lordosis needs more study.

Objective: Sway Back posture is one of the most common postural deformity.This study aimed to define Sway back posture prevalence and quantitatively meassure of the joints alignment in it.

Materials & Methods: In this cross sectional descriptive study The posture of 51 female students of Shahid Beheshti University of Medical Sciences at an average of 22.05±2.44 years was evaluated. First, subjects completed a general characteristics questionnaire. Scond, the amount of their pelvic sway was measured by a grid paper and plumb line. When the plumb line passed the more than 3cm posterior to mid point of ASIS (Anterior Superior Iliac Spine) - PSIS (Posterior Superior Jliac Spine) axis, the subjects were categorized in Sway back posture. Then with goniometer alignment of hip, knee and ankle joints were measured. Also, the pelvic inclination and kyphosis and lordosis angles were measured with a Pelvic Inclinometer and Flexicurve Ruler, respectively.

Results: The mean value of lordosis in Sway back posture group was greater than normal group (p = 0.004). Though the amount of kyphosis and anterior tilt were greater in Sway back posture than normal group, but did not show any significant difference between them (P>0.05). In Sway back posture group, the hip and knee joints tend to flexion. The ankle showed dorsiflexion which had a significant corelation with the pelvic sway. The prevalence of this deformity was 39.2% and was more common than other spinal deformities in young female subjects.

Conclusion: This study indicated that the prevalence of the Sway back posture in the population of our study is high (39.21%). Also, indicated that the lordose increased and the pelvic displaced to anterior without noticeable changing in alignment of the thorasic region, joint of lower extremity and pelvic inclination

Objective: Lumbar curvature is an important factor in posture and body movement that help us to understand low back pain problems. The aim of this study was evaluation of external load and trunk posture effect on lumbar curvature under static condition. 

Materials & Methods: This study is an interventional, quasi-experimental and case-control study. Ten women with non specific chronic low back pain and ten matched without low back pain women were participated in this study. We used simple and non random method for sampling. Two clinometers sensors were used to evaluate lumbar curvature. Six static tasks while holding three levels of load (0, 6, 12 Kg) and two levels of trunk position (neutral and 30 degree of flexion) were simulated for subjects. Data were analyzed by using Kolmogroff-Smirnoff, ANOVA (Repeated Measurement) and independent T-test.

Results: Findings revealed lumbar lordosis in patients with low back pain does not change to kyphosis while increasing external load from 0kg to 6kg and 12kg in neutral trunk position (P<0.05).

Conclusion: Dysfunction in passive system due to soft tissue disorder, afraid of pain, changes trunk muscles recruitment and reduction of moment arm are likely reasons for increased lumbar lordosis in patients with low back pain during loading.

Objective: The purpose of this study was the investigation of relationship between muscle imbalance syndrome in the lumbo-pelvic area (Pelvic Cross Syndrome) which includes the combination of weakness of phasic muscles and tightness of postural muscles, lordosis and chronic low back pain.

Materials & Methods: This study was a comparative - cross-sectional and case – control research. A convenience sample of 600 subjects participated in this study. The size of lordosis, strength of abdominal and gluteal muscles and the extensibility of iliopsoas and back extensor muscles were measured in each group. The best cut-off values obtained from Receiver Operating Characteristic (ROC) curve analysis were used to categorize subjects as having weak or tight muscles in accordance with the assumptions. The lumbar lordosis in subjects with and without patterns of muscle impairments, and the association between lordosis and low back pain was assessed. Data were analyzed by using statistical methods such as: ICC, Kolmogroff – Smirnoff, Independent T test and ANOVA.

Results: The Findings of this study showed no significant difference in the degree of lordosis in subjects with and without patterns of muscle impairment in pelvic cross syndrome (P=0.38) and no significant difference in the lordosis between subjects with and without low back pain among those with specific patterns of muscle impairment in pelvic cross syndrome (P=0.62). Data also showed no significant association between degree of lordosis and low back pain (P=0.25).

Conclusion: The findings of this study did not support the Pelvic Cross Syndrome theory, which indicates certain patterns of muscle impairment would lead to exaggerated LL and LBP. Our data show a relationship between muscle impairment and occurrence of LBP, but probably not via changing the degree of lumbar lordosis as it has been proposed in PCS theory.

Objective: Given high prevalence of pelvic organ prolapse in female, and necessity of effect assessment of it's risk factors in various societies, this study was aimed to investigate the correlation of thoracic and lumbar spinal curvature as well as pelvic tilt changes with pelvic organ prolapse.
Materials & Methods: In this cross-sectional and case-control study, fifteen females with pelvic organ prolapse, on the basis of inclusion criteria were selected by simple and convenient sampling from Imam Khomeini and Akbar abadi hospitals patients as case group. Also, fifteen females with zero or first degree of prolapse were selected by matching with cases as control group. Prolapse condition of both groups participants was assessed by pelvic organ prolapse qualification (POP-Q) system and spinal curvature of thoracic and lumbar as well as pelvic tilt were assessed by flexicurve ruler and pelvic inclinometer, respectively. Data were analyzed by Kolmogroff-Smirnoff, Independent T and Multiple Logistic Regression tests.
Results: There was no significant difference between two groups in kyphosis (P=0.26), lordosis (P=0.52) and pelvic tilt (P=0.41).
Conclusion: Although the results of study do not show significant correlation between kyphosis, lordosis and pelvic tilt with pelvic organ prolapse occurrence but similar direction of changes in the variables with our hypothesis and other studies preserve the likelihood of relationship between the increasing of kyphosis and decreasing of lordosis in pelvic organ prolapse in a large statistic society.

Objective: Accurate assessment of lumbar range of motion is of great value for both evaluating lumbar functions and monitoring treatment progress. Recent research indicates that there is no general consensus on the most valid and reliable method of measuring spinal range of motion. The purpose of this study was to determine the intra-rater reliability of lumbar flexion and extension measurements (within-day and between-days) using the dual inclinometer technique.  

Materials & Methods: Lumbar flexion and extension of 22 women (14 healthy and 8 with low back pain), were measured by the same examiner on three occasions. The first two measurements were taken with half an hour apart on the first occasion to assess the within-day reliability and the third measurement was taken one week later to assess the between-days reliability. 

Results: Within-day lumbar lordosis, flexion and extension measurements using dual inclinometer technique were shown to be very reliable with high Intraclass Correlation Coefficients (ICC) values (ICC were 98%, 77% and 69% for lordosis, flexion and extension measurements, respectively in healthy subjects and 94%, 95% and 69% for lordosis, flexion and extension measurements, respectively in patients group). Between-Days measurements also demonstrated high reliability with the high values of ICC (ICC were 96%, 70% and 67% for lordosis, flexion and extension measurements, in healthy subjects and 91%, 71% and 66% for lordosis, flexion and extension measurements, respectively in patients group).

Conclusion: The results indicated that, the dual inclinometer technique appears to be a highly reliable method for measuring lumbar lordosis, flexion and extension and can be used as a reliable tool in the assessment of lumbar range of motion and monitoring therapeutic interventions.