| Observation: Sagittal plane blockage (primarily decreased dorsiflexion) at the ankle and first metatarsophalangeal joints and flatfeet have been implicated as playing a role in chronic mechanical low back pain. The purpose of this study was to determine whether a link could be found between chronic mechanical low back pain, sagittal plane blockage of the feet and ankles or flatfeet. Design:This study was reviewed and approved by the Institutional Review Board of the Durban Institute of Technology. The study was a blinded non-probability correlation study involving 100 subjects with low back pain (Group 1) and 104 subjects without chronic mechanical low back pain (Group 2) between the ages of 18 and 45. Measurements included ankle and hallux dorsiflexion range of motion and difference in navicular height (navicular drop test) between resting and neutral standing postures. All tests were carried out at the 5% level of significance. Parametric testing was used to analyze the data. Inter-group comparisons were made using the unpaired t-test and intra-group comparisons were made using the paired t-test. To test the association between mechanical low back pain and static foot measurements a chi-square test was carried out. To determine the degree of association (correlation) the contingency coefficient was computed. Results:The results indicated an unpaired t-test (inter-group) statistically significant decrease of ankle dorsiflexion in individuals with chronic mechanical low back pain (Group 1) in comparison to individuals without low back pain (Group 2) in both the right foot (p=0.002) and left foot (p=0.032). These inter-group findings, though, were not supported by Chi-square and Cramer’s V tests (right foot p=0.085 and left foot p=0.188). Unpaired t-test (inter-group), Chi-Square and Cramer’s V tests showed no statistically significant difference between either group regarding hallux dorsiflexion. The unpaired t-test (inter-group) indicated a statistically significant difference regarding navicular drop between the two groups in the right foot (p=0.003) and left foot (p=0.009). Individuals with chronic mechanical low back pain (Group 1) had a significantly smaller difference in navicular height (or a higher arch) between the resting and neutral standing postures in comparison to individuals without low back pain (Group 2). These navicular drop findings were supported by Chi-square and Cramer’s V tests for the right (p=0.005) but not the left foot (p=0.324). Discussion: This study suggests saggital plane blockage (decreased dorsiflexion) may be a factor in chronic mechanical low back pain. The study also found a significant association between chronic mechanical low back pain and difference in navicular height between resting and neutral standing postures suggesting that chronic mechanical low back pain subjects have normally aligned (not flat) feet. Further research is indicated. This study was originally completed as part of a Master’s degree in the Department of
Chiropractic, Duban Institute of Technology (DIT), Durban, South Africa. We wish to thank DIT for its help and support. This abstract is reproduced with the permission of the publisher. |
