College of Massage Therapists of British Columbia (CMTBC) Practice Exam

What might contribute to a forward flexion of the trunk during mid and terminal stance in a patient with low back pain?

1. Quadriceps weakness

2. Hip flexor contracture

3. Hamstring tightness

4. Gluteal weakness

The correct answer is: Hip flexor contracture

A forward flexion of the trunk during mid and terminal stance in a patient with low back pain can be significantly influenced by hip flexor contracture. When the hip flexors are tight, they create limitations in the range of motion at the hip joint. This restriction can lead to compensatory mechanisms, such as trunk flexion, as the body attempts to accommodate the inability to extend the hip fully while maintaining balance and forward progression during ambulation. In patients with low back pain, the mechanics of movement are often altered to reduce discomfort or compensate for lack of mobility. If the hip flexors are contracted, the pelvis may tilt anteriorly or not align properly, forcing the trunk to flex forward to maintain a functional stance and gait. This can also increase lumbar lordosis and strain the lower back muscles, exacerbating pain and discomfort. The other choices relate to muscle groups that, while important in overall movement and stability, have different impacts on trunk positioning. Quadriceps weakness might lead to knee instability, preventing maintaining a straight posture but would not directly cause a forward trunk flexion. Hamstring tightness could contribute to pelvic positioning, but it doesn't typically result in trunk flexion during walking. Gluteal weakness may affect hip stability and control, potentially leading