Lumbopelvic Movement Research Articles

The effect of a soft active back support exosuit on trunk motion and thoracolumbar spine loading during squat and stoop lifts

Back support exosuits aim to reduce tissue demands and thereby risk of injury and pain. However, biomechanical analyses of soft active exosuit designs have been limited. The objective of this study was to evaluate the effect of a soft active back support exosuit on trunk motion and thoracolumbar spine loading in participants performing stoop and squat lifts of 6 and 10 kg crates, using participant-specific musculoskeletal models. The exosuit did not change overall trunk motion but affected lumbo-pelvic motion slightly, and reduced peak compressive and shear vertebral loads at some levels, although shear increased slightly at others. This study indicates that soft active exosuits have limited kinematic effects during lifting, and can reduce spinal loading depending on the vertebral level. These results support the hypothesis that a soft exosuit can assist without limiting trunk movement or negatively impacting skeletal loading and have implications for future design and ergonomic intervention efforts.

Relationship between onset of trunk muscle activities and pelvic kinematics in individuals with and without chronic low back pain.

Lumbopelvic movement patterns during prone hip extension has been proposed as a clinical screening method for trunk muscle dysfunction in patients with chronic low back pain (CLBP). However, correlations between trunk muscle onset and pelvic kinematics have not been investigated. To examine the correlation between trunk muscle onset and pelvic kinematics during prone hip extension in participants with CLBP. Fifteen patients with CLBP and 15 healthy individuals participated. We evaluated the muscle activities of the lumbar multifidus, the longissimus, and the semitendinosus via electromyogram and the displacement angles of the pelvic tilt, oblique and rotation. The onset of the multifidus at the ipsilateral side of hip extension was significantly delayed in the patients with CLBP compared to the control group (P< 0.001). The onset of the ipsilateral multifidus in the control group was significantly correlated with increased anterior pelvic tilt angle (P= 0.019, r= 0.597), whereas no significant correlation was observed in the CLBP group (P= 0.810, r=-0.068). The results suggest that pelvic kinematics during prone hip extension does not predict the delayed trunk muscle onset in patients with CLBP.

Are Anthropometric Measures, Range of Motion, or Movement Control Tests Associated with Lumbopelvic Flexion during Barbell Back Squats?

Resistance training with the barbell back squat (BBS) exercise is practiced in sports, recreation, and rehabilitation. Although extensively debated, it is commonly believed and recommended that maintaining a neutral lumbopelvic alignment during BBS is an important technical aspect that might reduce the risk of injury. There is limited knowledge of how objectively measurable factors affect the extent to which the lumbopelvic region moves into flexion during a BBS. The aim of the study was to investigate the association among anthropometric measurements, range of motion in the hips and ankle joints, lumbopelvic movement control tests, and flexion of the lumbopelvic region during execution of the BBS. Observational, cross sectional. Eighteen experienced powerlifters and Olympic weightlifters were included and measurements of lumbopelvic movements were collected with inertial measurement units during BBS performed at 70 % of 1RM. Examination of anthropometric properties, range of motion in the hip and ankle joints, and lumbopelvic movement control tests were collected as independent variables. Linear regression analysis was used to investigate which independent variables were associated with lumbopelvic flexion during a BBS. The linear regression showed that a higher range of motion in ankle dorsiflexion could statistically significantly explain an increased amplitude of lumbopelvic flexion during the BBS. Anthropometrics, range of motion of the hips, and performance in lumbopelvic movement control tests did not show any statistically significant associations. The results suggest that strength and conditioning professionals and clinicians who instruct and assess lifting technique in the BBS and/or use the BBS to assess performance or as an intervention should recognize that a higher range of motion in the ankle joints might affect lumbopelvic flexion during the BBS. In practice, the value of an individual assessment of lifting technique focusing on the goal of the movement should be emphasized. 3.

Understanding musculoskeletal disorders in dancers: The role of lumbopelvic muscles and movement competency

ObjectiveTo investigate whether transversus abdominis activation (TrA), hip strength, and movement competency are associated with the incidence of musculoskeletal disorder episodes (MDEs) in dancers when controlling for confounding variables. The secondary objectives were to determine if there were differences between professional and preprofessional dancers for the aforementioned factors, as well as to determine if there were differences in TrA activation and hip strength between the dominant and non-dominant sides. DesignProspective cohort study. Methods118 dancers were recruited. The independent variables were collected at the beginning of the dance season: 1) TrA activation, 2) hip strength, and 3) movement competency. To assess the development of MDEs, a weekly electronic diary was used over a 38-week period. MDEs were compiled for each dancer's whole body and subdivided into total musculoskeletal disorder episodes (all body parts) and lower quadrant musculoskeletal disorder episodes (lower limb and lower back). ResultsLower TrA, as well as higher hip abductor and external rotator strength, were associated with a lower incidence of MDEs. TrA activation (β = 0.260, p = 0.023) and hip external rotator strength (β = −0.537, p = 0.002) could significantly explain 25.4% of the variance of total MDEs, as well as 20.9% of the variance of lower quadrant musculoskeletal disorder episodes (β = 0.272, p = 0.016; β = −0.459, p = 0.011). No significant associations were found between movement competency and MDEs. ConclusionsHigher hip strength could be a protective factor for MDEs among dancers. Further studies are needed to better understand the involvement of the transversus abdominis in MDEs.

The clinical utility of the prone hip extension test in the diagnosis of motor control impairments associated with low back pain: A cross-sectional study using motion capture and electromyography

BackgroundThe prone hip extension test is used as a clinical tool to diagnose specific motor control impairments that have been identified in individuals with chronic low back pain. However, conventional protocols for performing the test are subjective and lack evidence for their effectiveness. The objective of the current study was to quantify lumbopelvic motion and muscle activation during this test and identify which motor control patterns best distinguish individuals with low back pain from asymptomatic controls. Methods18 individuals with sub-acute or chronic low back pain and 32 asymptomatic controls performed the prone hip extension test while a 3D motion capture system measured lumbar and pelvic movement patterns and an electromyography system measured the muscle activation patterns of the paraspinal, gluteus maximus, and hamstring muscles. A three-stage statistical analysis was performed, the final stage being a stepwise logistic regression analysis aimed at identifying the movement and muscle activation pattern variables that best distinguished the two groups. FindingsThe final regression model included three lumbar kinematic variables and several electromyographic amplitude variables for the gluteus maximus and hamstring muscles during right-sided prone hip extension. The final model correctly classified 86.7 % of the control group and 83.3 % of the low back pain group. InterpretationThe subject of asymmetrical gluteus maximus and hamstring muscle activation appears to be a potentially interesting area for future research on the utility of the prone hip extension test as a clinical tool in diagnosing motor control impairments associated with low back pain.

Effects of the NeuroHAB Program on Low Back Pain and Oswestry Disability Index Scores: A Retrospective Wait-List Control Study.

Movement theory and the study of movement dysfunction mark a paradigm shift in the treatment of low back pain symptoms, the majority of which are mechanical in origin at the outset. Treating movement dysfunction centers around unified and consistent rehabilitation that defines proficient movement for the lumbopelvic spine. The purpose of this study is to document the improvement in pain and disability of 290 patients who underwent NeuroHAB Functional Movement Therapy to reverse their lumbopelvic movement dysfunction attributed to causing their back pain symptoms between 2019 and 2023. Oswestry Disability Index (ODI) scores were collected from each participant on three occasions: the first consultation, after a waiting period/pre-intervention, and after the eight-week intervention. A single-factor ANOVA of all three ODI data sets was conducted, along with supporting descriptive statistics. A post-hoc t-test pairwise comparison was conducted for accuracy. The average ODI 1 score (taken at the first consultation) was 15.26 ± 6.1% (CI: 14.3-16.2); ODI 2 (after a waiting period, before NeuroHAB) was 14.71 ± 6.0% (CI: 13.82-15.59); and ODI 3 (post-intervention) was 9.09 ± 8.6% (CI: 8.305-9.875). There was no significant change from ODI 1 to ODI 2 (between the consultation and waitlist control periods). However, a significant reduction between ODI 2 and ODI 3 was observed (pre- and post-intervention) (mean difference: 5.62, p ≤ 0.001), and a 40.41% reduction was observed between ODI 1 (the ODI score taken at the first consultation) and ODI 3 (the ODI score taken after NeuroHAB, post-intervention) (mean difference: 6.17, p ≤ 0.001). A 50% ODI reduction was reported in the "Crippled" category (mean difference 16.15, p ≤ 0.001). The inclusion of functional movement proficiency and stability in future guidelines is a necessary step towards meaningful improvement in epidemic levels of back pain-related clinical and economic morbidity.

Lumbopelvic Stability during a Single Leg Step Down Predicts Elbow Varus Torque during Baseball Pitching.

During a baseball pitch, energy is transferred from the lower extremities through the lumbopelvic junction to the upper extremity. Reduced lumbopelvic stability has been associated with elbow injuries, but the mechanisms are unclear. Characterize the predictive ability of lumbopelvic stability on elbow varus torque during a baseball pitch. Cross-Sectional. Facilities at NCAA Division 1 universities. NCAA Division 1 baseball players (N=44; 19.6+1.3yrs). Pitchers completed a warm-up and then threw ten fastballs from a mound to a catcher. During the pitches, elbow varus torque was recorded using an inertial measurement unit and ball velocity was recorded with a radar gun. Participants also completed a single leg step down (SLSD) task with and without a cognitive Stroop, while triplanar pelvic and trunk kinematics were recorded by inertial measurement units. Statistical analysis consisted of a cluster analysis, principal component analysis (PCA), and a multivariate logistic regression model. Cluster analysis revealed 2 clusters: Low Torque-High Velocity and High-Torque-Low Velocity. The PCA analysis revealed 4 patterns of variability (principal components) during the SLSD: 1-sagittal plane, 2-transverse plane, 3-frontal plane trail limb, and 4-frontal plane lead limb. Logistic regression indicated increased transverse plane trunk and pelvis motion predicted higher odds of belonging to the High Torque-Low Velocity cluster; trunk [OR=2.9 (95%CI:1.1,8.0), p=0.036] and pelvis [OR=2.6 (95%CI:1.1,6.0), p=0.031]. Lumbopelvic movement assessed during the SLSD can identify deficits that relate to high elbow torque-low ball velocity during the baseball pitch. Specifically, higher pelvis and trunk transverse plane motion was associated with pitchers in the High Torque-Low Velocity cluster. Our assessment of trunk and pelvis motion during a SLSD provides a method for coaches and clinicians to identify a potential risk factor related to increased elbow varus torque and decreased ball velocity.

Postural-motor development, spinal range of movement and caregiver burden in Prader-Willi syndrome-associated scoliosis: an observational study.

Prader-Willi syndrome (PWS) is a rare genetic disorder characterized by hypothalamic dysfunction, hypotonia, cognitive deficits, and hyperphagia, primarily resulting from genetic abnormalities on chromosome 15. Among its varied manifestations, musculoskeletal issues, notably scoliosis, pose important challenges in management. This study aims to investigate differences in postural-motor development and spinal range of movement between preadolescents and adolescents with PWS, with and without scoliosis, while also exploring the potential impact of scoliosis on caregiving burden, an aspect yet to be thoroughly explored in existing literature. This observational study evaluated 13 individuals diagnosed with PWS, including 5 with scoliosis (PWS-Sc) and 7 without (PWS-NSc). Inclusion criteria comprised ages 8 to 18 years, confirmed PWS diagnosis through genetic testing, and scoliosis diagnosis. Anamnestic data, physical examinations, and surface measurements were collected, along with parental burden assessments using the Zarit Burden Interview (ZBI). Both groups displayed delays in achieving postural-motor milestones, with the PWS-Sc group exhibiting a more pronounced delay, although statistical significance was not achieved. The main curve magnitude in the PWS-Sc group averaged 31.5° Cobb, with 60% of cases presenting an S-shaped curve. Surface measurements of physiological curves did not differ significantly between groups, but the scoliosis-affected group exhibited lower lumbar extension values (p=0.04). The overall ZBI revealed higher scores in the PWS-Sc group, although statistical significance was not reached. However, significant differences were observed in single questions score evaluating aspects such as social life and caregiver uncertainty (p=0.04 and p=0.03, respectively). Despite the small sample size, delays in achieving postural-motor milestones, particularly in individuals with scoliosis, were observed. The differences recorded in lumbo-pelvic movement suggest that tailored interventions may be beneficial. The heightened caregiving burden in the scoliosis group underscores the need for targeted support. Early intervention and ongoing monitoring should be important for accurate diagnosis and appropriate care, potentially with psychological support for caregivers.

Lumbopelvic movement coordination during walking improves with transfemoral bone anchored limbs: Implications for low back pain

BackgroundLow back pain (LBP) is more prevalent in patients with transfemoral amputation using socket prostheses than able-bodied individuals, in part due to altered spinal loading caused by aberrant lumbopelvic movement patterns. Early evidence surrounding bone-anchored limb functional outcomes is promising, yet it remains unknown if this novel prosthesis influences LBP or movement patterns known to increase its risk. Research questionHow are self-reported measures of LBP and lumbopelvic movement coordination patterns altered when using a unilateral transfemoral bone-anchored limb compared to a socket prosthesis? MethodsFourteen patients with unilateral transfemoral amputation scheduled to undergo intramedullary hardware implantation for bone-anchored limbs due to failed socket use were enrolled in this longitudinal observational cohort study (7 F/7 M, Age: 50.2±12.0 years). The modified Oswestry Disability Index (mODI) (self-reported questionnaire) and whole-body motion capture during overground walking were collected before (with socket prosthesis) and 12-months following bone-anchored limb implantation. Lumbopelvic total range of motion (ROM) and continuous relative phase (CRP) segment angles were calculated during 10 bilateral gait cycles. mODI, total ROM, CRP and CRP variabilities were compared between time points. ResultsmODI scores were significantly reduced 12-months after intramedullary hardware implantation for the bone-anchored limb (P = 0.013). Sagittal plane trunk and pelvis total ROM during gait were reduced after implantation (P = 0.001 and P < 0.001, respectively). CRP values were increased (more anti-phase) in the sagittal plane during single limb stance and reduced (more in-phase) in the transverse plane during pre-swing of the amputated limb gait cycle (P << 0.001 and P = 0.029, respectively). No differences in CRP values were found in the frontal plane. SignificanceDecreases in mODI scores and lumbopelvic ROM, paired with the changes in lumbopelvic coordination, indicate that bone-anchored limbs may reduce LBP symptoms and reduce compensatory movement patterns for people with unilateral transfemoral amputation.

MRI Compatible Lumbopelvic Movement Measurement System to Validate and Capture Task Performance During Neuroimaging.

Research suggests that structural and functional changes within the brain are associated with chronic low back pain, and these cortical alterations might contribute to impaired sensorimotor control of the trunk and hips in this population. However, linking sensorimotor brain changes with altered movement of the trunk and hips during task-based neuroimaging presents significant challenges. An MRI-safe pressure measurement system was developed to ensure proper task completion during neuroimaging by capturing movement patterns of the trunk (sensors under the lower back) and hips (sensors embedded in the foam roll under the knees). Pressure changes were measured outside of the scanner by digital differential pressure sensors to capture time-series data and analog pressure gauges for real-time determination of task performance occurring within an MRI bore during brain imaging. This study examined the concurrent validity of air pressure changes between the digital and analog sensors. The digital and analog data were compared in 23 participants during the performance of modified bilateral and unilateral right and left hip bridges. Spearman's correlations were calculated for each sensor during the three bridging tasks and showed high positive correlations, indicating that over 87% of pressure change from the analog gauge can be explained by the pressure from the digital sensor. Bland-Altman plots showed no bias and mean differences were under three mmHg. This pressure system improves the rigor of future studies by validating the digital data from the system and increasing the capabilities of capturing lumbopelvic task performance occurring inside the scanner bore.

Different contribution of upper and lower lumbar spinal segments to standing/sitting: An EOS study of lumbopelvic movement

Different contribution of upper and lower lumbar spinal segments to standing/sitting: An EOS study of lumbopelvic movement

Lumbopelvic movement control in powerlifters with and without low back pain

ObjectivesTo measure lumbopelvic movement control in powerlifters with and without low back pain (LBP). DesignQuantitative Cross-sectional. ParticipantsTwelve powerlifters with LBP and 28 powerlifters without LBP. SettingPowerlifters were recruited in nine different cities and filmed while performing a movement control test battery. Main outcome measuresLumbopelvic movement control test battery consisting of seven tests, with a possible score between 0 and 13. The tests were rated by a physical therapist blinded to the group allocation and comparisons of the frequency of current/incorrect tests between groups were calculated. ResultsThere was no statistically significant difference in the movement control test battery between the powerlifters with LBP (Median = 7.0, (2–11)) and powerlifters without LBP (Median = 6.0, (1–10)) (P = 0.59). There were no statistically significant differences between groups when the individual movement control tests were analyzed separately. ConclusionsThe lack of significant differences between groups indicates that performance in lumbopelvic movement control test might not be associated with LBP in powerlifters. More studies on associations between LBP and movement control and other body functions are needed to guide assessment and treatment of powerlifters with LBP and for investigation of possible risk factors for LBP in powerlifters.

A Clinical Measure of Trunk Neuromuscular Function Predicts Falling in Older Adults With Chronic Low Back Pain.

Older adults with low back pain (LBP) are at risk for falling, but condition-specific mechanisms are unknown. Trunk neuromuscular function is critical for maintaining balance during mobility tasks and is often impaired in older adults with LBP. The purpose of this study was to assess whether aberrant lumbopelvic movements (or aberrant movements), a clinical index of trunk neuromuscular function, were associated with increased fall risk among older adults with chronic LBP over a 12-month follow-up period. This study analyzed data from a prospective cohort study of 250 community-dwelling older adults with chronic LBP. Participants were screened for 4 aberrant movements during 3 trials of forward flexion from a standing position: instability catch, painful arc, altered lumbopelvic rhythm, and Gower's sign. Aberrant movements were totaled to yield a summary score (ie, 0-4). Prospective falls were monitored via monthly fall calendars for 12 months. A generalized linear model with Poisson distribution and log link function was used to evaluate the association between aberrant movements and prospective fall risk. Age, sex, body mass index, LBP intensity, dynamic balance performance, prior falls, anxiolytic medication usage, and hip osteoarthritis characteristics were included as covariates in the model. Baseline aberrant movements were independently associated with greater fall risk (risk ratio = 1.249, 95% CI = 1.047-1.491, P = .014); each 1-unit increase in aberrant movement score imparted a 24.9% increase in the risk of falling. Aberrant movements increased the risk of falling among older adults with chronic LBP over a 1-year span.

再発性腰痛者における視覚的フィードバックが腰椎骨盤の運動制御に与える影響

[Purpose] The purpose of this study was to clarify the immediate effects of motor control training with visual feedback on lumbopelvic motion during an active hip abduction test in subjects with recurrent low back pain. [Participants and Methods] Thirty patients were divided into two groups: one group received visual feedback on pelvic motion and performed hip abduction exercise, and the other group performed hip abduction exercise without visual feedback. [Results] The visual feedback group showed an increase in contralateral oblique abdominal muscle activity and a decrease in pelvic elevation during hip abduction after the intervention. [Conclusion] The results suggest that the motor control training with visual feedback immediately inhibited excessive pelvic movement.

Extraction of Lumbar Spine Motion Using a 3-IMU Wearable Cluster.

Spine movement is a daily activity that can indicate health status changes, including low back pain (LBP) problems. Repetitious and continuous movement on the spine and incorrect postures during daily functional activities may lead to the potential development and persistence of LBP problems. Therefore, monitoring of posture and movement is essential when designing LBP interventions. Typically, LBP diagnosis is facilitated by monitoring upper body posture and movement impairments, particularly during functional activities using body motion sensors. This study presents a fully wireless multi-sensor cluster system to monitor spine movements. The study suggests an attempt to develop a new method to monitor the lumbopelvic movements of interest selectively. In addition, the research employs a custom-designed robotic lumbar spine simulator to generate the ideal lumbopelvic posture and movements for reference sensor data. The mechanical motion templates provide an automated sensor pattern recognition mechanism for diagnosing the LBP.

Biomechanical compensations during a stand-to-sit maneuver using transfemoral osseointegrated prostheses: A case series

BackgroundPatients with transfemoral amputation and socket prostheses are at a heightened risk of developing musculoskeletal overuse injuries, commonly due to altered joint biomechanics. Osseointegrated prostheses, which involve direct anchorage of the prosthesis to the residual limb through a bone anchored prosthesis, are a novel alternative to sockets yet their biomechanical effect is largely unknown. MethodsFour patients scheduled to undergo unilateral transfemoral prosthesis osseointegration completed two data collections (baseline with socket prosthesis and 12-months after prosthesis osseointegration) in which whole-body kinematics and ground reaction forces were collected during stand-to-sit tasks. Trunk, pelvis, and hip kinematics, and the surrounding muscle forces, were calculated using subject-specific musculoskeletal models developed in OpenSim. Peak joint angles and muscle forces were compared between timepoints using Cohen's d effect sizes. FindingsCompared to baseline with socket prostheses, patients with osseointegrated prostheses demonstrated reduced lateral trunk bending (d = 1.46), pelvic obliquity (d = 1.09), and rotation (d = 1.77) toward the amputated limb during the stand to sit task. This was accompanied by increased amputated limb hip flexor, abductor, and rotator muscle forces (d> > 0.8). InterpretationImproved lumbopelvic movement patterns and stabilizing muscle forces when using an osseointegrated prosthesis indicate that this novel prosthesis type likely reduces the risk of the development and/or progression of overuse injuries, such as low back pain and osteoarthritis. We attribute the increased muscle hip muscle forces to the increased load transmission between the osseointegrated prosthesis and residual limb, which allows a greater eccentric ability of the amputated limb to control lowering during the stand-to-sit task.

Hip–Spine Syndrome in the Nonarthritic Patient

Hip–spine syndrome refers to concurrent hip and spine pathology with overlapping symptoms. Most of the literature has studied it in relation to total hip arthroplasty literature and has been shown to increase dislocation risk. Lumbar spine and pelvic mobility have been studied less frequently in relation to nonarthritic pathologic hip states. Understanding the biomechanical relationship between the lumbar spine, pelvis, and hip can help elucidate how hip–spine syndrome affects the nonarthritic hip and how it impacts outcomes of hip arthroscopy. Changes in lumbar spine motion may be the reason certain predisposed patients develop symptomatic femoroacetabular impingement (FAI) or ischiofemoral impingement. Some athletes may be “hip users” with a low pelvic incidence, making them more reliant on hip motion due to less-intrinsic lumbopelvic motion. When these patients have FAI morphology, their increased reliance on hip motion makes them prone to experiencing femoroacetabular contact and concurrent symptoms. Other athletes may be “spine users,” with larger pelvic incidence and more baseline lumbopelvic motion, making them less reliant on hip motion and therefore less prone to experiencing hip impingement even with hip FAI morphology. Hip–spine syndrome also appears to have an impact on patient selection, role of nonoperative treatment, and hip arthroscopy surgical outcomes. Identifying patients with concurrent pathology may allow surgeons to recommend targeted physical therapy or counsel patients better on their expectations after surgery.

Sample Entropy as a Tool to Assess Lumbo-Pelvic Movements in a Clinical Test for Low-Back-Pain Patients.

Low back pain (LBP) obviously reduces the quality of life but is also the world’s leading cause of years lived with disability. Alterations in motor response and changes in movement patterns are expected in LBP patients when compared to healthy people. Such changes in dynamics may be assessed by the nonlinear analysis of kinematical time series recorded from one patient’s motion. Since sample entropy (SampEn) has emerged as a relevant index measuring the complexity of a given time series, we propose the development of a clinical test based on SampEn of a time series recorded by a wearable inertial measurement unit for repeated bending and returns (b and r) of the trunk. Twenty-three healthy participants were asked to perform, in random order, 50 repetitions of this movement by touching a stool and another 50 repetitions by touching a box on the floor. The angular amplitude of the b and r movement and the sample entropy of the three components of the angular velocity and acceleration were computed. We showed that the repetitive b and r “touch the stool” test could indeed be the basis of a clinical test for the evaluation of low-back-pain patients, with an optimal duration of 70 s, acceptable in daily clinical practice.

Patients with low back pain use stiffening strategy to compensate for movement control during active prone hip rotation: A cross-sectional study.

New motor adaptation to pain theory suggests that patients with low back pain (LBP) use the lumbopelvic stiffening strategy by redistribution of within and between muscle activities to protect painful structure. This could result in an altered postural control of the lumbopelvic region during active prone hip rotation (PHR). To investigate coordination and timing of lumbopelvic and hip movements, and smoothness of the lumbopelvic control during PHR between participants with and without LBP. Eight participants with LBP and eight participants without LBP were recruited. The electromagnetic tracking system was used to record kinematic data during PHR. Cross-correlation between hip rotation and lumbopelvic movement in the transverse plane was calculated. Correlation at zero time-lag, time-lag, correlation at time-lag, and maximal lumbopelvic motion were derived. Frequency of movement disruption was identified. An independent t-test was used in conjunction with the effect size and 95% minimal detectable difference (MDD95) to determine the difference in kinematic parameters. Participants with LBP demonstrated a significant delay (exceeding MDD95) in lumbopelvic motion while nonsignificant frequency of disrupted motion on the painful side PHR demonstrated a trend with a large effect size that exceeded MDD95. There were trends with moderate to large effect sizes and differences exceeding MDD95 in delay of lumbopelvic motion with greater movement disruption on the nonpainful side in participants with LBP. Participants with LBP used a lumbopelvic stiffening strategy for postural control to protect painful structures; however, the stiffening might complicate efforts to smoothly control lumbopelvic movement.

Task-Based Functional Connectivity and Blood-Oxygen-Level-Dependent Activation During Within-Scanner Performance of Lumbopelvic Motor Tasks: A Functional Magnetic Resonance Imaging Study.

There are a limited number of neuroimaging investigations into motor control of the lumbopelvic musculature. Most investigation examining motor control of the lumbopelvic musculature utilize transcranial magnetic stimulation (TMS) and focus primarily on the motor cortex. This has resulted in a dearth of knowledge as it relates to how other regions of the brain activate during lumbopelvic movement. Additionally, task-based functional connectivity during lumbopelvic movements has not been well elucidated. Therefore, we used functional magnetic resonance imaging (fMRI) to examine brain activation and ROI-to-ROI task-based functional connectivity in 19 healthy individuals (12 female, age 29.8 ± 4.5 years) during the performance of three lumbopelvic movements: modified bilateral bridge, left unilateral bridge, and right unilateral bridge. The whole brain analysis found robust, bilateral activation within the motor regions of the brain during the bilateral bridge task, and contralateral activation of the motor regions during unilateral bridging tasks. Furthermore, the ROI-to-ROI analysis demonstrated significant connectivity of a motor network that included the supplemental motor area, bilateral precentral gyrus, and bilateral cerebellum regardless of the motor task performed. These data suggest that while whole brain activation reveals unique patterns of activation across the three tasks, functional connectivity is very similar. As motor control of the lumbopelvic area is of high interest to those studying low back pain (LBP), this study can provide a comparison for future research into potential connectivity changes that occur in individuals with LBP.