Lumbopelvic Movement Research Articles

Effect of Hamstring Stretching on Pelvic Angle and Biofeedback Pressure during Passive Straight Leg Raising

Background In clinical settings, a pressure biofeedback unit (PBU) is sometimes used to detect pelvic movement and retrain movement patterns during lower limb movement. Hamstring length influences changes in pelvic movement during passive straight leg raising (PSLR). Purpose To determine the relationship between pelvic motion and biofeedback pressure measured by a PBU during PSLR, and to identify changes in biofeedback pressure after hamstring stretching. Study design Cross-sectional study Methods Twenty participants with short hamstrings were recruited for this study. A three-dimensional motion analysis system and PBU were used to measure pelvic angle and biofeedback pressure during PSLR, respectively. The pelvis angle and biofeedback pressure were measured before and after hamstring stretching, increasing PSLR in 10-degree increments. Results There was a significant relationship between pelvic motion and biofeedback pressure (Pearson’s <italic>r</italic>=0.76, <italic>p</italic>&lt;0.05). Linear regression equation using lumbopevic angle as an independent factor was as follows: Pressure of PBU=45.05+(3.35×angle of lumbopelvic motion) (R²=0.57, <italic>p</italic>&lt;0.05). Biofeedback pressure decreased significantly between PSLR angles of 10–60° after hamstring stretching (<italic>p</italic>&lt;0.05). The pelvic angle decreased significantly at PSLR angles of 50° and 60° after hamstring stretching (<italic>p</italic>&lt;0.05). Conclusions Biofeedback pressure measured with a PBU can be used to assess pelvic motion during muscle length tests following hamstring stretching.

Lumbopelvic coordination while walking in service members with unilateral lower limb loss: Comparing variabilities derived from vector coding and continuous relative phase

BackgroundContinuous relative phase and vector coding are two common approaches for quantifying lumbopelvic coordination and variability. Evaluating the application of such methodologies to the lower limb loss population is important for better understanding reported asymmetrical movement dynamics of the lumbopelvic region. Research QuestionHow do coordination variabilities derived from trunk-pelvic coupling angles and continuous relative phases compare among individuals with and without unilateral lower limb loss walking at self-selected speeds? MethodsFull-body kinematics were obtained from thirty-eight males with unilateral lower limb loss (23 transtibial and 15 transfemoral) and fifteen males without limb loss while walking along a 15 m walkway. Coordination variabilities were derived from trunk-pelvic coupling angles and continuous relative phases and compared using a multivariate approach, as well as in unilateral outcome measures between control participants and participants with lower limb loss. ResultsOverall, tri-planar measures of continuous relative phase variability were 19–43% larger compared to coupling angle variabilities for individuals without limb loss and individuals with transtibial limb loss. Individuals with transfemoral limb loss had 27% and 31% larger sagittal and transverse variabilities from continuous relative phases compared to coupling angles, respectively. During both prosthetic and intact limb stance, individuals with transtibial limb loss had 19–35% greater tri-planar measures of continuous relative phase variability compared to coupling angle variabilities. During intact stance phase, tri-planar measures of continuous relative phase variability were 27%− 42% larger compared to coupling angle variabilities for individuals without limb loss. SignificanceWhile both methods provide valid estimates of lumbopelvic movement variability during gait, continuous relative phase variability may provide a more sensitive estimate in the lower limb loss population capturing velocity-specific motions of the trunk and pelvis.

Recovery of the lumbopelvic movement and muscle recruitment patterns using motor control exercise program in people with chronic nonspecific low back pain: A prospective study.

This study aims to investigate the dysfunction and recovery of the lumbopelvic movement and motor control of people with chronic nonspecific low back pain after a structured rehabilitation which emphasizes on re-education and training of movement and motor control. The lumbopelvic movement and motor control pattern of 30 adults (15 with chronic low back pain, 15 healthy controls) were assessed using 3D motion and electromyographic analysis during the repeated forward bending test, in additional to the clinical outcome measures. Regional kinematics and muscle recruitment pattern of the symptomatic group was analysed before and after the 6-week rehabilitation, and compared to healthy controls. Significant improvement in back pain, functional capacity and self-efficacy of the symptomatic group was found after the rehabilitation. Patients with chronic nonspecific low back pain were capable to recover to a comparable level of the healthy controls in terms of their lumbopelvic movement and motor control pattern upon completion of a 6-week rehabilitation program, despite their dysfunction displayed at baseline. Phase specific motor control reorganization in which more profound and positive changes shown during the flexion phase. Our findings indicate that the recovery of the movement and motor control pattern in patients with chronic low back pain achieved to a comparable level of the healthy able-bodies. The improvement of both the physical outcome measures suggest that specific rehabilitation program which emphasizes on optimizing motor control during movements would help promoting the functional recovery of this specific low back pain subgroup.

Understanding the Pathophysiology of L5-S1 Loss of Lordosis and Retrolisthesis: An EOS Study of Lumbopelvic Movement Between Standing and Slump Sitting Postures

To understand the pathophysiology of L5-S1 loss of lordosis and retrolisthesis by comparing 2 commonly assumed physiological weight-bearing postures. This was a prospective comparative study of whole-body standing and slump sitting EOS radiographs in clinic patients presenting with back pain or lower limb radicular pain. Patients with prior spinal intervention, malignancy, trauma, inflammatory diseases, transitional lumbosacral vertebra, pregnancy, and L5-S1 retrolisthesis or spondylolisthesis from nondegenerative causes were excluded. C7 sagittal vertical axis, global cervical angle, global thoracic angle, global lumbar angle, thoracolumbar angle, T1-slope, pelvic incidence, pelvic tilt, sacral slope, L5-S1 angle, L5-S1 vertebral translation, L5-S1 disc height, and presence of L4-5 vertebral translation were measured. Univariate and multivariate analyses were performed to identify predictors of L5-S1 lordosis loss and retrolisthesis. L5-S1 loss of lumbar lordosis (7.02 ± 9.90°, P < 0.001), retrolisthesis (0.07 ± 0.411 cm, P < 0.001), and loss of disc height (0.10 ± 0.23 cm, P < 0.001) occurred when changing from standing to slump sitting along with other sagittal profile changes (P < 0.001). Taller L5-S1 disc height (odds ratio [OR] 2.57, P= 0.04), larger lumbar range-of-motion change (OR 3.82, P= 0.012), lower sacral slope on sitting (OR 2.50, P= 0.043), and presence of L4-5 spondylolisthesis (OR 2.75, P= 0.032) were predictive of larger L5-S1 lordosis loss (>7°) on multivariate analysis, while larger lumbar range-of-motion change (OR 2.21, P= 0.050) and presence of L4-5 spondylolisthesis (OR 3.08, P= 0.023) were predictive of greater L5-S1 retrolisthesis (>0.07 cm). Degenerative L5-S1 loss of lordosis and retrolisthesis likely result from long-standing lower lumbar spine bending forces against the posterior ligamentous complex with slump sitting, predisposed by a negatively sloped sacrum and increased lumbar flexibility.

Changing the pattern of the back-muscle flexion-relaxation phenomenon through flexibility training in relatively inflexible young men.

Although several studies have investigated the back-muscle flexion–relaxation phenomenon (FRP), the effect of individual flexibility on the FRP has been discussed infrequently, with very limited data on the influence of flexibility training on the FRP. This study thus examined the effect of flexibility training on the change of back-muscle FRP pattern in relatively inflexible young men. We collected and analyzed the valid data from 20 male participants (10 each with high and low flexibility included in the control and trained groups, respectively) when flexing their trunks at seven trunk flexion positions (0°–90°, in increments of 15°); their erector spinae and hamstring activation, pelvic tilt, and lumbosacral angle were then recorded. After 7 weeks of flexibility training for the low-flexibility group, no difference in flexibility was discovered between this group and the control (originally high-flexibility) group. The trunk flexion experiment was then repeated. The results showed that before the training stage, the low-flexibility group had lower erector spinae and higher hamstring activation, a larger pelvic tilt, and a smaller lumbosacral angle. By contrast, after training, the erector spinae and hamstring activation, pelvic tilt, and lumbosacral angle were significantly changed, and no intergroup differences were observed in FRP patterns. The study results suggest that flexibility training changes lumbopelvic movement and thereby reduces the degree of the back-muscle FRP when trunk flexion is performed.

Lumbar Bone Mineral Adaptation: The Effect of Fast Bowling Technique in Adolescent Cricketers.

Localized bone mineral density (BMD) adaptation of the lumbar spine, particularly on the contralateral side to the bowling arm, has been observed in elite male cricket fast bowlers. No study has investigated this in adolescents, or the role of fast bowling technique on lumbar BMD adaptation. This study aims to investigate lumbar BMD adaptation in adolescent cricket fast bowlers, and its relationship with fast bowling technique. Thirty-nine adolescent fast bowlers underwent anteroposterior dual x-ray absorptiometry scan of their lumbar spine. Hip, lumbopelvic and thoracolumbar joint kinematics, and vertical ground reaction kinetics were determined using three-dimensional motion capture and force plates. Significant partial (covariate: fat-free mass) and bivariate correlations of the technique parameters with whole lumbar (L1-L4) BMD and BMD asymmetry (L3 and L4) were advanced as candidate variables for multiple stepwise linear regression. Adolescent fast bowlers demonstrated high lumbar Z-Scores (+1.0; 95% confidence interval [CI], 0.7-1.4) and significantly greater BMD on the contralateral side of L3 (9.0%; 95% CI, 5.8%-12.1%) and L4 (8.2%; 95% CI, 4.9%-11.5%). Maximum contralateral thoracolumbar rotation and maximum ipsilateral lumbopelvic rotation in the period between back foot contact and ball release (BR), as well as contralateral pelvic drop at front foot contact, were identified as predictors of L1 to L4 BMD, explaining 65% of the variation. Maximum ipsilateral lumbopelvic rotation between back foot contact and BR, as well as ipsilateral lumbopelvic rotation and contralateral thoracolumbar side flexion at BR, were predictors of lumbar asymmetry within L3 and L4. Thoracolumbar and lumbopelvic motion are implicated in the etiology of the unique lumbar bone adaptation observed in fast bowlers whereas vertical ground reaction force, independent of body mass, was not. This may further implicate the osteogenic potential of torsional rather than impact loading in exercise-induced adaptation.

Aberrant Lumbopelvic Movements Predict Prospective Functional Decline in Older Adults with Chronic Low Back Pain

ObjectiveTo investigate if clinically observable aberrant lumbopelvic movements are associated with physical function at 12-month follow-up in older adults with chronic low back pain (CLBP), both directly and indirectly through baseline physical function. DesignSecondary analysis of a yearlong prospective cohort study. SettingClinical Research Laboratory. ParticipantsCommunity-dwelling older adults with CLBP (N=250). InterventionsNot applicable. Main Outcome MeasuresData from 239 participants were analyzed. Participants were screened at baseline for aberrant lumbopelvic movements during active trunk flexion; total observable aberrant movements were recorded and summed (range 0-4). Latent constructs of physical function were developed from an array of perception-based and performance-based outcome measures at baseline and 12 months, respectively. Structural Equation Modeling was used to assess the direct effect of baseline aberrant movement score on the latent construct of 12-month physical function, and its indirect effect through baseline physical function. ResultsAberrant movements were present in most participants (64.7%) and had a significant negative total effect on 12-month physical function (γ= -0.278, P<.001). Aberrant movement score's direct effect and indirect effect, through baseline functioning, were significantly negatively associated with physical function at 12-months, after adjusting for covariates (γ=-0.068, P=.038; γ= -0.210, P<.001, respectively). ConclusionsAberrant lumbopelvic movements are associated with decreased physical function at 12-month follow-up in older adults with CLBP, independent of baseline physical function and covariates. Future studies should evaluate if screening for aberrant movements may inform prognostic and interventional efforts in this patient population.

Immediate Effect of Modifying Lumbopelvic Motion During Sitting Knee Extension in People With Low Back Pain: A Repeated-Measures Study

ObjectiveThe aim of this study was to investigate the ability of people with low back pain (LBP) to modify the pattern of lumbopelvic rotation (LPR) when actively moving their lower limbs in sitting. MethodsIn this repeated-measures study in 38 men with chronic mechanical LBP (mean age, 38.4 ± 10.6 years), the timing and magnitude of LPR were investigated before and during the contraction of abdominal muscles during active knee extension while sitting. The kinematic data were collected using a motion-capture system, and OpenSim software was used for data analysis. The time difference between the start of knee extension and the start of LPR was measured and then adjusted to the movement time of the knee. The maximum LPR angle was also measured. ResultsParticipants increased the time difference between the start of knee extension and the start of LPR when contracting the abdominal muscles (P < .01). Before and during contraction of abdominal muscles, however, there were no differences in maximum LPR. ConclusionPeople with LBP are able to modify early lumbopelvic motion during active lower limb movement while sitting. This may reduce the frequency of lumbopelvic motion during activities of daily living in sitting in these people.

Limited lumbopelvic mobility does not influence short-term outcomes after primary hip arthroscopy: a propensity-matched controlled study.

ABSTRACTThere is a paucity of literature investigating the effect of lumbopelvic mobility on patient-reported outcome scores (PROs) after primary hip arthroscopy. The purpose of this study was (i) to report minimum 1-year PROs in patients with limited lumbopelvic mobility (LM) who underwent primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and (ii) to compare clinical results with a propensity-matched control group of patients with normal lumbopelvic mobility (NM). Data were reviewed for surgeries performed between November 2019 and March 2020. Patients were considered eligible if they received a primary hip arthroscopy for FAIS in the setting of LM (seated to standing change in sacral slope ≤ 10°). LM patients were propensity-matched to a control group of patients with normal lumbopelvic motion (seated to standing change in sacral slope > 10°) for comparison. A total of 17 LM and 34 propensity-matched NM patients were included in the study. LM patients showed significant improvement in all outcome measures and achieved the minimum clinically important difference (MCID) and patient acceptable symptomatic state (PASS) at high rates for modified Harris Hip Score (MCID: 94% and PASS: 82%) and International Hip Outcome Tool-12 (iHOT-12; MCID: 94% and iHOT-12: 76%). When LM patients were compared to a propensity-matched control group of NM patients, they demonstrated similar postoperative PROs and rates of achieving MCID/PASS. LM patients who undergo primary hip arthroscopy may expect favorable short-term PROs at minimum 1-year follow-up. These results were comparable to a control group of NM patients.

How accurate are visual assessments by physical therapists of lumbo-pelvic movements during the squat and deadlift?

ObjectivesTo investigate the accuracy of visual assessments made by physical therapists of lumbo-pelvic movements during the squat and deadlift and how much movement is considered injurious. DesignQuantitative Cross-sectional. Participants14 powerlifters, 10 Olympic weightlifters and six physical therapists. SettingThe lifters were recorded simultaneously by video and an inertial measurement unit (IMU) system while performing squats and deadlifts. The physical therapists assessed the videos and rated whether specific lumbo-pelvic movements were visible during the lifts and whether the movement amplitude was considered injurious. Main outcome measuresThe nominal visual assessments, if there was a movement and if it was considered injurious, were compared to the degrees of movement attained from the IMU system. ResultsDuring the squat, a posterior pelvic tilt of ≥34° was required to visually detect the movement. For other lumbo-pelvic movements, there was no significant difference in the amount of movement between those who were assessed as moving or not moving their lumbo-pelvic area, nor was there a difference in movement amplitude between those who were assessed as having an increased risk of injury or not. ConclusionsPhysical therapists did not consistently detect lumbo-pelvic movements during squats and deadlifts when performed by competitive lifters.

27646 Spinal Control Impairments During Two Clinical Tests of Lower Limb Movement in People with and without Low Back Pain

ABSTRACT IMPACT: Our work may be able to impact the examination and clinical decision making of a clinician to identify and target movement impairments to treat people with low back pain. OBJECTIVES/GOALS: Test if the magnitude of spinal control impairments is different in two clinical tests of lower limb movement in people with and without low back pain (LBP). The impairment is defined as the time difference between the start of limb to lumbopelvic motion. Also, test if the magnitude of impairments across tests is associated with LBP intensity and function. METHODS/STUDY POPULATION: 18 controls and 21 people with LBP (51.6% F, 34.5 ±11.5 yrs) participated in a cross-sectional, laboratory-based study. Subjects completed the modified Oswestry Disability Questionnaire (LBP-related functional limitation measure; 0-100%) and the Numeric Pain Rating Scale (LBP intensity; average pain prior 7 days; 0-10) self-report surveys and clinical tests of hip medial and lateral rotation performed in prone. A three-dimensional motion capture system was used to capture angular lumbopelvic and hip motion across time. A 2x2 mixed model ANOVA will be used to examine the effects of group, hip rotation test, and group x hip rotation test. Separate bivariate correlations will be used to quantify the association of magnitude of the impairment to (1) average LBP intensity and (2) LBP-related functional limitation. RESULTS/ANTICIPATED RESULTS: We hypothesize that, compared to healthy controls, people with LBP will display a greater magnitude of impairment across the hip medial and lateral rotation tests. In addition, we hypothesize that the magnitude of the difference in impairment between people with LBP vs controls will be larger during the hip lateral rotation test compared to the hip medial rotation test. Finally, we hypothesize that in people with LBP the magnitude of the impairments across tests will be associated with LBP intensity and LBP-related functional limitation. DISCUSSION/SIGNIFICANCE OF FINDINGS: If our hypotheses are supported, the hip rotation tests would further be recognized as a key part of a clinician’s examination and an important target for treatment of LBP.

Residual lumbar hyperlordosis is associated with worsened hip status 5 years after scoliosis correction in non-ambulant patients with cerebral palsy.

Cerebral palsy (CP) is a static encephalopathy with progressive musculoskeletal pathology. Non-ambulant children (GMFCS IV and V) with CP have high rates of spastic hip disease and neuromuscular scoliosis. The effect of spinal fusion and spinal deformity on hip dislocation following total hip arthroplasty has been well studied, however in CP this remains largely unknown. This study aimed to identify factors associated with worsening postoperative hip status (WHS) following corrective spinal fusion in children with GMFCS IV and V CP. Retrospective review of GMFSC IV and V CP patients in a prospective multicenter database undergoing spinal fusion, with 5years follow-up. WHS was determined by permutations of baseline (BL), 1year, 2years, and 5years hip status and defined by a change from an enlocated hip at BL that became subluxated, dislocated or resected post-op, or a subluxated hip that became dislocated or resected. Hip status was analyzed against patient demographics, hip position, surgical variables, and coronal and sagittal spinal alignment parameters. Cutoff values for parameters at which the relationship with hip status was significant was determined using receiver operating characteristic curves. Logistic regression determined odds ratios for predictors of WHS. Eighty four patients were included. 37 (44%) had WHS postoperatively. ROC analysis and logistic regression demonstrated that the only spinopelvic alignment parameter that significantly correlated with WHS was lumbar hyperlordosis (T12-L5) > 60° (p = 0.028), OR = 2.77 (CI 1.10-6.94). All patients showed an increase in pre-to-postop LL. Change in LL pre-to-postop was no different between groups (p = 0.318), however the WHS group was more lordotic at BL and postop (pre44°/post58° vs pre32°/post51° in the no change group). Age, sex, Risser, hip position, levels fused, coronal parameters, global sagittal alignment (SVA), thoracic kyphosis, and reoperation were not associated with WHS. Postoperative hyperlordosis(> 60°) is a risk factor for WHS at 5years after spinal fusion in non-ambulant CP patients. WHS likely relates to anterior pelvic tilt and functional acetabular retroversion due to hyperlordosis, as well as loss of protective lumbopelvic motion causing anterior femoracetabular impingement. III.

Changes in Lumbopelvic Motion and Trunk Muscle Activity during 2000 m Rowing Ergometer Trial

Changes in Lumbopelvic Motion and Trunk Muscle Activity during 2000 m Rowing Ergometer Trial

Ability of Physiotherapists and Physiotherapy Students to Evaluate and Classify Lumbar Movement Control Using Lumbopelvic Movement Control Tests.

Purpose: The aims of our study were to (1) describe the tests that physiotherapists use to assess lumbopelvic movement control and (2) compare physiotherapists' and physiotherapy students' ability to evaluate lumbar movement dysfunction in patients with non-specific low back pain (NSLBP). Method: A quantitative, observational, cross-sectional study design was used. A total of 93 qualified physiotherapists and 96 students participated in our study. The physiotherapists reported whether they were familiar with lumbopelvic movement control tests and indicated which tests they used to assess lumbopelvic movement control (Part 1). Both the physiotherapists and the students evaluated and classified lumbopelvic movement control while observing videos of patients with NSLBP (Part 2). The responses from physiotherapists and students were described and compared between the two groups using the Fisher exact test (p≤0.05). Odds ratios were calculated in terms of years of experience and level of education. Results: A total of 80 physiotherapists (86%) were familiar with lumbopelvic movement control tests, but only a few were using those tests as part of the assessment of patients; 12 (13%) used waiter's bow; 16 (17%) used rocking forward; 17 (18%) used rocking backward; 32 (34%) used sitting knee extension; 34 (37%) used prone knee flexion; and 70 (75%) used posterior pelvic tilt. The physiotherapy students and qualified physiotherapists generally agreed on the ratings of most of the videos (e.g., as correct or incorrect). A difference was found in only 3 of 24 videos for both the qualified physiotherapists and the physiotherapy students (p=0.001, p=0.007, and p=0.033, respectively), which indicates that qualified physiotherapists and students agreed and classified 21 videos the same. No differences were found in the ability of physiotherapists (regardless of experience) or students to classify patients as presenting with either a flexion or an extension pattern. Conclusions: The majority of physiotherapists were familiar with lumbopelvic movement control tests, but only a few used them. Both the physiotherapists and the students were able to classify patients with NSLBP presenting with either a flexion or an extension pattern.

Cricket Fast Bowling Technique and Lumbar Bone Stress Injury.

Lumbar bone stress injuries (LBSI) are the most prevalent injury in cricket. Although fast bowling technique has been implicated in the etiology of LBSI, no previous study has attempted to prospectively analyze fast bowling technique and its relationship to LBSI. The aim of this study was to explore technique differences between elite cricket fast bowlers with and without subsequent LBSI. Kinematic and kinetic technique parameters previously associated with LBSI were determined for 50 elite male fast bowlers. Group means were compared using independent-samples t-tests to identify differences between bowlers with and without a prospective LBSI. Significant parameters were advanced as candidate variables for a binary logistic regression analysis. Of the 50 bowlers, 39 sustained a prospective LBSI. Significant differences were found between injured and noninjured bowlers in rear knee angle, rear hip angle, thoracolumbar side flexion angle, and thoracolumbar rotation angle at back foot contact; the front hip angle, pelvic tilt orientation, and lumbopelvic angle at front foot contact; and the thoracolumbar side flexion angle at ball release and the maximal front hip angle and ipsilateral pelvic drop orientation. A binary logistic model, consisting of rear hip angle at back foot contact and lumbopelvic angle at front foot contact, correctly predicted 88% of fast bowlers according to injury history and significantly increased the odds of sustaining an LBSI (odds ratio, 0.88 and 1.25, respectively). Lumbopelvic motion is implicated in the etiology of LBSI in fast bowling, with inadequate lumbopelvifemoral complex control as a potential cause. This research will aid the identification of fast bowlers at risk of LBSI, as well as enhancing coaching and rehabilitation of fast bowlers from LBSI.

Corticomotor reorganization during short-term visuomotor training in the lower back: A randomized controlled study.

IntroductionAccumulating evidence suggests that motor skill training is associated with structural and functional reorganization of the primary motor cortex. However, previous studies have focussed primarily upon the upper limb, and it is unclear whether comparable reorganization occurs following training of other regions, such as the lower back. Although this holds important implications for rehabilitation, no studies have examined corticomotor adaptations following short‐term motor training in the lower back.MethodThe aims of this study were to (a) determine whether a short‐term lumbopelvic tilt visuomotor task induced reorganization of the corticomotor representations of lower back muscles, (b) quantify the variability of corticomotor responses to motor training, and (c) determine whether any improvements in task performance were correlated with corticomotor reorganization. Participants were allocated randomly to perform a lumbopelvic tilt motor training task (n = 15) or a finger abduction control task involving no lumbopelvic movement (n = 15). Transcranial magnetic stimulation was used to map corticomotor representations of the lumbar erector spinae before, during, and after repeated performance of the allocated task.ResultsNo relationship between corticomotor reorganization and improved task performance was identified. Substantial variability was observed in terms of corticomotor responses to motor training, with approximately 50% of participants showing no corticomotor reorganization despite significant improvements in task performance.ConclusionThese findings suggest that short‐term improvements in lower back visuomotor task performance may be driven by changes in remote subcortical and/or spinal networks rather than adaptations in corticomotor pathways. However, further research using tasks of varying complexities and durations is required to confirm this hypothesis.

Assessing sensorimotor control of the lumbopelvic-hip region using task-based functional MRI.

Recent brain imaging studies have suggested that cortical remodeling within sensorimotor regions are associated with persistent low back pain and may be a driving mechanism for the impaired neuromuscular control associated with this condition. This paper outlines a new approach for investigating cortical sensorimotor integration during the performance of small-amplitude lumbopelvic movements with functional MRI. Fourteen healthy right-handed participants were instructed in the lumbopelvic movement tasks performed during fMRI acquisition. Surface electromyography (EMG) collected on 8 lumbopelvic and thigh muscles captured organized patterns of muscle activation during the movement tasks. fMRI data were collected on 10 of 14 participants. Sensorimotor cortical activation across the tasks was identified using a whole brain analysis and further explored with regional analyses of key components of the cortical sensorimotor network. Head motion had low correlation to the tasks (r = -0.101 to 0.004) and head translation averaged 0.98 (0.59 mm) before motion correction. Patterns of activation of the key lumbopelvic and thigh musculature (average amplitude normalized 2-17%) were significantly different across tasks (P > 0.001). Neuroimaging demonstrated activation in key sensorimotor cortical regions that were consistent with motor planning and sensory feedback needed for performing the different tasks. This approach captures the specificity of lumbopelvic sensorimotor control using goal-based tasks (e.g., "lift your hip" vs. "contract your lumbar multifidus to 20% of maximum") performed within the confines of the scanner. Specific patterns of sensorimotor cortex activation appear to capture differences between bilateral and unilateral tasks during voluntary control of multisegmental movement in the lumbopelvic region.NEW & NOTEWORTHY We demonstrated the feasibility of using task-based functional magnetic resonance imaging (fMRI) protocols for acquiring the blood oxygen level-dependent (BOLD) response of key sensorimotor cortex regions during voluntary lumbopelvic movements. Our approach activated lumbopelvic muscles during small-amplitude movements while participants were lying supine in the scanner. Our data supports these tasks can be done with limited head motion and low correlation of head motion to the task. The approach provides opportunities for assessing the role of brain changes in persistent low back pain.

Straight Leg Raise Test: Influence of Lumbosant© and Assistant Examiner in Hip, Pelvis Tilt and Lumbar Lordosis

The passive straight leg raise (PSLR) test is widely used to assess hamstring extensibility. However, to accurately measure hamstring extensibility throughout PSLR, appropriate stabilization of the pelvis must be provided in order to minimize the possible influence of any compensatory movement in the scores reached. The main purpose of this study was to demonstrate the degree of influence of the Lumbosant© and an assistant examiner in hamstring extensibility in healthy young adults. A secondary objective was to verify the variability of the posterior pelvic tilt movement. Hamstring muscle extensibility was measured using the traditional (only an examiner) and new (using a low-back protection support Lumbosant© and two trained [principal and assistant] examiners) PSLR procedures. Correlation coefficients were expressed using r values, accompanying descriptors and 90% confidence intervals. Variance explained was expressed via the R2 statistic. To examine possible differences, the Mann-Whitney U-test was conducted. Additionally, Cohen’s d was calculated for all results, and the magnitudes of the effect were interpreted and statistical significance set at p &lt; 0.05. A stepwise multiple regression analysis was performed to examine the relationship between scores and values. The final score that was determined with the new PSLR is significantly lower (13° approximately) than the one obtained through the traditional procedure (75.3 ± 14.4° vs. 89.2 ± 20.8°; d = −0.777 [moderate]). The data presented in this study suggest that the PSLR may overestimate hamstring extensibility unless lumbopelvic movement is controlled. Therefore, we recommend the use of Lumbosant© and an auxiliary examiner to obtain more accurate hamstring extensibility scores.

Overhead throwing in cricketers: A biomechanical description and playing level considerations

ABSTRACT This study aimed to describe stationary overhead throwing biomechanics in South African cricketers, considering playing level, and relative to baseball. Kinematics and ground reaction forces were collected during throwing trials. Inverse dynamics was used to calculate joint kinetics. Inter-subject variability was calculated using the coefficient of variance. A one-dimensional statistical parametric mapping ANOVA was conducted to assess differences between the kinematic waveforms in elite and amateur cricketers (p < 0.05). Fifteen cricketers (elite = 8; amateur = 7) participated in this study. The basic parameters of a cricketer’s throwing action are described. Substantial inter-subject variability was noted for all variables, except lumbopelvic movement. Cricketers presented with 74.9 ± 27.3° glenohumeral external rotation and 94.8 ± 23.7° elbow flexion, at maximum external rotation (MER). Amateur cricketers displayed decreased elbow flexion range of motion between 2-14% of the throwing cycle (F = 9.365;p = 0.01); greater shoulder (121.0vs85.9 N; F = 0.36,p = 0.021) and elbow compression (105.6vs72.8 N;F = 0.007,p = 0.043), and superior shoulder force (203.1vs115.5 N;F = 2.43,p = 0.022) at MER, when compared with elite cricketers. Cricketers display similarities to baseball pitchers when throwing overhead from a stationary position. The “preparatory arc” utilised is different to the wind-up noted for baseball. The forces exerted on the shoulder and elbow, in amateur cricketers specifically, are substantially greater at MER and may indicate the potential risk for injury.

Effect of wearing jeans on the back muscle flexion-relaxation phenomenon

The flexion–relaxation phenomenon (FRP) in back muscles is related to the lower back load. Although the FRP has been widely discussed, the effect of wearing jeans—a common attire in workplaces—on the FRP is unexplored. This study recruited 20 male participants with high and low flexibilities (10 each) and measured the related muscle activity and lumbopelvic movement at five trunk flexion angles (0°–90°) when wearing two types of bottom wears (swim trunks and fit jeans). Results revealed that the bottom wear type and trunk angle significantly affected all responses, whereas flexibility affected only erector spinae and hamstring activities. Participants with high flexibility and wearing swim trunks exhibited greater erector spinae activity than did those with low flexibility and wearing jeans. Thus, those who have low flexibility or are wearing jeans are likely to experience more activity reductions in erector spinae. However, the result with hamstring activity was the opposite. Wearing jeans limited participants’ pelvic rotation, forcing them to bend their lumbar spine further to complete trunk flexion, thus reducing erector spinae activity. A looser attire should be chosen to avoid constraining the pelvic rotation when work involves a deep trunk flexion. Relevance to industryPeople wearing jeans have limited pelvic movement and decreased erector spinae activity during deep trunk flexion, and this may further strain their interspinous ligaments. Thus, people should not wear fit jeans when in workplaces where their work involves stooping or trunk flexion exceeding 45° to minimize the load on their lower back.