Trunk Axial Rotation Research Articles

Validity and reliability of the iPhone to measure rib hump in scoliosis.

This was a prospective blinded validity and reliability analysis. The aim of this study was validation and reliability evaluation of the Scoligauge iPhone app. The scoliometer is used to clinically measure the rib hump in scoliosis as a means to evaluate the axial trunk rotation. The increasing availability of smartphone with built-in accelerometer led to the development of a vast number of applications to measure angles. Of these, the Scoligauge mimics a scoliometer. The aim of this study was to compare the validity of the Scoligauge iPhone application without an associated adapter with the traditional scoliometer and to test the reliability of the application in a clinical setting. Two observers measured the rib hump deformity on 34 consecutive patients with idiopathic scoliosis with an average Cobb angle of 24.2 ± 13.5 degrees (range, 4 to 65 degrees). Measurements were made with an iPhone without the adapter and with a scoliometer. The validity as well as the interobserver and intraobserver reliability were calculated using the intraclass coefficient (ICC) and the Bland-Altman test. The mean difference between the scoliometer and the Scoligauge application was 0.4 degrees [95% confidence interval (CI) of ± 3.1 degrees] with an ICC of 0.947 (P < 0.001). The intraobserver and interobserver ICC were 0.961 (P < 0.001) and 0.901 (P < 0.001), respectively. The mean intraobserver difference was 0.0 degrees (95% CI of ± 2.7 degrees) and the mean interobserver difference was 0.1 degrees (95% CI of ± 4.4 degrees). The intraobserver and interobserver reliability of the Scoligauge iPhone app, as well as its validity compared with the scoliometer, are excellent. The mean differences between measurements are small and clinically not significant. Thus, the Scoligauge application is valid for clinical evaluation even without special adapter. Level I (Diagnostic Study).

A kinematic analysis for shoulder and pelvis coordination during axial trunk rotation in subjects with and without recurrent low back pain

The purpose of this study was to compare the kinematics of the shoulder and pelvis based on range of motion (ROM), angular velocity, and relative phase (RP) values during trunk axial rotation. Nineteen subjects with recurrent low back pain (LBP) and 19 age-matched control subjects who are all right limb dominant participated in this study. All participants were asked to perform axial trunk rotation activities at a self-selected speed to the end of maximum range in a standing position. The outcome measures included ROM, angular velocity, and RP on the shoulder and pelvis in the transverse plane and were analyzed based on the demographic characteristics between groups. The LBP group demonstrated decreased ROM (p=0.02) and angular velocity (p=0.02) for the pelvis; however, there was no group difference for the shoulder girdle. The ROM difference between the shoulder and pelvic transverse planes had a significant interaction with age (F=14.75, p=0.001). The LBP group demonstrated a higher negative correlation between the shoulder (r=–0.74, p=0.001) and pelvis (r=–0.72, p=0.001) as age increased while no significant correlations were found in the control group. The results of this study indicated that there was a difference in pelvic rotation in the transverse plane between groups during axial trunk rotation. It would be important to coordinate postural stability between the shoulder and pelvic girdles during ambulation; however, the pattern of trunk movement decreased with age due to possible pelvic stiffness in subjects with recurrent LBP. Therefore, improved pelvic flexibility for coordinated trunk movement patterns would help subjects with recurrent LBP.

Preliminary Assessment of Dressage Asymmetry within Sitting Trot and Shoulder‐in

IntroductionDespite dressage popularity, little research exists in relation to the rider's posture and effect on aids given to the horse. The aim was to investigate asymmetry during sitting trot and shoulder‐in between varying rider abilities.MethodsFull body kinematics were collected at 120 Hz (XSENS MVN Biomech) for 10 novice (age 28 ± 12 years, height = 168 ± 7 cm) and 10 advanced (age 29 ± 6 years, height = 163 ± 4 cm) predominantly right handed participants, with one left handed rider in each group. Range of motion for right hip, left hip, right knee, left knee, right ankle, left ankle, ASIS vertical movement, trunk rotation were generated in Visual 3D.ResultsIndependent t‐tests demonstrated significant differences between groups within right and left hip external rotation when straight (P &lt; 0.001, d = 2.52; P = 0.02, d = 1.25), shoulder‐in right (P = 0.01, d = 1.47; P = 0.02, d = 1.31), only significant in right hip within shoulder‐in left (P = 0.01, d = 1.30). Axial rotation to the right was found in all conditions, with the range significantly (P&lt;0.05) increased between groups in straight and shoulder‐in right, as did right ASIS vertical excursion when riding straight (P = 0.01, d = 1.90), and left ASIS excursion within shoulder‐in left (P = 0.04, d = 1.03).ConclusionsRight trunk axial rotation is considered closely linked to right hand dominance, rotating the rider's trunk to the dominant rein aid. Left shoulder‐in scored higher which may be because right trunk rotation is one of the aids given to the horse when executing this dressage movement.Ethical Animal ResearchStudy protocols approved by the University of Central Lancashire, before commencing the study. Sources of funding: none. Competing interests: none.

The Relationship Between Gluteal Muscle Activation and Throwing Kinematics in Baseball and Softball Catchers

The purpose of this study was to determine the relationship between gluteal muscle activation and pelvis and trunk kinematics when catchers throw to second base. Forty-two baseball and softball catchers (14.74 ± 4.07 years; 161.85 ± 15.24 cm; 63.38 ± 19.98 kg) participated in this study. Muscle activity of the bilateral gluteus maximus and medius as well as pelvis and trunk kinematics throughout the throwing motion were analyzed. It was discovered that at foot contact, there were 2 significant inverse relationships between stride leg gluteus maximus activity and pelvis axial rotation (r = -0.31, r2 = 0.10, p = 0.05), and between trunk axial rotation and pelvis lateral flexion (r = -0.34, r2= 0.12, p = 0.03). In addition, at foot contact, a significant positive relationship between the drive leg (throwing arm side) and trunk flexion (r = 0.33, r2 = 0.11, p = 0.04) was present. The results of this study provide evidence of gluteal activation both concentrically and eccentrically, in attempt to control the pelvis and trunk during the throwing motion of catchers. The gluteal muscles play a direct role in maintaining the stability of the pelvis, and catchers should incorporate strengthening of the entire lumbopelvic-hip complex into their training regimen. Incorporating concentric and eccentric gluteal exercises will help to improve musculoskeletal core stability, thereby assisting in upper extremity injury prevention.

Normative data for modified Box and Blocks test measuring upper-limb function via motion capture

Motion analysis is an important tool for examining upper-limb function. Based on previous work demonstrating a modified Box and Blocks (BB) test with motion capture to assess prosthetic performance, we collected data in 16 nondisabled participants to establish normative kinematics for this test. Four motions of the modified BB test were analyzed to establish kinematic data for upper-limb and trunk motion. The test was repeated for right and left arms in standing and seated positions. Data were compared using a nonparametric Friedman test. No differences were found between right- and left-hand performance other than for task completion time. Small but significant differences were found for standing and seated performance, with slightly greater ranges in standing for axial trunk rotation, medial-lateral sternum displacement, and anterior-posterior hand displacement. The kinematic trajectories, however, were very consistent. The consistency in our nondisabled data suggests that normative kinematic trajectories can be defined for this task. This motion capture procedure may add to the understanding of movement in upper-limb impairment and may be useful for measuring the effect of interventions to improve upper-limb function.

Kinematic Analysis of the Upper Limb Motor Strategies in Stroke Patients as a Tool towards Advanced Neurorehabilitation Strategies: A Preliminary Study

Advanced rehabilitation strategies of the upper limb in stroke patients focus on the recovery of the most important daily activities. In this study we analyzed quantitatively and qualitatively the motor strategies employed by stroke patients when reaching and drinking from a glass. We enrolled 6 hemiparetic poststroke patients and 6 healthy subjects. Motion analysis of the task proposed (reaching for the glass, bringing it to the mouth, and putting it back on the table) with the affected limb was performed. Clinical assessment using the Fugl-Meyer Assessment for Upper Extremity was also included. During the reaching for the glass the patients showed a reduced arm elongation and trunk axial rotation due to motor deficit. For this reason, as observed, they carried out compensatory strategies which included trunk forward displacement and head movements. These preliminary data should be considered to address rehabilitation treatment. Moreover, the kinematic analysis protocol developed might represent an outcome measure of upper limb rehabilitation processes.

Trunk axial rotation in baseball pitching and batting

The purpose of this study was to quantify trunk axial rotation and angular acceleration in pitching and batting of elite baseball players. Healthy professional baseball pitchers (n = 40) and batters (n = 40) were studied. Reflective markers attached to each athlete were tracked at 240 Hz with an eight-camera automated digitizing system. Trunk axial rotation was computed as the angle between the pelvis and the upper trunk in the transverse plane. Trunk angular acceleration was the second derivative of axial rotation. Maximum trunk axial rotation (55 ± 6°) and angular acceleration (11,600 ± 3,100 °/s2) in pitching occurred before ball release, approximately at the instant the front foot landed. Maximum trunk axial rotation (46 ± 9°) and angular acceleration (7,200 ± 2,800 °/s2) in batting occurred in the follow-through after ball contact. Thus, the most demanding instant for the trunk and spine was near front foot contact for pitching and after ball contact for batting.

The crunch factor's role in golf-related low back pain

Background contextThe golf swing exposes the spine to complex torsional, compressive, and shearing loads that increase a player's risk of injury. The crunch factor (CF) has been described as a measure to evaluate the risk of low back injuries in golfers and is based on the notion that lateral flexion and axial trunk rotation jointly contribute to spinal degeneration. However, few studies have evaluated the appropriateness of this measure in golfers with low back pain (LBP). PurposeTo objectively examine the usefulness of the CF as a measure for assessing the risk of low back injury in golfers. Study designField-based research using a cross-sectional design. MethodsThis research used three-dimensional motion analysis to assess the golf swings of 12 golfers with LBP and 15 asymptomatic controls. Three-dimensional kinematics were derived using Vicon Motus, and the CF was calculated as the instantaneous product of axial trunk rotation velocity and lateral trunk flexion angle. ResultsMaximum CFs and their timings were not significantly different between the symptomatic and asymptomatic groups. Furthermore, for those golfers who produced higher CFs (irrespective of the group), the increased magnitude could not be attributed to an increased axial angular trunk velocity or lateral flexion angle, but rather to a concomitant increase in both of these variables. ConclusionsThe findings suggested that although the fundamental concepts that underpin the CF seem sensible, this measure does not appear to be sensitive enough to distinguish golfers with LBP from the asymptomatic players.

Three-dimensional trunk kinematics in golf: between-club differences and relationships to clubhead speed

The aims of this study were (i) to determine whether significant three-dimensional (3D) trunk kinematic differences existed between a driver and a five-iron during a golf swing; and (ii) to determine the anthropometric, physiological, and trunk kinematic variables associated with clubhead speed. Trunk range of motion and golf swing kinematic data were collected from 15 low-handicap male golfers (handicap = 2.5 ± 1.9). Data were collected using a 10-camera motion capture system operating at 250 Hz. Data on clubhead speed and ball velocity were collected using a real-time launch monitor. Paired t-tests revealed nine significant (p ≤ 0.0019) between-club differences for golf swing kinematics, namely trunk and lower trunk flexion/extension and lower trunk axial rotation. Multiple regression analyses explained 33.7–66.7% of the variance in clubhead speed for the driver and five-iron, respectively, with both trunk and lower trunk variables showing associations with clubhead speed. Future studies should consider the role of the upper limbs and modifiable features of the golf club in developing clubhead speed for the driver in particular.

Factors affecting shoulder-pelvic integration during axial trunk rotation in subjects with recurrent low back pain. Park WH, Kim YH, Lee TR, Sung PS. Eur Spine J 2012;21(7):1316-23. Epub 2012 Mar 29

Factors affecting shoulder-pelvic integration during axial trunk rotation in subjects with recurrent low back pain. Park WH, Kim YH, Lee TR, Sung PS. Eur Spine J 2012;21(7):1316-23. Epub 2012 Mar 29

Scoliometer measurements of patients with idiopathic scoliosis

Patients with idiopathic scoliosis are exposed to approximately 25 radiographic examinations of their spine throughout the clinical follow-up using the Cobb angle. Several non-invasive and radiation-free methods have been proposed to measure scoliotic deformities, including the scoliometer. To measure the intra- and interrater reliability of the scoliometer measurements, to assess the correlation of the values obtained by the scoliometer measurements with the Cobb angles obtained by radiography, and to assess the sensitivity and specificity of the scoliometer measurements for the different diagnostic criteria for the referral of idiopathic scoliosis. Sixty-four patients were selected for the study: half with idiopathic scoliosis and half without. The 17 levels of the spine of each volunteer were measured with a scoliometer in the forward bending position. The measurements were performed three times on 42 volunteers by two different raters to obtain data for calculating the reliability values. Anteroposterior radiographs were taken to determine the Cobb angles, which were then compared with the highest trunk rotation value. Sensitivity and specificity were evaluated using radiograph criteria for referral: a Cobb angle of 10º and axial trunk rotation values between 5º and 10º. Excellent intrarater reliability values and very good interrater reliability values were obtained. The correlation between the scoliometer measurements and radiograph analyses was considered good (r=0.7, p<0.05). The highest sensitivity value was for a trunk rotation of 5º at 87%. The scoliometer measurements showed a good correlation with the radiographic measurements.

The interrelationship of the thorax and pelvis under varying task constraints

The purpose of this study was to investigate the interrelationship between the thorax and pelvis during coupled movement patterns. Fifty-seven participants were assessed using an infrared motion analysis system to track trunk movement during maximal pelvis and thorax rotations over four trunk inclinations and two pelvic constraint conditions. A repeated-measures multivariate analysis of variance investigated the effects of forward trunk inclination and pelvic constraint on thorax and pelvic rotation. Forward trunk inclination from neutral to 45° resulted in a 46% (p < 0.001) decrease in axial pelvic rotation and a 15% (p < 0.001) decrease in axial thorax rotation with an unconstrained pelvis. A constrained pelvis resulted in a 15% (p < 0.001) decrease in axial thorax rotation. An externally constrained pelvis allowed the thorax to achieve an average of 18° (SD = 2°) greater rotational range of motion across all angles. This study reinforced the importance of allowing the pelvis to rotate during whole body axial rotation tasks. Practitioner Summary: Results indicated that maximum axial trunk rotation is best achieved in a neutral posture, when the pelvis is allowed to contribute and flexion at the hips should be minimised. For example, if a recumbent task requires rotation of the torso, then the chair seat should be allowed to swivel.

Coordination of trunk and pelvis in young and elderly individuals during axial trunk rotation

It has been well known that complex tasks such as walking and arm reaching can be achieved by the coordination of the trunk and pelvis. However, understanding of the effect of aging on the coordination of the trunk and pelvis during axial trunk rotation is still lacking. The present study examined relative phase of the trunk and pelvis during axial trunk rotation, and compared it between young and older groups. 22 healthy young (age: 23.9±4.6, gender: 11 male and 11 female) and 22 healthy elderly (age: 68.4±4.9, gender: 11 male and 11 female) individuals participated in the experiment and performed axial trunk rotation. Relative phase between the trunk and pelvis was calculated based on the angular displacements of the two segments. The results demonstrated age-related changes in coordination pattern of the trunk and pelvis during axial trunk rotation.

Factors affecting shoulder–pelvic integration during axial trunk rotation in subjects with recurrent low back pain

Shoulder-pelvic integration could play a central role in the control of dynamic posture and movement. However, kinematic coordination during axial trunk rotation has not been carefully investigated in subjects with recurrent low back pain (LBP). The purpose of this study was to compare the maximum rotational angles of the shoulders and pelvis in the transverse plane between subjects with and without recurrent LBP. A total of 38 age-matched subjects (19 control subjects: 69.00 ± 5.75 years old and 19 subjects with LBP: 68.79 ± 5.40 years old) participated in the study. The axial trunk rotation test was conducted in the upright position with bilateral hips and knees fully extended and both feet shoulder width apart. The results of this study indicated that there was a difference in pelvic girdle rotation between groups (100.79 ± 26.46 in the control group, 82.12 ± 23.16 in the LBP group; t = 2.31, p = 0.02); however, there was no difference for the shoulder girdle (177.63 ± 36.98 in the control group, 156.42 ± 30.09 in the LBP group; t = 1.91, p = 0.06). There were interactions with age (F = 9.27, p = 0.004) and BMI (F = 7.50, p = 0.01) with the rotational angles of the shoulder and pelvis. These results indicated a different pattern of trunk rotation movement with the age and BMI serving as important factors to consider for recurrent LBP. The results of our study also indicated a different pattern of shoulder and pelvic coordination with age and gender. Clinicians need to consider the consequences of limited shoulder-pelvic rotational angles, especially limited rotational angle on the pelvis during trunk axial rotation. Further studies are required to determine the causes of the underlying problems for clinical decision-making and altered shoulder-pelvic rotation in subjects with recurrent LBP.

Three-dimensional kinematic analysis of pelvic and lower extremity differences during trunk rotation in subjects with and without chronic low back pain

ObjectiveTo investigate three-dimensional angular changes of the pelvis and lower extremities during trunk axial rotation in subjects with and without chronic low back pain (LBP). DesignRepeated-measures design. ParticipantsThirty volunteers participated in the study (15 with LBP, 15 without LBP). The mean age of the subjects was 44 (standard deviation 15.8) years (range 27 to 63 years). Main outcome measuresAll participants were asked to perform five sets of axial trunk rotation activities with a bar in a standing position. The outcome measures included three-dimensional rotational angles of the pelvis and lower extremities (foot, calf and thigh). ResultsThe angular change of the pelvis in the sagittal plane differed between subjects with and without LBP (P=0.03). There were no significant differences in angular changes of the lower extremities in the frontal and transverse planes between groups. ConclusionsThe angular change of the pelvis in the sagittal plane differed significantly between groups. Further research is needed to investigate the three-dimensional characteristics of biomechanical and neuromuscular aspects in subjects with LBP.

Kinematics of Baseball and Softball Catchers Throwing Down to Second Base

PURPOSE: To determine differences in torso and shoulder kinematics in baseball and softball catchers when throwing to second base from their stance or knees. METHODS: Nineteen baseball and softball catchers volunteered to participate (15.63 + 3.47 years; 165.91 + 12.50 cm; 67.71 +17.86 kg). Ten electromagnetic sensors were attached to participants to determine joint positions throughout the throwing motion. Participants were allotted an unlimited time to warm-up, in their catching gear to gain familiarity with the throwing surface. Each participant received a pitch from a pitcher and then completed a series of 10 (5 from knees and 5 from stance) throws to second base located regulation distance from home plate (25.6 m/38.8 m). The kinematic variables analyzed included trunk axial rotation, trunk lateral flexion, shoulder rotation, shoulder elevation, shoulder plane of elevation, pelvis axial rotation, and pelvis lateral flexion. Kinematic variables were analyzed at front foot contact (FC), maximum external rotation (MER), ball release (BR), and maximum internal rotation (MIR). RESULTS: Significant kinematic differences, at each event mark, were identified using a MANOVA followed by paired sample t test, p <.05, to determine the variables that were different between the two types of throws. At FC, trunk axial rotation, shoulder plane of elevation, shoulder elevation, pelvis lateral flexion, and pelvis axial rotation were significantly different. During MER significant differences occurred with trunk flexion, trunk lateral flexion, and pelvis lateral flexion. Ball release produced significant differences in trunk flexion, trunk lateral flexion, and pelvis lateral flexion. Differences at MIR included trunk flexion and trunk lateral flexion. CONCLUSIONS: When the catchers threw from the stance they had a greater degree of shoulder plane of elevation as well as shoulder elevation. Throwing from the stance allowed them to position their throwing arm in a more biomechanically efficient position of shoulder elevation and abduction. It is often assumed that catchers throw from the knees in attempt to produce a quicker release. The results of this study demonstrate that throwing from the knees results in significantly different kinematics than throwing from the stance which could ultimately predispose injury.

Kinematic analysis of symmetric axial trunk rotation on dominant hip

Axial rotation of the trunk has been reported as a significant risk of low back dysfunction. However, a lack of biomechanical investigation exists that explains how twisting is accomplished with simultaneous asymmetric handling between the hip joints and lumbar spine. We used a three-dimensional motion analysis to measure movements of the bilateral hips and lumbar spine. Forty-four persons participated in the study, and the results indicated that spinal range of motion (ROM) was significantly different based on dominance (F = 198.83, p = 0.001), region x dominance (F = 14.21, p = 0.001), and dominance x dimension (F = 141.08, p = 0.001). We also found a three-way interaction between region x dominance x dimension (F = 26.30, p = 0.001). These results indicated that the motion of the transverse and sagittal planes significantly increased when the participants attempted to rotate their hips, especially on the nondominant side. Decreased axial trunk ROM on the side of dominance might stiffen passive structures of the hip joints. The functions of the hip joints and lumbar spine might be altered three dimensionally based on the side of dominance.

Three-dimensional kinematics of the upper limb during a Reach and Grasp Cycle for children

The ability to reach, grasp, transport, and release objects is essential for activities of daily living. The objective of this study was to develop a quantitative method to assess upper limb motor deficits in children with cerebral palsy (CP) using three-dimensional motion analysis. We report kinematic data from 25 typically developing (TD) children (11 males, 14 females; ages 5–18 years) and 2 children with spastic hemiplegic CP (2 females, ages 14 and 15 years) during the Reach and Grasp Cycle. The Cycle includes six sequential tasks: reach, grasp cylinder, transport to mouth ( T 1), transport back to table ( T 2), release cylinder, and return to initial position. It was designed to represent a functional activity that was challenging yet feasible for children with CP. For example, maximum elbow extension was 43 ± 11° flexion in the TD group. Consistent kinematic patterns emerged for the trunk and upper limb: coefficients of variation at point of task achievement for reach, T 1, and T 2 for trunk flexion–extension were (.11, .11, .11), trunk axial rotation (.06, .06, .06), shoulder elevation (.13, .11, .13), elbow flexion–extension (.25, .06, .23), forearm pronation–supination (.08, .10, .11), and wrist flexion–extension (.25, .21, .22). The children with CP demonstrated reduced elbow extension, increased wrist flexion and trunk motion, with an increased tendency to actively externally rotate the shoulder and supinate the forearm during T 1 compared to the TD children. The consistent normative data and clinically significant differences in joint motion between the CP and TD children suggest the Reach and Grasp Cycle is a repeatable protocol for objective clinical evaluation of functional upper limb motor performance.

Kinematics of table tennis topspin forehands: effects of performance level and ball spin

The purpose of this study was to investigate whether performance level and ball spin affect arm and racket kinematics of the table tennis topspin forehand. Nine advanced and eight intermediate male table tennis players hit topspin forehands against light and heavy backspins. Five high-speed video cameras were used to record their strokes at 200 fps. Contributions of joint rotations to the racket speed, the racket kinematics at ball impact, the time required for racket acceleration and the maximum slope of the racket speed-time curve (s max) were determined. The advanced players showed a significantly larger contribution of lower trunk axial rotation to the racket speed at impact and a significantly larger value of smax, and tended to require a less time for racket acceleration than the intermediate players. The racket speed at impact was not significantly different between the two player groups. The players adjusted the racket face angle rather than the inclination of the racket path at impact to the different ball spins. The results suggest that the ability to accelerate the racket in less time in the topspin forehand against backspin balls may be an important factor that affects the performance level.

Head and trunk rotation during walking turns in Parkinson's disease

Head and trunk axial rotation during walking to align with a new path are integral components of direction change (turning). Turning is problematic in people with Parkinson's disease (PD), who appear to move en-bloc when turning and when walking straight. Axial rotation has been little investigated in this group. Accordingly, head, thorax, and pelvis rotation relative to the laboratory axes (global rotation) was investigated in 10 patients with PD and 10 matched comparison subjects when walking straight and when turning 60 and 120 degrees . Data were selected at three footfalls before and three after a pole denoting the corner. Although rotation was reduced overall in patients with PD, final differences were minimized by rotation commencing at an earlier step in the patient group. When rotation was measured at various distances relative to the corner, the patient group demonstrated greater rotation than their peers. In support of clinical observations, patients constrained thorax and pelvis closely together around the corner, while control subjects maintained a pattern of reciprocal oscillation when turning. Stride length reduction appears to contribute more to inefficient turning in PD than under-scaled amplitude of rotation.