Lumbopelvic Movement Control: Effect of Injury History, and the Role of Cortical Control and Its Practical Application 1

NCT04786717 | Completed

• 1 other identifier: YM110027E(1)
• Study Type: interventional
• Target: 41
• Locations: 1 country
• Sites: 1

Brief Summary

Lumbopelvic movement control is crucial for movement stability during weight loading training, and also an important risk factor for the occurrence and recurrence of low back pain (LBP). Previous studies indicated that athletes with LBP had poorer lumbopelvic movement control, and the deficits in lumbopelvic control could be remained after LBP remission. However, there has been no study investigating the effect of LBP history (LBPH) on the performance of the loaded squatting task, and lumbopelvic movement control in people who practice regular weight training. Therefore, the aims of this study are to examine the differences in lumbopelvic movement control, kinematics and muscle activation during the loaded squatting task in weight training practitioners with LBP, LBPH, and asymptomatic controls, to compare the cortical control mechanisms between 3 types of motor control training strategies, and to investigate the intervention effect of motor control training on restoring the lumbopelvic movement control and squatting performance.

Conditions

Biomechanical Phenomena

Keywords

back pain history; deep squat; movement control; cortical control; imagery training

Outcome Measures

Primary Outcomes (8)

• Lumbopelvic kinematics

  The investigator will place three markers at subjects' 1st lumbar vertebrae, 2nd sacrum vertebrae, and lateral side of left greater trochanter. The investigator will record the track of each marker through the video system(Noraxon myoVIDEOTM, Noraxon USA Inc., USA) while the subject is squatting. According to the record, the investigator will analyze the angles between 1st lumbar vertebrae and 2nd sacrum vertebrae which are the lumbar flexion angles and the lumbar extension angles.

  pre-intervention

• Lumbopelvic kinematics

  The investigator will place three markers at subjects' 1st lumbar vertebrae, 2nd sacrum vertebrae, and lateral side of left greater trochanter. The investigator will record the track of each marker through the video system(Noraxon myoVIDEOTM, Noraxon USA Inc., USA) while the subject is squatting. According to the record, the investigator will analyze the angles between 1st lumbar vertebrae and 2nd sacrum vertebrae which are the lumbar flexion angles and the lumbar extension angles.

  after 4 weeks of intervention

• Hip kinematics

  The investigator will place three markers at subjects' 1st lumbar vertebrae, 2nd sacrum vertebrae, and lateral side of left greater trochanter. The investigator will record the track of each marker through the video system(Noraxon myoVIDEOTM, Noraxon USA Inc., USA) while the subject is squatting. According to the record, the investigator will analyze the angles between 2nd sacrum vertebrae and greater trochanter which are the hip flexion angles and the hip extension angles.

  pre-intervention

• Hip kinematics

  The investigator will place three markers at subjects' 1st lumbar vertebrae, 2nd sacrum vertebrae, and lateral side of left greater trochanter. The investigator will record the track of each marker through the video system(Noraxon myoVIDEOTM, Noraxon USA Inc., USA) while the subject is squatting. According to the record, the investigator will analyze the angles between 2nd sacrum vertebrae and greater trochanter which are the hip flexion angles and the hip extension angles.

  after 4 weeks of intervention

• Muscle activation

  The investigator will record the muscle activation of erector spinae, rectus abdominus, internal obliques, and gluteus maximus through the electromyography (Noraxon TeleMyo sEMG System, Noraxon USA Inc., USA)

  pre-intervention

• Muscle activation

  The investigator will record the muscle activation of erector spinae, rectus abdominus, internal obliques, and gluteus maximus through the electromyography (Noraxon TeleMyo sEMG System, Noraxon USA Inc., USA)

  after 4 weeks of intervention

• Lumbopelvic control ability

  Using lumbar motor control test battery to test the stability of subjects' lumbar. This test battery is consisted of 10 motor control test based from previous studies. If the subjects complete the test successfully, they will get 1 point in each test, otherwise they may not get any points. Therefore, the minimum of the scale is 0 point, and the maximum is 10 points, and the higher scores mean the subjects can control their lumbar vertebrae much better.

  pre-intervention

• Lumbopelvic control ability

  Using lumbar motor control test battery to test the stability of subjects' lumbar. This test battery is consisted of 10 motor control test based from previous studies. If the subjects complete the test successfully, they will get 1 point in each test, otherwise they may not get any points. Therefore, the minimum of the scale is 0 point, and the maximum is 10 points, and the higher scores mean the subjects can control their lumbar vertebrae much better.

  after 4 weeks of intervention

Study Arms (3)

core muscle training

EXPERIMENTAL

Training the endurance of the core muscle.

Other: core muscle training

movement control training

EXPERIMENTAL

Based from the initial test, the subjects will receive lumbar movement control exercise. They will perform each lumbar movement control exercise in different position.

Other: movement control training

combined imagery and movement control training

EXPERIMENTAL

The intervention of this group is mostly same as the movement control training group. The different part is that the first 3 times of the movement will be practiced through image training, and the subjects will practice the real movement in the rest of 7 times.

Other: combined imagery and movement control training

Interventions

core muscle training OTHER

The intervention of this group will focus on training the endurance of the core muscle.

core muscle training

movement control training OTHER

Based from the initial test, the subjects will receive either lumbar flexion control exercise or lumbar extension control exercise. They will perform each lumbar movement control exercise in different position. Starting from the lying position, then progressing to sitting, standing with support, and the last level will be standing without support. Each set of movement will be practiced 10 times, totally 10 sets. It will take approximately 5\~8 minutes to finish each movement. The subjects will learn 5\~8 types of the movement every week.

movement control training

combined imagery and movement control training OTHER

The intervention of this group is mostly same as the movement control training group. The different part is that the first 3 times of the movement will be practiced through image training, so the subjects will not have any real movement, and the last 7 times they will perform the lumbar motor control exercise literally. Each set of movement will be practiced 10 times, totally 10 sets. It will take approximately 5\~8 minutes to finish each movement. The subjects will learn 5\~8 types of the movement every week.

combined imagery and movement control training

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Frequency of weight loading squatting training:
• \. At least 1 time/week, at least 1 year.
• LBP group:
• Present symptoms from T12 to the upper buttock
• Numerical rating scale (NRS) score ≥ 3/10
• Present episode of LBP lasting \> 24 hours
• LBPH group:
• Previous symptoms from T12 to the upper buttock
• Presently in symptom remission
• At least 2 episodes of LBP in the past 1 year, each lasting \> 24 hours, and following a period of at least 2\~4 weeks pain-free, OR at least 1 episode of LBP, each lasting 2 months.
• Asymptomatic controls:
• \. Without any history of LBP that limited their function or required treatment from a health professional in the past 2 years.

You may not qualify if:

• Inability to perform parallel-squat due to LBP
• Pain and ROM limitation in lower extremities
• LBP due to traumatic injury
• Previous spine surgery
• Spinal deformities: HIVD, spondylosis, scoliosis, spinal stenosis
• Neurological sign, and radiating pain to lower extremities
• Systematic disease: rheumatoid arthritis

Sponsors & Collaborators

• National Yang Ming Chiao Tung University: lead

Study Sites (1)

National Yang Ming University

Taipei, 11221, Taiwan

Location

Study Officials

• Yi-Fen Shih, PhD

  Department of Physical Therapy and Assistive Technology, National Yang-Ming Chiao-Tung University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: March 3, 2021
• First Posted: March 8, 2021
• Study Start: November 14, 2021
• Primary Completion: June 1, 2022
• Study Completion: June 1, 2022
• Last Updated: September 30, 2022

Record last verified: 2022-09

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)