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

NCT ID: NCT04786717

Last Updated: 2022-09-30

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 41 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-11-14
• Study Completion Date: 2022-06-01

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.

Detailed Description

Lumbopelvic movement control is crucial for movement stability during high 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 for those athletes who have recovered from LBP, some research data still showed that poor lumbopelvic control remained. 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. In the next part of the study, investigators will further investigate the intervention effect of motor control training on restoring the lumbopelvic movement control and squatting performance. Methods: This is an exploratory, cross-sectional, and intervention study. First part: investigators plan to recruit 15 participants between 20-40 years old, practicing loaded squatting for 1 day a week for at least one year, and having LBPH; 15 matched participants with current LBP, and 15 controls for the study. All subjects will undergo a series of squatting task (4 X 10 repetitions) and the kinematics and muscle activation of the rectus abdominus, transverse abdominus/internal obliqus, eractor spinae, and gluteus maximus will be recorded and analyzed using Noraxon myoRESEARCH (Noraxon U.S.A., Inc., Scottsdale, AZ, USA). A set of lumbopelvic movement control tests will also be conducted. The kinematics, muscle activation, and movement control test scores will be compared between groups. The second part, investigators plan to recruit 45 weight training practitioners with LBPH, randomized into three groups (core muscle training, movement control training, combined imagery and movement control training), and compare the effect of 4-week training on squatting performance and lumbopelvic movement control. Statistical analysis: Comparisons of all continuous variables are performed using the analysis of variance (ANOVA), and the intervention effect will be assessed using the repeated measures ANOVA. Chi squared test is used to examine the group differences in lumbopelvic movement control testing. The significance level is set at 0.05.

Conditions

Biomechanical Phenomena

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

core muscle training

Training the endurance of the core muscle.

Group Type: EXPERIMENTAL

core muscle training

Intervention Type: OTHER

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

movement control training

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

Group Type: EXPERIMENTAL

movement control training

Intervention Type: 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.

combined imagery and movement control training

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.

Group Type: EXPERIMENTAL

combined imagery and movement control training

Intervention Type: 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.

Interventions

core muscle training

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

Intervention Type: OTHER

movement control training

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.

Intervention Type: OTHER

combined imagery and movement control training

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.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

Frequency of weight loading squatting training:

1. At least 1 time/week, at least 1 year.

LBP group:

1. Present symptoms from T12 to the upper buttock

2. Numerical rating scale (NRS) score ≥ 3/10

3. Present episode of LBP lasting > 24 hours

LBPH group:

1. Previous symptoms from T12 to the upper buttock

2. Presently in symptom remission

3. 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:

1. Without any history of LBP that limited their function or required treatment from a health professional in the past 2 years.

Exclusion Criteria

1. Inability to perform parallel-squat due to LBP

2. Pain and ROM limitation in lower extremities

3. LBP due to traumatic injury

4. Previous spine surgery

5. Spinal deformities: HIVD, spondylosis, scoliosis, spinal stenosis

6. Neurological sign, and radiating pain to lower extremities

7. Systematic disease: rheumatoid arthritis

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Yang Ming Chiao Tung University

OTHER

Sponsor Role: lead

Responsible Party

Yi-Fen Shih

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Yi-Fen Shih, PhD

Role: STUDY_DIRECTOR

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

Locations

National Yang Ming University

Taipei, , Taiwan

Countries

Taiwan

Other Identifiers

YM110027E(1)

Identifier Type: -

Identifier Source: org_study_id