Lumbopelvic Movement Control: Effect of Injury History, and the Role of Cortical Control and Its Practical Application 1
Condition: Biomechanical Phenomena
Study type: Interventional

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.
    

Intervention name(s): core muscle training; movement control training; combined imagery and movement control training
Intervention type(s): Other; Other; Other
Intervention description(s): The intervention of this group will focus on training the endurance of the core muscle.; 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.; 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.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: back pain history; deep squat; movement control; cortical control; imagery training