The Effects of a One-Time Core Stability Intervention Protocol on Anterior Pelvic Tilt During a Dynamic Overhead Squat
Creators: name: Dyer, Katherine Elizabeth
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2014

description: Context: Injury at the lower extremity is related to core stability as well as Lumbo-Pelvic-Hip-Complex and lower extremity kinematics, including increased anterior pelvic tilt, trunk flexion, hip adduction, hip internal rotation, and knee abduction. Increases in these kinematic variables are known to occur in tandem with Lumbar Lordosis, resultant Lower Back Pain (LBP), and other injury at the lower extremity-- particularly at the knee by increasing risk for ACL sprain. There is no clear empirical research drawing a cause and effect relationship between a core stability program and altered lower extremity kinematics, even though there is ample anecdotal evidence to speak to the connection. Objective: To determine if a core training protocol has an impact on anterior pelvic tilt, trunk flexion, hip internal rotation, hip adduction, and knee abduction during an Overhead Squat Assessment and if such a Core Stability Intervention Protocol (CSIP) could be an effective clinical tool in the treatment of LBP as well as other implications it might have for injury reduction at the lower extremity. Design: Paired samples t-test. Setting: Research laboratory. Participants: Thirty-eight (38) healthy participants (20 females, 18 males) assigned to the same treatment protocol (n = 38; age = 21.13 +/- 1.06 years; height = 171.97 +/- 8.77 cm; mass = 68.56 +/- 11.25 kg). Intervention: All participants performed 5 Overhead Squats, the CSIP, and then repeated the 5 Overhead Squats again. The Core Stability Intervention Protocol included eight (8) exercises with four (4) performed in supine and four (4) performed in prone position, each for 2 sets of 5 repetitions. The exercises were focused on engaging the Transverse Abdominis while also utilizing the extensors, flexors, and rotators of the hip, trunk, and neck. Main Outcome Measures: The Motion Monitor (MM) Flock of Birds electromagnetic motion analysis system was used to quantify joint kinematics through joint dis-placement (DSP) values for (Anterior Pelvic Tilt, Trunk Flexion, Hip Internal Rotation, Hip Adduction, Knee Abduction) during the squat tasks. All measures were performed pre- and post- Intervention. Five (5) paired samples t-tests were performed with a 95% confidence interval (P = .05). Results: No significant results were found with Anterior Pelvic Tilt (t = 0.754, P = 0.455, pre-test = 24.89 +/- 6.63, post-test = 24.33 +/- 6.85) Hip Internal Rotation (t = 1.789, P = 0.082, pre-test = 11.36 +/- 9.53, post-test = 9.69 +/- 7.90), or Knee Abduction (t = 1.014, P = 0.317, pre-test = -0.95 +/- 3.21, post-test = -1.37 +/- 2.99). Significant results were found with Trunk Flexion (t = 2.81, P = 0.008, pre-test = 29.99 +/- 11.77, post-test = 27.6 +/- 10.76) and Hip Adduction (t= 10.951, P < 0.001, pre-test = 1.12 +/- 3.0, post-test = -7.92 +/- 4.82). Trunk Flexion had weak clinical significance (d = 0.21) and Hip Adduction was clinically significant (d = 2.31). Conclusions: While there was no significant change in Anterior Pelvic Tilt, Hip Internal Rotation, or Knee Abduction, there was significantly less Trunk Flexion and Hip Adduction when comparing pre to post treatment displacement means. Trunk Flexion did not show enough of a change to be clinically significant, while the decrease in Hip Adduction was clinically significant. This has huge implications for rehabilitation programs with the goal of trying to lower hip adduction which is correlated to an increased risk of injury at the lower extremity, particularly at the knee with the ACL injury. There is now empirical evidence to say that the CSIP works as an intervention in altering lower extremity kinematics in the laboratory setting. Future research should examine the real world clinical effect of a multiple-session, longer term CSIP on more involved dynamic movements (jump-landing, cutting, running, etc.).