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Objectives: To investigate the accuracy of visual assessments made by physical therapists of lumbo-pelvic movements during the squat and deadlift and how much movement is considered injurious., Design: Quantitative Cross-sectional., Participants: 14 powerlifters, 10 Olympic weightlifters and six physical therapists., Setting: The lifters were recorded simultaneously by video and an inertial measurement unit (IMU) system while performing squats and deadlifts. The physical therapists assessed the videos and rated whether specific lumbo-pelvic movements were visible during the lifts and whether the movement amplitude was considered injurious., Main Outcome Measures: The nominal visual assessments, if there was a movement and if it was considered injurious, were compared to the degrees of movement attained from the IMU system., Results: During the squat, a posterior pelvic tilt of ≥34° was required to visually detect the movement. For other lumbo-pelvic movements, there was no significant difference in the amount of movement between those who were assessed as moving or not moving their lumbo-pelvic area, nor was there a difference in movement amplitude between those who were assessed as having an increased risk of injury or not., Conclusions: Physical therapists did not consistently detect lumbo-pelvic movements during squats and deadlifts when performed by competitive lifters., Competing Interests: Declaration of competing interest None declared., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: To observe isolated lumbopelvic-hip complex (LPHC) stability and muscle activity using the Seated Trunk Control Test (STCT) and evaluate the relationship between LPHC stability and 2-dimensional kinematics during movements., Design: Descriptive Study., Setting: Laboratory., Participants: 22 healthy participants (12F, 10M, 23.5 ± 3.1yrs, 173.0 ± 9.0 cm, 76.1 ± 10.7 kg)., Main Outcome Measure(s): Time to first error and number of errors, and muscle activity of the abdominals, erector spinae, and gluteus medius were recorded during the STCT. Lateral trunk movement, hip and knee frontal plane projection angles, hip and knee flexion during single leg squats and single leg drop vertical jumps were measured. Pearson r correlations were calculated among STCT performance, muscle activity, and 2-dimensional kinematics., Results: Number of errors was moderately correlated to hip and knee flexion during single leg squatting (r = 0.456-0.649, p < 0.05). Number of errors and time to first error were moderately correlated to knee-frontal plane projection angle and hip flexion respectively during single leg drop vertical jumping (r = 0.463-0.515, p < 0.05)., Conclusions: Decreased LPHC stability relates to decreased sagittal plane motion during single leg squatting and increased frontal plane motion during single leg drop vertical jumping. Pairing the STCT with 2-dimensional kinematic analysis can demonstrate influence of LPHC function., Competing Interests: Declaration of competing interest None., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: To quantify the cross-sectional area (CSA) of lumbar dorsal root ganglion (DRG) by magnetic resonance imaging (MRI) and investigate the relationship between the cross-sectional area (CSA) of DRGs and sensory nerve action potentials (SNAP) amplitude in the lower extremities., Methods: Thirty-eight DRGs (20 L5 roots and 18 S1 roots) in 10 adult subjects were reviewed retrospectively. The CSA of the DRG was calculated from MR images of the coronal plane. SNAP amplitudes of the superficial peroneal nerve and sural nerve were corresponded to L5 and S1-DRGs., Results: The mean CSA of DRGs was 66.6 ± 13.7 mm 2 in L5-DRG and 79.5 ± 14.3 mm 2 in S1-DRG. The means of SNAP amplitudes were 19.6 ± 6.2 μV in superficial peroneal nerves and 24.6 ± 9.0 μV in sural nerves. In multivariate regression analysis, the CSA of DRGs had a significant correlation with SNAP amplitude., Conclusion: The area of L5 and S1-DRGs may be positively correlated with SNAP amplitude., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Although diaphragmatic myofascial release techniques are widely used in clinical practice, few studies have evaluated the simultaneous acute effects of these techniques on the respiratory and musculoskeletal systems., Objective: To evaluate the immediate effects of diaphragmatic myofascial release in sedentary women on the posterior chain muscle flexibility; lumbar spine range of motion; respiratory muscle strength; and chest wall mobility., Design: A randomized placebo-controlled trial with concealed allocation, intention-to-treat analysis, and blinding of assessors and participants., Participants: Seventy-five sedentary women aged between 18 and 35 years., Intervention: The sample was randomly allocated into one of two groups; the experimental group received two diaphragmatic myofascial release techniques in a single session, and the control group received two placebo techniques following the same regimen., Outcomes Measures: The primary outcome was chest wall mobility, which was analyzed using cirtometry. The secondary outcomes were flexibility, lumbar spine range of motion, and respiratory muscle strength. Outcomes were measured before and immediately after treatment., Results: The manual diaphragm release techniques significantly improved chest wall mobility immediately after intervention, with a between-group difference of 0.61 cm (95% CI, 0.12-1.1) for the axillary region, 0.49 cm (95% CI, 0.03-0.94) for the xiphoid region, and 1.44 (95% CI, 0.88-2.00) for the basal region. The techniques also significantly improved the posterior chain muscle flexibility, with a between-group difference of 5.80 cm (95% CI, 1.69-9.90). All movements except flexion of the lumbar spine significantly increased. The effects on respiratory muscle strength were non-significant., Conclusion: The diaphragmatic myofascial release techniques improve chest wall mobility, posterior chain muscle flexibility, and some movements of the lumbar spine in sedentary women. These techniques could be considered in the management of people with reduced chest wall and lumbar mobility., Trial Registration: NCT03065283., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objective: To compare lumbopelvic stability between dancers and non-dancers by assessing lumbopelvic motor control, abdominal muscles automatic-activation, lumbar range of motion and dynamic stability., Design: Cross-sectional., Setting: University/superior-dance-conservatory., Participants: Twenty-two dancers and 22 non-dancers., Main Outcome Measurements: The active straight leg raise test (ASLR) was used to test lumbopelvic motor control with pressure feedback (mmHg). Transversus, rectus anterior and internal oblique muscles thicknesses were measured at rest and ASLR. For dynamic stability, the modified Star Excursion Balance Test (mSEBT) was employed., Results: Significant differences were revealed in lumbopelvic motor control between groups (p < 0.001). Abdominal muscles automatic-activation showed no differences between the groups. There were significant differences in the mSEBT for most of the test's directions, with dancers performing better than the non-dancers (p < 0.05). For the dancers, there were positive associations between motor control and dynamic stability, and between abdominal muscle thickness and mSEBT. For non-dancers, the rectus anterior activation correlated with the mSEBT., Conclusions: The dancers had better lumbopelvic motor control, dynamic stability and lumbar movements except in terms of extension, as compared with non-dancers. Therefore, this novel study could stimulate a new line of research to determine the influence of these outcomes on sports performance, prevention and injury rehabilitation., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: Measuring thoracic spine mobility can be of interest to competitive swimmers as it has been associated with shoulder girdle function and scapular position in subjects with and without shoulder pain. At present, no reliability data of thoracic spine mobility measurements are available in the swimming population. This study aims to evaluate the within-session intra- and interrater reliability of the "lumbar-locked rotation test" for thoracic spine rotation in competitive swimmers aged 10 to 18 years. This reliability study is part of a larger prospective cohort study investigating potential risk factors for the development of shoulder pain in competitive swimmers., Design: Within-session, intra- and inter-rater reliability., Setting: Competitive swimming clubs in Belgium., Participants: 21 competitive swimmers., Main Outcome Measures: Intra- and inter-rater reliability of the lumbar-locked thoracic rotation test., Results: Intraclass correlation coefficients (ICCs) ranged from 0.91 (95% CI 0.78 to 0.96) to 0.96 (0.89-0.98) for intra-rater reliability. Results for inter-rater reliability ranged from 0.89 (0.72-0.95) to 0.86 (0.65-0.94) respectively for right and left thoracic rotation., Conclusion: Results suggest good to excellent reliability of the lumbar-locked thoracic rotation test, indicating this test can be used reliably in clinical practice., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The aims of this pilot study were to verify which muscle strength tests better explain bone mineral content (BMC) of the femoral neck and lumbar spine and to develop predictive equations to estimate femoral neck and lumbar spine BMC. Twenty-nine subjects aged 56-76 years old (12 women and 17 men) participated in the study. Femoral neck and lumbar spine BMC was evaluated by Dual X-ray absorptiometry (DXA). Muscle strength measurements included maximal isometric voluntary contractions of knee extensors and flexors, vertical jump, 5-repetition maximum of the leg press (5-RM LP ) and seated leg curl (5-RM LC ), and handgrip strength. Women presented a moderate to strong correlation between femoral neck BMC and 5-RM LP (r = 0.819), 5-RM LC (r = 0.879), knee extensors peak torque (r = 0.699), and handgrip strength (r = 0.663), as well as between lumbar spine BMC and the 5-RM LP test (r = 0.845) and manual grip strength (r = 0.699). For females, the 5-RM LP and 5-RM LC tests most fully explained femoral neck BMC (R 2  = 0.859) and the 5-RM LP test and body mass explained lumbar spine density (R 2  = 0.757) for females. Men did not present correlations between BMC and strength variables. For females, the 5-RM LP and 5-RM LC variables explained the variations of femoral neck BMC, while 5-RM LP and body mass explained lumbar spine BMC. Future studies should evaluate a larger sample size and prioritize the strength tests with a greater predictive capacity., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objectives: To investigate the changes in lumbar kinematic and paraspinal muscle activation before, during, and after a 4-week minimalist running training., Design: Prospective cohort study., Setting: University research laboratory., Participants: Seventeen habitually shod recreational runners who run 10-50 km per week., Main Outcome Measures: During stance phases of running, sagittal lumbar kinematics was recorded using an electrogoniometer, and activities of the lumbar paraspinal muscles were assessed by electromyography. Runners were asked to run at a prescribed speed (3.1 m/s) and a self-selected speed., Results: For the 3.1 m/s running speed, significant differences were found in the calculated mean lumbar posture (p = 0.001) during the stance phase, including a more extended lumbar posture after minimalist running training. A significant reduction in the contralateral lumbar paraspinal muscle activation was also observed (p = 0.039). For the preferred running speed, similar findings of a more extended lumbar posture (p = 0.002) and a reduction in contralateral lumbar paraspinal muscle activation (p = 0.047) were observed., Conclusion: A 4-week minimalist running training program produced significant changes in lumbar biomechanics during running. Specifically, runners adopted a more extended lumbar posture and reduced lumbar paraspinal muscle activation. These findings may have clinical implications for treating individuals with running-related lower back pain., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objectives: To investigate the effects of elastic therapeutic tape when applied overlaying the lumbar extensors on different measures of muscle performance, compared to a placebo taping technique and a no-tape control., Design: A cross-sectional experimental study., Setting: A biomechanics laboratory., Participants: Twenty one participants received three taping conditions in a randomised order: elastic therapeutic tape, a placebo tape and a no-tape control. Peak torque, the time taken to reach peak torque and peak velocity were measured using an isokinetic dynamometer., Main Outcome Measures: Concentric lumbar extension peak torque at 60°/s, time taken to reach peak torque and peak velocity was measured using an isokinetic dynamometer. Friedman's test and post-hoc Wilcoxon signed-rank test were used to determine the statistical differences between the three taping conditions. Level of signicance was set at 0.05.fi., Results: A statistically significant improvement in peak lumbar extensor torque was observed when comparing elastic therapeutic tape with the no-tape control (p < 0.05). However, there was no significant differences in time taken to reach peak torque and peak velocity (p > 0.05)., Conclusions: Results demonstrate that the application of elastic therapeutic tape overlaying the primary lumbar extensors significantly improves the maximal lumbar extension peak torque in healthy, asymptomatic adults., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objective: The aim of this work was to analyze muscle strength in Pilates novices who used the Reformer equipment during twelve training sessions., Methods: Twenty-four healthy young female volunteers, who were non-smokers and did not exercise regularly, were split into a control group (mean age 28 ± 4 years and BMI 24.55 ± 3.21 kg/m 2 ) and a training group (mean age 29 ± 4 years and BMI 22.69 ± 2.87 kgm 2 ). The data were checked for normality using the Kolmogorov-Smirnov test, and were then analyzed using the t-test (p < 0.05)., Results: After the training sessions, there were statistically significant differences between the groups for the scapular stabilizer muscles (p = 0.0263) and the lumbar muscles (p = 0.0001). For the scapular stabilizers, the initial/final values were 14.69 ± 2.80/14.79 ± 2.89 (control group) and 15.99 ± 3.54/17.44 ± 2.88 (Pilates group). The corresponding values for the lumbar muscles were 53.83 ± 11.66/53.28 ± 11.14 (control group) and 54.75 ± 10.27/64.80 ± 10.20 (Pilates group)., Conclusion: After twelve sessions of Pilates with the Reformer equipment, there were improvements in lumbar extensor and scapular stabilizer strength. Several benefits are reported by practitioners of Pilates, but until now, there has been limited scientific evidence of the improvement of strength in the trunk and limbs after application of the technique., (Published by Elsevier Ltd.)

Due to new research results in the past few years, interest in the fascia of the human body has increased. Dysfunctions of the fascia are indicated by various symptoms, amongst others, musculoskeletal pain. As a result stronger focus has been put on researching therapeutic approaches in this area. The main aim of this study was to investigate the effect of Foam Roll exercises on the mobility of the thoracolumbar fascia (TLF). Study has been conducted in a randomized and controlled trial which sampled 38 healthy athletic active men and women. The subjects were randomly assigned to a Foam Roll Group (FMG), a Placebo Group (PG) and a Control Group (CG). Depending on the assigned group the volunteers were either instructed to do exercises with the Foam Roll, received a pseudo treatment with the Foam Roll or received no treatment. A total of three measurements were carried out. The most important field of research was the mobility of the TLF, which was determined using a sonographic assessment. In addition the lumbar flexion and the mechanosensivity of relevant muscles were determined. After the intervention, the FMG showed an average increase of 1.7915 mm for the mobility of the TLF (p < 0.001/d = 0.756). In contrast, only an average improvement of 0.1681 mm (p = 0.397) was shown in the PG, while the CG showed a slight improvement of 0.0139 mm (p = 0.861). However, no significant changes were observed with regard to the lumbar flexion and mechanosensivity of the treated muscles. Thus, evidence is that the use of Foam Roll exercises significantly improves the mobility of the thoracolumbar fascia in a healthy young population., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Changes in thoracolumbar fascial thickness, structure and shear strain are associated with lower back pain (LBP). Therapeutic taping techniques such as Kinesio-Taping (KT) are increasingly used to treat LBP, albeit with variable effects and unclear mechanisms. However, evidence for quantifying how treatment effects in vivo fascia properties is inadequate. We therefore aimed to explore taping mechanisms using an in vivo ultrasound measurement., Methods: Thoracolumbar ultrasound videos of known orientations and positions were taken from 12 asymptomatic participants (8 males and 4 females, aged 22.9 ± 3.59) while performing velocity-guided lumbar flexion with and without KT applied. An automated algorithm using cross-correlation to track contiguous tissue layers across sequential frames in the sagittal plane, was developed and applied to two movements of each subject in each taping condition. Differences of inter-tissue movements and paracutaneous translation at tissue boundaries were compared., Results: Significant reduction in the mean movement of subcutaneous tissue during lumbar flexion before and after taping was found. There was no difference in other observed tissue layers. Tissue paracutaneous translations at three boundaries were significantly reduced during lumbar flexion when KT was applied (skin-subcutaneous: 0.25 mm, p < 0.01; subcutaneous-perimuscular tissue: 0.5 mm, p = 0.02; and perimuscular-muscle: 0.46, p = 0.05). No overall reduction in lumbar flexion was found (p = 0.10)., Conclusions: KT reduced subcutaneous inter-tissue movement and paracutaneous translation in the superficial thoracolumbar fascia during lumbar flexion, and the relationship of such difference to symptomatic change merits exploration. Combining ultrasound data with muscle activation information may be useful to reveal potential mechanisms of therapeutic taping in patients with LBP., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objective: To determine reproducibility of a battery of clinical tests for evaluating lumbopelvic motor control (LMC)., Design: Test-retest design., Participants: Fifty healthy subjects., Outcome Measures: Two raters independently examined performance on 12 clinical tests for evaluating LMC. All tests were scored on a seven-point scale, based on qualitative and quantitative performance. Subjects were measured twice, with a two week interval between examinations. Intra- and inter-rater reproducibility of each test were determined using intraclass correlation coefficients (ICCs), standard error of measurement, smallest detectable change (SDC) and limits of agreement., Results: Reliability of the tests ranged from poor to excellent. Intra-rater ICCs ranged from 0.00 to 0.82, whereas inter-rater ICCs varied from 0.00 to 0.96. SDC values were smallest for supine leg raising, bent knee fall out, prone bridge and unilateral prone bridge (<2 points)., Conclusion: This study shows limited reproducibility of a battery of 12 clinical tests for the evaluation of LMC in a healthy population. Supine leg raising, bent knee fall out, prone bridge, and unilateral prone bridge showed the smallest measurement errors. The other 8 tests were found to have large measurement errors. Based on these results, dichotomization of the rating method might be considered in order to improve reproducibility values., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Stress Urinary Incontinence (SUI) is a common condition and can cause social isolation and decreased quality of life. The literature demonstrates that perineal exercises are effective in promoting urinary continence and lumbar stability. This uncontrolled (group) pilot study, using a pre-test-post-test design, investigated whether a weekly session of Holistic Gymnastics(®) conducted during a one-year period, could change outcomes in a group of twenty women diagnosed with SUI. In the first and last evaluation, the subjects underwent a clinical examination and were asked to complete two questionnaires, one regarding quality of life and the other about lumbar disability. Improvement in the quality of life was observed in nine out of ten domains. There was also an improvement in lumbar disability. These results suggest that a program with therapeutic exercises can be effective in controlling urinary incontinence and improve the quality of life and lumbar disability in woman with SUI., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Purpose: According to the conventional arch model of the pelvis, stability of the sacroiliac joints may require a predominance of form and force closure mechanisms: the greater the vertical shear force at the sacroiliac joints, the greater the reliance on self-bracing by horizontally or obliquely oriented muscles (such as the internal oblique). But what happens to the arch model when a person stands on one leg? In such cases, the pelvis no longer has imposts, leaving both the arch, and the arch model theory, without support. Do lumbopelvic muscle activation patterns in one-legged stances under load suggest compatibility with a different model? This study compares lumbopelvic muscle activation patterns in two-legged and one-legged stances in response to four levels of graded trunk loading in order to further our understanding the stabilization of the sacroiliac joints., Methods: Thirty male subjects experienced four levels of trunk loading (0%, 5%, 10% and 15% of body weight) by holding a bucket at one side, at three conditions: 1) two-legged standing with the bucket in the dominant hand, 2) ipsilateral loading: one-legged standing with the bucket in the dominant hand while using the same-side leg, and 3) contralateral loading: one-legged standing using the same leg used in condition 2, but with the bucket in the non-dominant hand. During these tasks, EMG signals from eight lumbopelvic muscles were collected. ANOVA with repeated design was performed on normalized EMG's to test the main effect of load and condition, and interaction effects of load by condition., Results: Latissimus dorsi and erector spinae muscles showed an antagonistic pattern of activity toward the direction of load which may suggest these muscles as lateral trunk stabilizers. Internal oblique muscles showed a co-activation pattern with increasing task demand, which may function to increase lumbopelvic stability (P < 0.05). No unilateral pattern of the internal obliques was observed during all trials., Conclusions: Our results suggest that the lumbopelvic region uses a similar strategy for load transfer in both double and single leg support positions which is not compatible with the arch analogy. Our findings are more consistent with a suspensory system (wire-spoke wheel model). If our proposed model holds true, the pelvic ring can only be integrated by adjusting tension in the spokes and by preserving rim integrity or continuity. Thus, we propose that in order to restore tension integrity throughout the pelvic ring, efforts to unlock restrictions, muscular correction of positional faults and lumbopelvic or even respiratory exercises following sacroiliac joint dysfunctions must be taken into consideration. Our hypothetical model may initiate thinking and act as a guide to future work based on a biomechanical approach to the problem of sacroiliac joint dysfunction., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Unlabelled: Decreased voluntary wheel running has recently been proposed as a preclinical pain measure for inflammatory pain, but whether this reflects pain evoked by use of the affected limbs is unknown. To assess the role of inflammation site as a determinant of this measure, complete Freund's adjuvant (CFA), formalin, or equivolume vehicle was subcutaneously injected into the plantar surface of the hind paws (bilateral) or L1 dorsum dermatome (leaving paws unaffected) of male Sprague Dawley rats. CFA-induced hind paw mechanical allodynia (P < .001) did not correlate with reduced voluntary wheel running. Intraplantar formalin did not attenuate voluntary running, despite eliciting robust licking/writhing/flinching behavior and hind paw mechanical allodynia (P < .001). Subcutaneous L1 dorsum dermatome formalin, but not CFA, induced licking/writhing/flinching behavior (P < .001), but neither induced hind paw mechanical allodynia or attenuated voluntary running. That voluntary running is decreased by hind paw CFA, but not by L1 dorsum CFA, implies that the behavior is a measure of CFA-induced pain evoked by use of the affected limbs rather than supraspinal pain processing that is independent of inflammation site. Furthermore, the results suggest that interpretation of voluntary wheel running data cannot simply be explained by correlation with mechanical allodynia., Perspective: Whether decreased voluntary running is dependent on inflammation site is unknown. We show that intraplantar, but not L1 dorsum, CFA suppressed voluntary running and formalin-induced licking/writhing/flinching behavior but had no effect on voluntary running. These data suggest that suppressed voluntary running by CFA likely reflects pain evoked by use of the affected limbs., (Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.)

The aim of the current study was to investigate, using a controlled, repeated measure design, the neurophysiological responses following an acute bout of muscle energy technique (MET). Transcranial magnetic stimulation elicited motor evoked potentials using a 110 mm double cone coil placed over the motor area of the brain, while Hoffman reflexes (H-reflex) were measured from the posterior tibial nerve using electrical stimulation. Responses were measured using surface electromyography electrodes placed over the lateral head of the gastrocnemius muscle in 12 asymptomatic volunteers. An MET aimed at the lumbosacral joint was performed bilaterally. Data were collected pre-intervention, after a control intervention, and after the MET intervention. A significant increase was found in evoked potential silent period (SP) duration (F2,22 = 7.64; p = 0.03) over time following MET, but not the control intervention. A significant decrease was found in H-reflex (F1.3,14.4 = 13.8; p = 0.01) over time following the MET intervention. MET applied to the lumbosacral joint produced a significant decrease in corticospinal and spinal reflex excitability, suggesting overall decreased motor excitability., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The aim of this study was to determine the kinematic differences between movements on a new exercise device (EX) that promotes a stable trunk over a moving, unstable base of support, and overground walking (OW). Sixteen male participants performed EX and OW trials while their movements were tracked using a 3D motion capture system. Trunk and pelvis range of motion (ROM) were similar between EX and OW in the sagittal and frontal planes, and reduced for EX in the transverse plane. The pelvis was tilted anteriorly, on average, by about 16° in EX compared to OW. Hip and knee ROM were reduced in EX compared to OW. The exercise device appears to promote similar or reduced lumbopelvic motion, compared to walking, which could contribute to more tonic activity of the local lumbopelvic musculature., (Copyright © 2013 Elsevier Ltd. All rights reserved.)