- freely available
J. Funct. Morphol. Kinesiol. 2017, 2(3), 29; https://doi.org/10.3390/jfmk2030029
2. Materials and Methods
4.1. Strength and/or Flexibility of Trunk, Spine and Hips
4.2. Unilateral Trunk Flexion/Extension Strength Imbalances
4.3. Hip and Trunk Side-to-side Strength Asymmetries
Conflicts of Interest
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|Topic||Authors||Main Aims||Sample||Outcome Measures||Main Results|
|Strength and/or Flexibility levels of Trunk, Spine and Hips||Bayramoglu et al. 2001 *||To compare women with and without CLBP on obesity, spine flexibility, levels of pain, and trunk strength. In addition, to test the association between these variables, and to investigate the effect of a follow-up strength training on the CLBP group.||45 women (25 with CLBP and 20 without CLBP).||- BMI.|
- Isokinetic trunk flexion-extension PT.
|Women with CLBP had lower flexor and extensor trunk muscle peak torques, greater BMI and lower spine ROM. Strength training resulted in greater flexor and extensor trunk muscle strength, and reduced trunk flexor/extensor ratio (60˚/sec only). No correlation between levels of pain and trunk muscle strength or spinal ROM.|
|Renkawitz et al. 2006||To examine the relationship between LBP, clinical symptoms, neuromuscular imbalance and trunk strength extension before and after exercise program.||82 amateur tennis players with (19 females and 27 males) and without (12 females and 24 males) LBP.||- Trunk extension isometric MVC|
- Spine mobility and flexibility.
|Although there was a significant correlation between LBP and neuromuscular imbalance of erector spinae, no clear associations between LBP, trunk extension strength, and clinical testings were found before and after the exercise program.|
|Grosdent et al. 2015 **||To compare tennis players with and without LBP on trunk strength and flexibility.||60 male elite tennis players with (38) and without (22) LBP.||- Trunk extension, rotation, flexion and lateral-flexion isometric MVC|
- Pelvic and lumbar flexion mobility.
|No significant difference between tennis players with and without LBP on trunk strength and spine flexibility.|
|Nadler et al. 1998||To investigate if leg length discrepancy, lower extremity laxity and hip flexor tightness were predictors of LBP.||257 college athletes (170 males and 87 females).||- Hip flexors flexibility.|
- Leg length discrepancy.
- Ligamentous stability.
- Overuse syndrome.
|Although ligamentous laxity or overuse were found to be potential predictors of LBP, leg length discrepancy and hip inflexibility were not associated to future LBP episodes.|
|Lee et al. 1999 *||To evaluate trunk strength weakness as a risk factor of LBP in a 5-year prospective study.||30 male and 37 female young adults with no history of LBP.||- Isokinetic trunk flexion-extension and rotation PT.||Participants with history of LBP in the following 5 years (8 male and 10 female) did not differ from the non-LBP incidence group on trunk flexion-extension and rotation PT. However, women with LBP had lower extension/flexion ratio compared to women without LBP.|
|Arab et al. 2010||To investigate hip abductors strength and ITB tightness in subjects with LBP.||300 (100 with LBP + ITB; 100 with LBP only; 100 without LBP).||- Hip abduction isometric MVC|
- Length of ITB test.
|No significant difference in hip strength levels between LBP individuals with and without ITB. However, subjects without LBP had greater hip abductor strength compared to subjects with LBP.|
|Carpes et al. 2008||To evaluate the effects of a short training program on trunk strength and stability of subjects with CLBP.||6 subjects with one year of nonspecific LBP.||- Qualitative pain grade test.|
- Low back stabilization tests
- Low back and pelvis kinematics.
- Body balance
- Strength and stability of low back and pelvis complex.
|Participants with CLBP improved 3-D kinematics, body balance, pelvis inclination, and low back flexion ROM. Qualitative pain grade test indicated pain decreased and pelvic strength increased.|
|Unilateral Trunk Flexion/Extension strength Imbalances||Shirado et al. 1995||To compare trunk extensors and flexors strength between different assessment positions of the isokinetic dynamometer, and flexor/extensor strength ratios between subjects with and without CLBP.||50 healthy subjects (25 males and 25 females) and 48 patients with CLBP (26 males and 22 females).||- Isokinetic concentric and eccentric trunk flexion-extension PT.||Trunk flexion-extension PT was greater in the siting posture with feet against the floor. Flexion/extension and eccentric/concentric strength ratios were greater in subjects with CLBP at almost all isokinetic speeds compared to non-CLBP.|
|Oddsson et al. 2003||To compare lumbar muscle strength, neuromuscular fatigue, and muscle imbalances between subjects with and without CLBP.||34 male adults (20 healthy and 14 CLBP patients).||- Trunk extension isometric MVC.|
- EMG over L1, L2 and L5 levels of lower back
- Subjective pain tests.
|CLBP patients showed less fatigue and did not produce a “true” maximal torque. Muscle imbalances were present in both groups, although greater in CLBP when averaged. Patients with CLBP had altered lumbar back EMG.|
|Correia et al. 2016||To compare trunk endurance time, muscle activation and fatigue in tennis players with and without low back pain.||35 (28 males and 7 females) national level tennis players.||- Trunk flexion, extension and side bridge isometric endurance strength.|
- History of LBP incidence EMG of rectus abdominis, external oblique, iliocostalis lumborum and longuissimus thoracis.
|Players with LBP had lower muscle activation of trunk extensor muscles, less abdominal endurance, and less trunk extensor co-contraction patterns.|
|Suzuki et al. 1983||To determine if trunk levels of strength and fatigue are related to low-back-pain syndrome, and the association between trunk muscle strength and lumbar lordosis.||140 (90 patients with persistent LBP and 40 healthy free pain adults) participants.||- Isokinetic trunk flexion-extension PT.||Patients with CLBP had lower muscle strength and greater muscle fatigue of trunk flexors than extensors. In addition, trunk strength and fatigue were negatively associated to lumbar lordosis.|
|Hip and Trunk side-to-side strength asymmetries||Nadler et al. 2000||To investigate the association between LBP and previous LE on hip abduction and extension side-to-side strength asymmetries of Division I collegiate athletes.||210 (140 males and 70 females) Division I collegiate athletes.||- Hip abduction and extension isometric mean MVC.|
- History of LBP incidence.
|Only female athletes with LBP or LE presented greater side-to-side hip extensors asymmetry compared to athletes without LBP or LE. There was no side-to-side asymmetry difference between male tennis players with and without LBP or LE.|
|Nadler et al. 2001||To investigate if athletes with hip side-to-side strength asymmetry would be more likely to need treatment of LBP over the subsequent year on Division I collegiate athletes.||163 (100 males and 63 females) Division I collegiate athletes.||- Hip abduction and extension isometric MVC |
- History of LBP incidence.
|Side to side hip extensor strength asymmetry was predictive of LBP treatment over the ensuing year for female athletes. No association was found between hip abductor side-to-side asymmetry in women or hip abductor and hip extensor side-to-side asymmetries and prediction of LBP in male athletes.|
|Nadler et al. 2002||To investigate the effects of core-strengthening training on LBP incidence on Division I collegiate athletes.||1st year: 166 (101 males and 63 females); 2nd year: 236 (162 males and 74 females); 3rd year: 225 (170 males and 55 females) Division I collegiate athletes.||- Hip extension isometric mean MVC.|
- Monitoring of LBP incidence.
|Although core strengthening training reduced hip extensor side-to-side asymmetry, there was no effect of on LBP incidence reduction.|
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