Search Results (22)

Background: Impaired lumbopelvic control and inefficient bending mechanics are associated with low back pain and functional limitations. The Founder Exercise is a movement retraining strategy intended to promote hip-dominant movement, trunk control, and postural awareness during forward bending. However, empirical evidence examining movement performance following Founder Exercise instruction is limited. This study examined immediate pre-to-post differences in hip hinge kinematics and movement confidence surrounding a standardized Founder Exercise instructional session in healthy adults. Methods: A within-subject pretest-posttest design was used. Thirty-three healthy adults (72.7% female; mean age, 25.1 ± 2.9 years) completed assessments of foot orientation, sagittal-plane joint kinematics, and movement confidence before and after a single Founder Exercise instructional session. Joint kinematics were assessed using two-dimensional video analysis. Paired-samples t-tests or Wilcoxon signed-rank tests, as appropriate based on the distributions of the paired differences, were used to evaluate the kinematic outcomes. The exploratory summed confidence score and individual ordinal confidence items were evaluated using Wilcoxon signed-rank tests. Holm adjustments were applied separately to the 11 kinematic comparisons and the 10 individual-item comparisons. Results: Statistically significant immediate pre-to-post differences were observed in several kinematic variables. Hip flexion increased from 80.7° ± 18.1° at pretest to 104.6° ± 14.3° at posttest, shoulder flexion increased from 62.8° ± 23.9° to 145.3° ± 13.9°, and craniovertebral angle decreased from 25.7° ± 12.9° to 11.2° ± 10.0° (all p < 0.001). The summed score from the unvalidated, study-specific confidence scale was higher at posttest (median = 49.0, IQR = 40.0–50.0) than at pretest (median = 40.0, IQR = 36.0–50.0; p < 0.001). After Holm adjustment of the individual ordinal-item analyses, statistically significant differences remained for five of the 10 items; all confidence findings were considered exploratory. No statistically significant differences were observed in knee flexion or ankle motion after Holm adjustment. Conclusions: A brief Founder Exercise instructional session was followed by immediate differences in selected two-dimensional hip hinge angles and higher exploratory movement-confidence scores in healthy adults. These findings do not establish changes in lumbopelvic control, muscle activation, spinal loading, movement efficiency, or clinical outcomes. Controlled studies incorporating direct measures of lumbar and pelvic motion, muscle activity, external forces, and clinically relevant outcomes are needed before biomechanical or clinical conclusions can be drawn. Full article

Introduction: Chronic non-specific low back pain (CNLBP) is associated with altered lumbopelvic mechanics and impaired hip mobility. This study examined whether changes in pain-provoking hip flexion are associated with changes in low back pain and assessed agreement between inertial measurement units (IMUs) and a markerless motion capture system. Methods: Thirty-six patients with CNLBP completed a longitudinal repeated-measures rehabilitation protocol consisting of approximately 13 physiotherapy sessions over a period of up to 6 weeks. Active hip flexion was assessed in the symptomatic limb (the limb provoking lumbar pain). Hip flexion was recorded during the same movement trial using IMUs and a markerless system. Pain and disability were assessed using the Visual Analogue Scale and Oswestry Disability Index. Results: Improvements in hip flexion were moderately associated with pain reduction (markerless: r = −0.52; IMU: r = −0.57), with negligible associations with disability. Markerless and IMU measurements showed a strong correlation (r = 0.87), while Bland–Altman analysis showed consistent underestimation by the markerless system (bias = −3.67°). Conclusions: Symptom-specific hip mobility is associated with pain reduction in CNLBP, highlighting the role of lumbopelvic biomechanics. IMUs demonstrated higher consistency, while markerless systems offered a more accessible alternative for clinically meaningful movement assessment. Full article

Background: Low back pain (LBP) is a leading cause of disability, particularly in young adults. Decreased trunk endurance and altered movement patterns have been associated with lumbar symptoms and functional limitations; however, their concurrent relationships in active populations with minimal disability remain insufficiently characterized. This study was designed as an exploratory cross-sectional analytical study. Methods: The sample comprised 71 physically active university students (mean age, ~23 years; 79% men). Trunk endurance was assessed using the McGill isometric tests, and selected movement-pattern measures were obtained from four Functional Movement Screen (FMS) tasks focused on lumbopelvic control. The total FMS score was calculated, asymmetries were recorded in the Inline Lunge and Rotary Stability tasks, and lumbar-related disability was measured using the Oswestry Disability Index (ODI). Associations were analyzed using correlations and adjusted linear regression, and asymmetry-based comparisons were evaluated using non-parametric tests. Results: The average ODI was very low (approximately 4%), suggesting a floor effect. Greater trunk endurance was associated with lower ODI values, whereas the association between total FMS and ODI was weak and did not reach statistical significance in the adjusted model. Inline Lunge asymmetry was associated with higher ODI values, but this finding should be interpreted cautiously because of the very small subgroup size. Conclusions: In this physically active young adult sample, trunk endurance and selected movement-pattern measures provided complementary descriptive information on lumbar-related function; however, the observed associations were modest and should be interpreted cautiously. Full article

Faster lower-limb motion is closely related to soccer performance, but the contribution of lumbopelvic motion to achieving it remains unclear. This cross-sectional study aimed to examine whether faster lower-limb motion in soccer players was accompanied by greater lumbopelvic motion. Fifty-one male high school soccer players performed a thigh-raising (hip flexion) task from a standing position at low (approximately 100°/s) and high (approximately 400°/s) speeds. Lumbopelvic motion was measured at the lumbar spinous process (L3). Rotation (LBrot, transverse plane) and flexion–extension (LBf/e, sagittal plane) were derived from the angular velocity. Motions were compared between speeds using the Wilcoxon tests. In the dominant leg, both LBrot (10.2° vs. 8.1°, r = 0.62) and LBf/e (6.4° vs. 5.0°, r = 0.57) were greater at high speed. In the non-dominant leg, both LBrot (11.2° vs. 8.6°, r = 0.49) and LBf/e (6.9° vs. 5.3°, r = 0.62) were also greater at high speed. High-speed trials exhibited consistent movement patterns, whereas low-speed trials did not. These findings suggest that minimizing lumbopelvic motion may not always be optimal for achieving faster lower-limb motion, which may inform coaching and clinical practice regarding the appropriate degree of lumbopelvic motion during lower-limb tasks across movement speeds. Full article

Introduction: Manual therapists routinely evaluate changes in pain, movement, and function through clinical tests that support clinical reasoning. The Prone Hip Extension Test (PHET) is commonly used as a self-perturbation task to assess lumbopelvic control and hip motion patterns related to gait. Performing the PHET actively and passively may reveal how voluntary activation and passive structures influence joint kinematics and contribute to force production. This study aimed to compare active and passive PHET execution and investigate how initial (IP) and final hip positions (FP) correlate with lower-limb neuromuscular function. Methods: Seven healthy volunteers (24.3 ± 3.4 years; 173.1 ± 7.5 cm; 72.1 ± 9.5 kg) without musculoskeletal conditions participated. Hip kinematics were recorded using a 12-camera Qualisys Oqus system (200 Hz) with 22 reflective markers, processed in Qualisys Track Manager 2.13 and exported to Visual3D. Participants performed three PHET trials in both IP and FP, with mean an-gles considered for analysis. Knee isokinetic performance was assessed on a Biodex System 4 at 180°/s and 300°/s for flexion and extension. Results: Significant differences between active and passive PHET emerged in the FP for rotational movements bilaterally (p = 0.02) and in IP adduction/abduction for both hips (right p = 0.03; left p = 0.02). No side-to-side differences were observed. Passive FP of the right hip showed multiple significant correlations with isokinetic flexion and extension parameters at 180°/s and 300°/s, particularly with torque/body weight, acceleration and deceleration times, and agonist/antagonist ratios (ρ ranging from −0.86 to 0.90). Conclusions: Meaningful differences exist between active and passive PHET performance, especially in frontal-plane IP and rotational FP measures. Additionally, passive FP strongly correlates with several neuromuscular variables, suggesting that PHET kinematics may reflect lower-limb isokinetic function. Full article

Background and Objectives: Postpartum lumbopelvic pain (PLPP) is a common condition that negatively affects many women’s quality of life. We aimed to analyze the influence of emotional well-being, kinesiophobia, and sleep quality as predictors of PLPP during the first year postpartum. Materials and Methods: A cross-sectional study was conducted with 192 women in their first year postpartum. Validated questionnaires were administered to evaluate pain (Oswestry Disability Index, ODI), postpartum depression (PPD) (Edinburgh Postnatal Depression Scale, EPDS), sleep quality (Pittsburgh Sleep Quality Index, PSQI), and kinesiophobia (Tampa Scale of Kinesiophobia, TSK-11). Bivariate correlations and binary logistic regression were performed to identify predictors of PLPP. Results: Overall, 42.2% of participants reported lumbopelvic pain. The prevalence of postpartum depressive symptoms was 59.9%, and kinesiophobia was present in 30.7% of women with pain. Both PPD and kinesiophobia were significantly associated with the presence of PLPP (p < 0.001). In the multivariate model, depression was the main predictor (OR = 8.1), followed by kinesiophobia (OR = 3.6). Sleep quality was not an independent predictor but may be related to PLPP through indirect mechanisms. No significant associations were found with sociodemographic, obstetric, or lifestyle variables. Conclusions: PPD and kinesiophobia are key factors in the occurrence of PLPP, while sleep quality may act as a mediating variable. These findings highlight the need for postnatal interventions addressing emotional health and fear of movement to improve the prevention and management of lumbopelvic pain in this population. Full article

Background/Objectives: This paper analyzes the movement and relationships within the lumbopelvic–hip complex during forward trunk bending in young women with chronic low back pain. Methods: This study involved 24 women aged 20–24 with chronic low back pain. They were randomly divided into two equal-sized groups: Group 1 participated in a 12-week functional training program, and Group 2 was a control without any intervention. The level of perceived pain was assessed using the Visual Analog Scale (VAS). Qualitative motion analysis was performed using the BTS SMART-D system. Custom indicators were developed to evaluate the angular relationships and ranges of motion in the lumbar spine and the lumbopelvic–hip complex. The functional training program consisted of three sections: motor control and stabilization, muscle strengthening, and stretching exercises. Statistical analysis was performed using Statistica 13.3. Results: The therapy resulted in a reduction in perceived pain levels reported by the participants. There was a significant improvement in the quality of the forward trunk bending pattern in women who underwent functional training. Conclusions: Significant modifications in the quality, technique, and angular relationships within the lumbopelvic–hip complex were observed during the forward trunk bending pattern in women undergoing functional training. It has proven to be an effective form of therapy for chronic low back pain. Full article

Movement theory and the study of movement dysfunction mark a paradigm shift in the treatment of low back pain symptoms, the majority of which are mechanical in origin at the outset. Treating movement dysfunction centers around unified and consistent rehabilitation that defines proficient movement for the lumbopelvic spine. The purpose of this study is to document the improvement in pain and disability of 290 patients who underwent NeuroHAB Functional Movement Therapy to reverse their lumbopelvic movement dysfunction attributed to causing their back pain symptoms between 2019 and 2023. Oswestry Disability Index (ODI) scores were collected from each participant on three occasions: the first consultation, after a waiting period/pre-intervention, and after the eight-week intervention. A single-factor ANOVA of all three ODI data sets was conducted, along with supporting descriptive statistics. A post-hoc t-test pairwise comparison was conducted for accuracy. The average ODI 1 score (taken at the first consultation) was 15.26 ± 6.1% (CI: 14.3–16.2); ODI 2 (after a waiting period, before NeuroHAB) was 14.71 ± 6.0% (CI: 13.82–15.59); and ODI 3 (post-intervention) was 9.09 ± 8.6% (CI: 8.305–9.875). There was no significant change from ODI 1 to ODI 2 (between the consultation and waitlist control periods). However, a significant reduction between ODI 2 and ODI 3 was observed (pre- and post-intervention) (mean difference: 5.62, p ≤ 0.001), and a 40.41% reduction was observed between ODI 1 (the ODI score taken at the first consultation) and ODI 3 (the ODI score taken after NeuroHAB, post-intervention) (mean difference: 6.17, p ≤ 0.001). A 50% ODI reduction was reported in the “Crippled” category (mean difference 16.15, p ≤ 0.001). The inclusion of functional movement proficiency and stability in future guidelines is a necessary step towards meaningful improvement in epidemic levels of back pain-related clinical and economic morbidity. Full article

As an essential lower-back movement pattern, lumbo-pelvic rhythm (LPR) during forward trunk flexion and backward return has been investigated on a large scale. It has been suggested that abnormalities in lumbo-pelvic coordination are related to the risk of developing low back disorders. However, considerable differences in the approaches used to monitor LPR make it challenging to integrate findings from those investigations for future research. Therefore, the aim of this systematic review was to summarize the use of wearable technology for kinematic measurement with sensory biofeedback for LPR monitoring by assessing these technologies’ specific capabilities and biofeedback capacities and exploring their practical viability based on sensor outcomes. The review was developed following the PRISMA guidelines, and the risk of bias was analyzed using the PREDro and STROBE scales. PubMed, Web of Science, Scopus, and IEEEXPLORE databases were searched for relevant studies, initially returning a total of 528 articles. Finally, we included eight articles featuring wearable devices with audio or vibration biofeedback. Differences in protocols and limitations were also observed. This novel study presents a review of wearable tracking devices for LPR motion-mediated biofeedback for the purpose of correcting lower back posture. More research is needed to determine the long-term effectiveness of these devices, as well as their most appropriate corresponding methodologies. Full article

Highlighting the crucial role of monitoring and quantifying lumbopelvic rhythm for spinal curvature, the Ergotex IMU, a portable, lightweight, cost-effective, and energy-efficient technology, has been specifically designed for the pelvic and lumbar area. This study investigates the concurrent validity of the Ergotex device in measuring sagittal pelvic tilt angle. We utilized an observational, repeated measures design with healthy adult males (mean age: 39.3 ± 7.6 y, body mass: 82.2 ± 13.0 kg, body height: 179 ± 8 cm), comparing Ergotex with a 3D optical tracking system. Participants performed pelvic tilt movements in anterior, neutral, and posterior conditions. Statistical analysis included paired samples t-tests, Bland–Altman plots, and regression analysis. The findings show minimal systematic error (0.08° overall) and high agreement between the Ergotex and optical tracking, with most data points falling within limits of agreement of Bland–Altman plots (around ±2°). Significant differences were observed only in the anterior condition (0.35°, p < 0.05), with trivial effect sizes (ES = 0.08), indicating that these differences may not be clinically meaningful. The high Pearson’s correlation coefficients across conditions underscore a robust linear relationship between devices (r > 0.9 for all conditions). Regression analysis showed a standard error of estimate (SEE) of 1.1° with small effect (standardized SEE < 0.26 for all conditions), meaning that the expected average deviation from the true value is around 1°. These findings validate the Ergotex as an effective, portable, and cost-efficient tool for assessing sagittal pelvic tilt, with practical implications in clinical and sports settings where traditional methods might be impractical or costly. Full article

Dental professionals are exposed to significant unavoidable physical stress, and theoretical ergonomic recommendations for a sitting workplace are inapplicable in many dental activities. Work-related musculoskeletal disorders (WMSDs) represent a serious health problem among dental professionals (prevalence: 64–93%), showing involvement of 34–60% for the low back and 15–25% for the hips. Muscle stress; prolonged sitting; forward bending and twisting of the torso and head; unbalanced working postures with asymmetrical weight on the hips and uneven shoulders; and others are inevitable for dental professionals. Therefore, the approach for the prevention and treatment of WMSDs must be therapeutic and compensatory. This project was conceived to provide a Yoga protocol for dental professionals to prevent or treat WMSDs from a preventive medicine perspective, and it would represent a Yoga-based guideline for the self-cure and prevention of musculoskeletal problems. Methods: Specific Yoga positions (āsana, such as Virāsana, Virabhadrāsana, Garudāsana, Utkatāsana, Trikonāsana, Anuvittāsana, Chakrāsana, Uttanāsana, Pashimottanāsana) have been selected, elaborated on and adapted to be practiced in a dental office using a dental stool or the dental office walls or a dental unit chair. The protocol is specifically devised for dental professionals (dentists, dental hygienists and dental assistants) and targeted for the low back, hips and legs (including knees and ankles). The protocol includes Visranta Karaka Sthiti (supported positions) in sitting (Upavistha Sthiti) and standing (Utthistha Sthiti) positions, twisting/torsions (Parivrtta), flexions/forward bend positions (Pashima) and extensions/arching (Purva) for musculo-articular system decompression and mobilization. Results: Over 60 Yogāsana—specifically ideated for back detensioning and mobilization, lumbar lordosis restoration, trunk side elongation, hip release and leg stretches and decontraction—are shown and described. The paper provides a meticulous description for each position, including the detailed movement, recommendations and mistakes to avoid, and the breathing pattern (breath control) in all the breath-driven movements (āsana in vinyāsa). An exhaustive analysis of posture-related disorders affecting the lower body among dental professionals is reported, including low-back pain, hip pain and disorders, piriformis syndrome and quadratus femoris dysfunction (gluteal pain), iliopsoas syndrome, multifidus disorders, femoroacetabular and ischiofemoral impingement, spinopelvic mobility, lumbopelvic rhythm, impairment syndromes, lower crossed syndrome, leg pain, knee pain and ankle disorders. Conclusions: A detailed guideline of āsana for low-back decompression, hip joint destress, piriformis and gluteal muscle release, lumbar lordosis recovery and a spinopelvic mobility increase has been elaborated on. The designed Yogāsana protocol represents a powerful tool for dental professionals to provide relief to retracted stiff muscles and unbalanced musculoskeletal structures in the lower body. Full article

Spinal manipulation (SM) is a common manual therapy technique; however, there is limited knowledge regarding the coordination of hand and foot forces during SM. This study investigated the biomechanics of force transmission and generation in the hands and feet of a single therapist who performed pelvic SM on 45 healthy subjects. Two force plates were used to measure the ground reaction forces (GRF) from the feet, and one controller was used to measure the contact hand forces (CHF). The results showed that foot force preceded hand force and that the foot and hand exhibited opposing patterns of force variation. The CHF peak was positively correlated with the CH preload maximum and minimum forces and negatively correlated with the GRF run-down. These findings suggested that the therapist used a coordinated strategy of avoiding weight support with the feet and supporting the weight with the hands to amplify the thrust force. This study provides new insights into the biomechanics of SM and has implications for teaching, motor learning, and safety. Full article

Spine movement is a daily activity that can indicate health status changes, including low back pain (LBP) problems. Repetitious and continuous movement on the spine and incorrect postures during daily functional activities may lead to the potential development and persistence of LBP problems. Therefore, monitoring of posture and movement is essential when designing LBP interventions. Typically, LBP diagnosis is facilitated by monitoring upper body posture and movement impairments, particularly during functional activities using body motion sensors. This study presents a fully wireless multi-sensor cluster system to monitor spine movements. The study suggests an attempt to develop a new method to monitor the lumbopelvic movements of interest selectively. In addition, the research employs a custom-designed robotic lumbar spine simulator to generate the ideal lumbopelvic posture and movements for reference sensor data. The mechanical motion templates provide an automated sensor pattern recognition mechanism for diagnosing the LBP. Full article

(1) Background: The aim of the present study was to evaluate and to detect neuromuscular deficiencies in static and dynamic tests among federated youth basketball players. (2) Methods: Cross-sectional study with 778 basketball players. Specific tests and trials were conducted to evaluate members of teams from several clubs in male and female from under 12 (U12) to under 17 (U17) categories. The evaluations consisted of static physical measurements and dynamic measurements. (3) Results: 575 players were included in this study. A total of 95% of participants are unable to keep their ankle stable in monopodial loading; 86% present dynamic lower extremity valgus with statistically significant differences between categories (p = 0.004); 94% are unable to keep the pelvis stable when performing a single-leg squat; 93% are unable to keep their trunk stable when performing the same movement. During landing, 96% present dynamic lower extremity valgus. The thighs of 92% do not reach parallel (peak of jump). (4) Conclusions: The most frequent neuromuscular deficits in federated youth basketball players are related to instability, the most frequent being ankle instability, followed by lumbo-pelvic instability, dynamic postural instability and dynamic knee valgus. Deficits in jumping/landing technique are also very frequent in all the items analyzed (jumping, landing and plyometrics). The performed tests, which mostly showed a poor performance by the sample, can be indicative of injury probability. Full article

Low back pain (LBP) obviously reduces the quality of life but is also the world’s leading cause of years lived with disability. Alterations in motor response and changes in movement patterns are expected in LBP patients when compared to healthy people. Such changes in dynamics may be assessed by the nonlinear analysis of kinematical time series recorded from one patient’s motion. Since sample entropy (SampEn) has emerged as a relevant index measuring the complexity of a given time series, we propose the development of a clinical test based on SampEn of a time series recorded by a wearable inertial measurement unit for repeated bending and returns (b and r) of the trunk. Twenty-three healthy participants were asked to perform, in random order, 50 repetitions of this movement by touching a stool and another 50 repetitions by touching a box on the floor. The angular amplitude of the b and r movement and the sample entropy of the three components of the angular velocity and acceleration were computed. We showed that the repetitive b and r “touch the stool” test could indeed be the basis of a clinical test for the evaluation of low-back-pain patients, with an optimal duration of 70 s, acceptable in daily clinical practice. Full article