Research Roundup: February 2020

 

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Differences in Hip Strength, Gluteus Medius Activity, and Trunk, Pelvis, and Lower Limb Biomechanics During Different Functional Tasks.

Komsak Sinsurin, Raul Valldecabres & Jim Richards (2020) An exploration of the differences in hip strength, gluteus medius activity, and trunk, pelvis, and lower-limb biomechanics during different functional tasks, International Biomechanics, 7:1, 35-43, DOI: 10.1080/23335432.2020.1728381

This small study of healthy volunteers explored differences in the coronal biomechanics of the trunk, pelvis, hip, and knee joints, as well as gluteus medius muscle activity during walking and step down tasks.

 

Key Points 
  • Functional impairment of glute med can lead to excessive lateral trunk bending, which is often observed in people with knee problems.
  • During gait, the following was observed:
    • Increased contralateral pelvic drop and pelvic obliquity excursion, compared to step-down tasks.
    • Increased lateral bending versus step-down tasks.
    • Significantly greater knee adduction, compared to step-down tasks.
    • Peak hip adduction moments were greater than in step-down tasks.
  • Greater glute med activity was recorded during step-down tasks, compared with level walking.
  • Greater stability and balance are required for step-down tasks, than for gait, which is why less lateral trunk bending and pelvic obliquity should be observed in healthy adults. 
  • Loading on the medial knee increases with step-down tasks, and increases as the height of the step increases.
  • Glute med activity is greater in the first 50% of stance phase in gait, and greater in the second 50% stance phase during step-down tasks.
  • The hip has greater control in the frontal plane than the knee joint.
  • A value of 1.4 Nm/kg is posited as a threshold to determine hip abductor weakness that requires rehabilitation.

 

Clinically: Pilates in Practice
  • Functional increases in glute med strength need to be trained in a variety of activities, rather than static single leg loading.
  • Because of the increased task demands during step-down for glute med strength, adding these exercises in early will likely lead to carry-over into gait: step ups and step downs on the Wunda Chair.
  • Work on hip/knee adduction/abduction through flexion/extension in alternative positions: sleeper on the Reformer; bend/stretch with feet in straps (Reformer) or leg springs (Cadillac). 
  • Using alternative spring load positions on the Trapeze Table can challenge adduction/abduction during hip/knee flexion exercises. 
  • Trunk lateral bending is also influenced by oblique strength, so increasing oblique strength will decrease the load requirements on the glute med, and can thus decrease load on the medial knee: side leg kick; side lift.

 

 

Choice of Practice-Task Order Enhances Golf Skill Learning

An, Jongseong, Rebecca Lewthwaite, Seungmin Lee, and Gabriele Wulf. "Choice of practice-task order enhances golf skill learning." Psychology of Sport and Exercise 50 (2020), 101737. doi:10.1016/j.psychsport.2020.101737.

This small study observed the motor learning effects of allowing small choices by individuals.

 

Key Points 
  • Autonomy is a key motivational factor in the OPTIMAL theory of motor learning.1
    • Enhances expectancies for performance.
    • Increases task focus.
    • Enhanced processing of task errors.
    • Greater neuro-cognitive engagement.
  • Lack of autonomy can be stressful and therefore negatively impact performance.
    • Stress also takes focus away from task performance.

  • In the "choice group", participants selected the order of their practice, which were seemingly small choices.
  • Having a choice enhanced learning, compared to the group that did not choose the order of their practice.
  • Positive affect and confidence were also higher in the choice group.
  • Confidence and positive affect were higher in the choice group as well.
  • The autonomy-supportive condition, in which learners were able to choose the order of methods, enhanced learning of the task.

  • Relatively small choices can facilitate performance and learning.

 

Clinically: Pilates in Practice
  •  Small choices can affect learning and retention, so when designing a rehabilitation program, ask clients which order they want to perform tasks.
  • Give choices in studio, and for home exercise programs.
  • Don't be constrained by choreography and flow.
  • Encourage communication and a sense of autonomy with regards to program design.

 

1. Wulf, G., & Lewthwaite, R. (2016). Optimizing Performance through Intrinsic Motivation and Attention for Learning: The OPTIMAL theory of motor learning. Psychonomic Bulletin & Review, 23, 1382-1414.

 

 

Is T9-11 the True Thoracolumbar Transition Zone ?

Murphy, J. et al. “Is T9-11 the true thoracolumbar transition zone?” Journal of clinical orthopaedics and trauma 11 5 (2020): 891-895.

The authors of this retrospective review study hypothesised that the true thoracolumbar junction is "at T10-11; the point of transition from floating to false ribs resulting in increased mobility at T10-11."

 

Key Points
  • For clinical purposes, the thoracolumbar transition zone is considered to be T11-L2 for due to the variation in the location of the caudal end of the cord, as well as the biomechanical weakness of false ribs at T11.
  • Articulation between thoracic vertebrae and ribs plays an active role in stability and load-bearing of the thoracic spine, along with the ligaments and facet joint capsules.
  • The lumbar spine is relatively more mobile. 

  • Mean age in the patient cohort was 25.3 years; 300 MRIs were reviewed.
  • Disc degeneration was most frequent and most severe at T8-9 and T9-10, followed by T10-11.
  • T9-11 demonstrated the highest mean load gradient across two discs, in flexion, sitting, and standing.

  • The authors conclude that imaging and assessment for low back pain needs to include higher spinal segments into the low thoracic spine, up to and including T8-9.

 

Clinically: Pilates in Practice
  • A relatively immobile upper thoracic spine will download forces and load to lower thoracic segments, therefore work to maintain and improve upper- and mid-thoracic mobility: prone pulling straps on the long box; Eagle prone on the Cadillac; dart; oblique curl ups at the Tower; seated chest curls at the Wunda Chair. 
  • Build strength through the lower thoracic spine through upper transverse, oblique, and mid multifidus training: Teaser; assisted roll ups on the Cadillac; Side Bend; down stretch on the Reformer; rotated swan on the Wunda Chair.
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