Lumbopelvic Movement Control: Effect of Injury History, and the Role of Cortical Control and Its Practical Application 2
Study Details
Study Description
Brief Summary
Impaired motor control is a risk factor for groin pain in athletes participating multidirectional sports, which leads to decreased hip muscle strength and range of motion. Injured athletes with adductor-related groin pain who trained with motor control strategy would return to sports activities earlier than those who only trained with muscle strengthening. Previous studies have demonstrated the benefits of motor imagery with action observation (AOMI) on motor control and muscle strength in athletes, which also revealed that AOMI combined with physical training (AOMI-PT) can lead to faster recovery of motor control than physical training (PT) alone. Besides, monitoring the neurophysiological changes of brain activation and the functional connection to the peripheral muscular activation after training helps to understanding the mechanisms on the training effects.
Therefore, the aim of this study is to compare (1) the cortical control mechanisms between 3 types of motor control training strategies; and (2) the effects of 3 types of motor control training on motor control performance in athletes with long-standing adductor-related groin pain.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Impaired motor control is a risk factor for groin pain in athletes participating multidirectional sports, which leads to decreased hip muscle strength and range of motion. Injured athletes with adductor-related groin pain who trained with motor control strategy would return to sports activities earlier than those who only trained with muscle strengthening. Previous studies have demonstrated the benefits of motor imagery with action observation (AOMI) on motor control and muscle strength in athletes, which also revealed that AOMI combined with physical training (AOMI-PT) can lead to faster recovery of motor control than physical training (PT) alone. Besides, monitoring the neurophysiological changes of brain activation and the functional connection to the peripheral muscular activation after training helps to understanding the mechanisms on the training effects.
Therefore, the aim of this study is to compare (1) the cortical control mechanisms between 3 types of motor control training strategies; and (2) the effects of 3 types of motor control training on motor control performance in athletes with long-standing adductor-related groin pain.
The investigators will recruit 45 athletes with hip adductors-related groin pain, and compare the effect of three types of motor control training (physical training, motor imagery with action observation, physical training combined motor imagery with action observation) on Y balance test performance, cortico-muscular coherence (CMC), and event-related desynchronization (ERD, α band) and event-related synchronization (ERS, β band). Due to only few studies about the issue, we will recruit extra 15 healthy athletes for pilot study to investigate the reliability of the research measurements and refine the protocols.
Chi squared test is used to examine the group differences in motor imagery ability and severity of groin pain. The repeated measures analysis of variance (ANOVA) will be used to compare the intervention effect on motor control test and CMC between groups. Independent t-test and paired t-test will also be used to compare the neurophysiological changes on brain activation during training. The alpha level was set at 0.05.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: motor imagery with action observation The subjects will perform the exercises mentally for 3 sets with video, 10 reps for 1 set. |
Other: motor imagery with action observation
Hip adduction with elastic band, sliding, and Copenhagen adduction exercise will be instructed to the subjects with video, and they will practice each exercise for 3 times in physical to familiarize with the program. Then, the subjects will mentally simulate each exercise with video 10 times for a set, 3 sets totally. With 1 min interval between each sets, it will take approximately 6 minutes to finish each movement. It will also take 5 min for resting between each program.
|
| Experimental: physical training The subjects will perform the exercise physically for 3 sets with supervision of investigator, 10 reps for 1 set. |
Other: physical training
Hip adduction with elastic band, sliding, and Copenhagen adduction exercise will be instructed to the subjects with video, and they will practice each exercise for 3 times in physical to familiarize with the program. Then, the subjects will physically perform each exercise with supervision of investigator 10 times for a set, 3 sets totally. With 1 min interval between each sets, it will take approximately 6 minutes to finish each movement. It will also take 5 min for resting between each program.
|
| Experimental: combine physical training and motor imagery with action observation The subjects will perform the exercise mentally with video for 1 set and physically with supervision of investigator for 2 sets, 3 sets totally, 10 reps for 1 set. |
Other: combine physical training and motor imagery with action observation
Hip adduction with elastic band, sliding, and Copenhagen adduction exercise will be instructed to the subjects with video, and they will practice each exercise for 3 times in physical to familiarize with the program. Then, each exercises will be mentally simulated with video for a set and physically performed with supervision of investigator for 2 sets, 10 times for each set and 3 sets totally. With 1 min interval between each sets, it will take approximately 6 minutes to finish each movement. It will also take 5 min for resting between each program.
|
Outcome Measures
Primary Outcome Measures
- Motor control ability [pre-intervention]
The subjects will stand on Y-balance kit and reach their legs alternatively to anterior, posterolateral and posteromedial direction following the tempo with 5 sec forward and 5 sec backward, with dominant leg first, in sequence. The subjects will practice 4 times first to familiarize the test procedure, then the final three measurements were collected and normalized with subjects' lower limb length for statistical analysis.
- Cortico-muscular coherence [pre-intervention]
The investigator will place 64-leads EEG on subjects' head and bipolar surface EMG(MP150, BIONOMADIX; BIOPAC, Systems, Inc.) on subjects' internal oblique abdominis, gluteus medius and adductor longus. The investigator will collect the signals and process them into cortico-muscular coherence as the functional connection between cortex and muscle during motor control task.
- Event-related synchronization or desynchronization [immediately after the intervention]
The investigator will collect the EEG signals from subjects during the first and the last set of intervention, and the signals will be band-pass filtered (3-60 Hz) and processed with power spectrum density analysis to calculate frequency power at alpha (4-12 Hz) and beta (13-30 Hz) bands. The training data will be normalized with resting values to determine event-related synchronization or desynchronization, which represent the cortical activation changes during physical or imagery training.
- Motor control ability [immediately after the intervention]
The subjects will stand on Y-balance kit and reach their legs alternatively to anterior, posterolateral and posteromedial direction following the tempo with 5 sec forward and 5 sec backward, with dominant leg first, in sequence. The subjects will practice 4 times first to familiarize the test procedure, then the final three measurements were collected and normalized with subjects' lower limb length for statistical analysis.
- Cortico-muscular coherence [immediately after the intervention]
The investigator will place 64-leads EEG on subjects' head and bipolar surface EMG(MP150, BIONOMADIX; BIOPAC, Systems, Inc.) on subjects' internal oblique abdominis, gluteus medius and adductor longus. The investigator will collect the signals and process them into cortico-muscular coherence as the functional connection between cortex and muscle during motor control task.
Eligibility Criteria
Criteria
Pilot study (n=15)
Inclusion Criteria:
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athletics specialize in projects with excessive hip range of motion, e.g. soccer, track and fields, hockey, etc.
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training for at least 2.5 hrs/week
Exclusion Criteria:
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any symptoms or surgery history on lumbar or lower extremities
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any neurological disease affects on motor imagery ability
Main research (n=45)
Inclusion Criteria:
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athletics specialize in projects with excessive hip range of motion, e.g. soccer, track and fields, hockey, etc.
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groin pain on dominant leg with tenderness on hip adductor
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symptoms lasting for 2 to 6 month and related to training or sports. The training maintained for at least 2.5 hrs/week.
Exclusion Criteria:
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sign of hip-related groin pain (hip flexion <115°, hip internal rotation <15°)
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sign of other soft tissue related groin pain (tenderness on psoas, pubis, inguinal)
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surgery history on lumbar or lower extremities
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any symptoms on lumbar, knee, or ankle
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any neurological disease affects on motor imagery ability
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | National Yang Ming University | Taipei | Taiwan | 11221 |
Sponsors and Collaborators
- National Yang Ming University
Investigators
- Study Director: Yi-Fen Shih, Ph.D, Department of Physical Therapy and Assistive Technology, National Yang-Ming Chiao-Tung University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- YM110027E(2)