Hamstring Injury Clinical Trial
Official title:
The Impact of Unilateral Lumbar Mobilisations on Hamstring Strength, sEMG Activity and Failure Point of the Hamstring Nordic Exercise
The aim of this study is to build on previous published work, which has indicated lumbar
mobilisations have the ability to increase hamstring extensibility and decrease muscle
activity. The primary aim of this project is investigate if lumbar mobilisations have an
affect on the Nordic Hamstring exercise.
Aim: To investigate the short-term effects L4 and L5 Unilateral Posterior Anterior (UPA)
Mobilisations on the lumbar spine on the Nordic Hamstring Exercise. Measures will include
hamstring peak torque, sEMG activity and knee angle at first rapid change in angular
acceleration.
The study aims to investigate the short-term effects L4 and L5 Unilateral Posterior Anterior
(UPA) Mobilisations on the lumbar spine on the Nordic Hamstring Exercise. Measures will
include hamstring peak torque, sEMG activity and knee angle at first rapid change in angular
acceleration.
Recruitment will take place via flyer and email. All testing will take place in the biodex
laboratory at Teesside University. Due to the nature of the cross-over design participants
will attend the laboratory six times, two for familiarisation sessions, and a remaining four
testing session all 72 hours apart. The four testing sessions will contain two control and
two intervention sessions attended in a randomised order.
Following recruitment participants will be required to complete a medical questionnaire and
sign a consent form following reading the participant information sheet.
The Nordic Hamstring exercise will be performed by each participant across the intervention
and control conditions. Participants will watch a video of a subject completing the Nordic
exercise program. They will also receive the following verbal instructions:
'Players start in a kneeling position, with the torso from the knees upward held rigid and
straight. The training partner ensures that the player's feet are in contact with the ground
throughout the exercise by applying pressure to the player's heels/lower legs. The player
then lowers his upper body to the ground, as slowly as possible to maximize loading in the
eccentric phase. Hands and arms are used to break his forward fall and to push him back up
after the chest has touched the ground, to minimize loading in the concentric phase (Mjølsne
et al, 2005; Petersen et al, 2011).
All participants will be given the opportunity to ask questions as necessary.
A standardised warm-up on an ergometer will be undertaken for 5 minutes at 60% max resting
heart rate.
Following the warm-up all participants will familiarise themselves with the Nordic Hamstring
Exercise on the hamstring solo equipment. They will be able to practice up to 8 repetitions.
This data will be used for a reliability study to understand the number of required
repetitions for the main study.
During testing participants will attend the same laboratory for the remaining four testing
sessions. They will receive two intervention sessions, when the lumbar mobilisations will be
performed, and two when the control is administered.
The same warm-up undertaken during the familiarisation session will be undertaken prior to
testing.
The intervention will consist of unilateral lumbar mobilisations at the L4 and L5 level in a
Posterior Anterior direction. The side of the mobilisation will be determined by dominate leg
- considered the kicking foot. The mobilisations will be administered by a physiotherapist
with at least 12 years clinical experience. Teksan grip sensors will be worn by the
physiotherapist to calculate the force applied to the participant. Grade three mobilisations
will be applied for a one minute period three times at both L4 and L5 level.
For the control, all participants will be laid prone on the medical plinth in the same
position will no mobilisations administered.
Outcome measures will include collection of hamstring peak force data, sEMG of the Biceps
Femoris, 3D Motion capture data and subjective likert scale of exercise difficulty.
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