The reliability, variability and minimal detectable change of multiplanar isometric trunk strength testing using a fixed digital dynamometer.

Trunk strength plays a vital role in athletic performance, rehabilitation and general health, however, current assessment methods are expensive, non-portable or unreliable. This study aimed to investigate the within- and between-session reliability, variability, standard error of measurement and minimal detectable change (MDC) of trunk strength in the sagittal (flexion and extension) and frontal planes (left and right lateral flexion) using a fixed digital dynamometer. Eighteen participants (ten men and eight women) attended two sessions separated by 7 days. Participants were fitted with a trunk harness which was secured to an immovable base via a digital dynamometer. Three maximal voluntary isometric contractions were completed across four positions (prone, supine, left-side recumbent and right-side recumbent, respectively) on a glute-hamstring raise machine. All positions demonstrated excellent reliability and low variability within session (ICC: 0.95-0.98; CV: 5-7%) and between sessions (ICC: 0.98-0.99; CV: 4-6%), across all positions. The between-session MDC ranged from 8% (prone) to 13% (right-side recumbent), translating to absolute values between 2.9 and 3.2 kg across all positions. Maximal isometric force testing using a fixed digital dynamometer provides reliable measurements of multiplanar trunk strength, providing a practical method for use in clinical practice.

INVESTIGATION OF OPTIMAL LUMBAR SPINE POSTURE DURING A SIMULATED LANDING TASK IN ELITE GYMNASTS.

BACKGROUND: Lumbar spine range of motion (ROM) is a key component of injury prevention and normative data has not currently been determined for an elite gymnastics population. In current clinical practice, it is commonplace to measure sagittal spinal alignment, during 'high-load, low-dynamic' control tasks, subjectively, while also only considering the lumbar spine as a single segment. PURPOSE: To develop normative data for total lumbar spine ROM and ROM during a simulated landing task (SLT) in an elite gymnastics population, evaluating findings in the context of the existing biomechanical literature. STUDY DESIGN: Repeated measures, cross sectional design. METHODS: Lumbar spine and low lumbar spine (LLS) ROM during a SLT were measured, using the Dorsa Vi: Vi Perform™ system in asymptomatic male and female elite gymnasts. Values for maximal ROM and LLS angle during the SLT were collated and descriptively analyzed. Lumbar ROM and posture was evaluated in relation to the current biomechanical literature and a proposed Conceptual Compressive Lumbar Load Distribution Model (CCLLDM). RESULTS: Thirty elite gymnasts (15 male, 15 female), participated. Participants were members of the British Artistic Gymnastics elite senior and junior training program and were between the ages of 16 to 30 years. Mean (SD) maximal lumbar spinal movements were 64.23˚ (6.34 °) for flexion and 25.89˚ (11.14 °) for extension. During the SLT, participants performed lumbar spine flexion of 15.96˚ (8.80 °), when considered as a single segment. When considering the lumbar spine as a two segment model the LLS position during the SLT was towards end range anterior pelvic tilt, suggesting LLS extension. CONCLUSION: These data provide a baseline for asymptomatic lumbar spine movements in an elite gymnastics population and provides insight into upper and lower lumbar spine movement during a SLT. The data and newly developed CCLLDM provide clinicians with a potential framework to identify sporting skills that may be associated with increased spinal tissue load. LEVELS OF EVIDENCE: 3b.

Validity of the Digital Inclinometer and iPhone When Measuring Thoracic Spine Rotation.

CONTEXT: Spinal axial rotation is required for many functional and sporting activities. Eighty percent of axial rotation occurs in the thoracic spine. Existing measures of thoracic spine rotation commonly involve laboratory equipment, use a seated position, and include lumbar motion. A simple performance-based outcome measure would allow clinicians to evaluate isolated thoracic spine rotation. Currently, no valid measure exists. OBJECTIVE: To explore the criterion and concurrent validity of a digital inclinometer (DI) and iPhone Clinometer app (iPhone) for measuring thoracic spine rotation using the heel-sit position. DESIGN: Controlled laboratory study. SETTING: University laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 23 asymptomatic healthy participants (14 men, 9 women; age = 25.82 ± 4.28 years, height = 170.26 ± 8.01 cm, mass = 67.50 ± 9.46 kg, body mass index = 23.26 ± 2.79) were recruited from a student population. MAIN OUTCOME MEASURE(S): We took DI and iPhone measurements of thoracic spine rotation in the heel-sit position concurrently with dual-motion analysis (laboratory measure) and ultrasound imaging of the underlying bony tissue motion (reference standard). To determine the criterion and concurrent validity, we used the Pearson product moment correlation coefficient (r, 2 tailed) and Bland-Altman plots. RESULTS: The DI (r = 0.88, P < .001) and iPhone (r = 0.88, P < .001) demonstrated strong criterion validity. Both also had strong concurrent validity (r = 0.98, P < .001). Bland-Altman plots illustrated mean differences of 5.82° (95% confidence interval [CI] = 20.37°, -8.73°) and 4.94° (95% CI = 19.23°, -9.35°) between the DI and iPhone, respectively, and the reference standard and 0.87° (95% CI = 6.79°, -5.05°) between the DI and iPhone. CONCLUSIONS: The DI and iPhone provided valid measures of thoracic spine rotation in the heel-sit position. Both can be used in clinical practice to assess thoracic spine rotation, which may be valuable when evaluating thoracic dysfunction.