Background: Diastasis rectus abdominis (DRA) is a separation of the rectus abdominis during and after pregnancy. Physiotherapy is the first choice of intervention but it is unclear which type of training is the most effective.  Purpose: The aim of the study was twofold. The aim of the first part was to evaluate the effects of training the rectus abdominis in women with DRA postpartum. The aim of the second part was to describe how these women experienced this training program.  Method: Three women were included in the study. Firstly a single subject experimental design with A-B design was implemented. Inter-recti distance (IRD), activity impairment, muscle strength and endurance, pain and aesthetics was measured. Secondly a qualitative design was carried out to describe the participants' experiences. It was implemented with interviews analyzed with qualitative content analysis.  Results: Two of the participants got significantly decreased IRD. One of the participants got significantly improved in the activity impairment ´getting up from lying down with and without a weight´. There was no improvement in the other outcome measures. Two categories comprised by two subcategories each were identified by the qualitative analysis: positive and motivating experiences of the training and experiences of positive results of the training. The categories reveal positive experiences of the training design and exercises as well as becoming stronger and gaining trust to use the body again as the main result after the training period. Conclusion: An individually designed training program focusing on the rectus abdominis muscle could be effective for reducing the IRD and getting stronger when getting up from lying down in women with DRA 2-12 months postpartum. Training the rectus abdominis with regular supervision was experienced positively and motivating after pregnancy. The most important experienced result was becoming stronger and gaining increased trust in the body.

Bakgrund: Urininkontinens och rektusdiastas är vanliga besvär postpartum och kan kvarstå upp till flera år efter förlossningen. Träning för bäckenbottenmuskulaturen och magmuskulaturen är vanliga rekommendationer för dessa besvär, men evidensen kring om det har positiva effekter är inte samstämmig i olika studier. Fysioterapi ingår i nuläget inte i vårdkedjan efter förlossning. Detta trots att fysioterapeuter kan ha en roll postpartum med råd kring träning och aktivitet.        Syfte: Syftet med denna litteraturöversikt var att undersöka om fysioterapeutiskt ledd träning kan reducera problematik för kvinnor postpartum gällande urinläckage samt rektusdiastas jämfört med sedvanlig vård eller självständig träning. Metod: Detta är en litteraturstudie som granskat totalt 8 stycken artiklar. De har kvalitetsgranskats via PEDro-scale. Sökningar har gjorts i 3 olika databaser. Relevanta artiklar valdes ut via titel och abstract.  Resultat: Övervägande del av artiklarna kring träning för bäckenbottenmuskulaturen för att reducera urininkontinens visar på att träning har en positiv effekt första tiden postpartum men att det inte finns några signifikanta resultat på att träning har en långsiktig effekt. Sammanställning av artiklarna kring träning för rektusdiastas visar inte på en signifikant förbättring av rektusdiastas.  Diskussion: Tidigare forskning visar på ungefär samma resultat som granskas i denna litteraturstudie. Otillräcklig och lågkvalitativ forskning gör att evidensen inte är tillräckligt stark för att dra nya slutsatser.  Konklusion: Det behövs mer forskning kring hur fysioterapeutiskt ledd träning kan reducera problematik för kvinnor postpartum med urininkontinens samt rektusdiastas, kortsiktigt och långsiktigt.

Bakgrund: Rektusdiastas är en delning av musculus rectus abdominis och är vanligt hos kvinnor som fött barn. Det kan ge besvär som instabilitet i bålen samt smärta i ländrygg och bäcken, men även oro och rädsla. Rektusdiastsen påverkar den vardagliga fysiska aktiviteten hos patientgruppen och fysioterapi rekommenderas i första hand som behandling. Evidensen är dock begränsad och svenska kliniska riktlinjer finns inte i dagsläget. Syfte: Syftet är att utforska fysioterapeuters erfarenheter av att arbeta med mödrar som har besvär av rektusdiastas efter förlossning till att få en mer fungerande fysisk aktiv vardag. Metod: En kvalitativ intervjustudie valdes där informanterna rekryterades genom ett ändamålsenligt urval samt snöbollsurval. En semistrukturerad intervjuguide nyttjades och datan analyserades genom en manifest kvalitativ innehållsanalys med en induktiv ansats. Resultat: Behandling för mödrar med besvär av rektusdiastas är främst att ge information och träning. För att hjälpa mödrarna med problematiska vardagsaktiviteter ges råd och strategier för att klara av dessa. Fysioterapeuter önskar kliniska riktlinjer och att kunskapen undervisas om redan på grundutbildningen. Slutsats: Behandling utifrån biopsykosociala faktorer är viktigt för patientgruppen. Fysioterapeuter kan hjälpa patientgruppen och det är viktigt att kunskapen sprids så alla får den vård de har rätt till. / Background: Diastasis recti is a split of the musculus rectus abdominis and is common among women who have given birth. It can lead to problems such as instability in the abdomen and pain in the lumbar region and pelvis, but also anxiety and fear. Diastasis recti affects the daily physical activity among this patient group, and to fix this physiotherapy is recommended. The evidence is limited and there are currently no Swedish clinical guidelines. Purpose: The purpose is to explore physiotherapists experience of working with mothers that are bothered by diastasis recti after childbirth to have a more functional physical activity everyday life. Method: A qualitative interview study where the informants were recruited through a purposive sampling and snowball sampling. The interviews were based on a semi-structured interview guide and analyzed through a manifest qualitative content analysis with an inductive approach. Result: Treatment for mothers with diastasis recti was mainly to provide information and exercises. To help mothers with problematic everyday activities, advice and strategies were given. Physiotherapist’s desire clinical guidelines and that knowledge about diastasis recti is a subject for education at university. Conclusion: Treatment based on biopsychosocial factors is important for this patient group. Physiotherapists can help this patient group and it is important that knowledge about the subject is spread so that everyone can receive the care they are entitled to.

Bakgrund: Ospecifik ländryggssmärta är en av de vanligaste orsakerna till att man söker hjälp inom primärvården. För långvarig, ospecifik ländryggssmärta är träning ett förstahandsval och fokus har under det senaste årtiondet legat på bålstabiliserande träning. Psykosociala faktorer som self-efficacy och rörelserädsla kan vara viktiga att beakta vid behandlingen då de spelar en roll i hur ländryggssmärtan utvecklas. Syfte: Att undersöka hur skattad smärta, self-efficacy och rörelserädsla samt funktionsnivå förändrades hos enskilda patienter med långvarig, ospecifik ländryggssmärta under och efter en intervention i grupp med bålstabiliserande träning. Metod: Designen var en A-B-A single-subject design (SSED). Smärtnivå, self-efficacy och rörelserädsla mättes med självskattningsformulär en gång per vecka under fas A-B-A och funktionsnivå före och efter avslutad intervention. Interventionen pågick under åtta veckor, en gång per vecka. Data presenterades visuellt och analys gjordes även av statistisk (2-SD band metod) och klinisk signifikans. Resultat: Analysen visade att skattad smärta, self-efficacy, rörelserädsla och funktionsnivå förändrades i positiv riktning hos flera patienter. Statistisk och klinisk signifikans varierade. Slutsats: Graderad bålstabiliserande träning i grupp under handledning av sjukgymnast verkar för flera av deltagarna ha en positiv effekt på såväl smärtnivå, self-efficacy, rörelserädsla som funktionsnivå. Eftersom SSED har en begränsad generaliserbarhet bör resultaten replikeras i ytterligare studier. / Background: Non-specific low back pain is one of the most common reasons for seeking help in primary care. For chronic, non-specific low back pain exercise rehabilitation is a first choice and focus in the last decade has been on motor control exercises. Psychosocial factors such as self-efficacy and fear of movement may be important to consider in the treatment as they play a role in how low back pain develops. Aim: To investigate how rated pain, self-efficacy and fear of movement as well as level of function changed in individual patients with chronic, nonspecific low back pain during and after an intervention group with motor control exercises. Method: The design was an A-B-A single-subject design (SSED). Pain level, self-efficacy and fear of movement were measured by self-assessment questionnaires once a week during phase A-B-A and level of function before and after the intervention. The intervention lasted for eight weeks, once a week. Data were presented visually and analysis was done to prove statistical (2-SD band method) and clinical significance. Results: The analysis showed that rated pain, self-efficacy, fear of movement and level of function changed in a positive direction for several of the patients. Statistical and clinical significance varied. Conclusion: Graded motor control exercises in a group under the supervision of a physiotherapist seem to have a positive effect for several of the participants with regards to level of pain, self-efficacy, fear of movement as well as level of function. Since SSED has a limited generalizability, results should be replicated in further studies.

Made available in DSpace on 2014-06-11T19:22:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-04-07Bitstream added on 2014-06-13T18:48:40Z : No. of bitstreams: 1 strang_r_me_botfm.pdf: 1503065 bytes, checksum: c600d4becf4eafb0269428ce7cb268b7 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Foi realizado estudo experimental em ratos, visando avaliar o efeito da ablação cirúrgica dos músculos retos abdominais (MRA), nos padrões utilizados nos retalhos TRAM, sobre a resistência da parede abdominal. Utilizou-se 60 ratos machos da linhagem Wistar, divididos aleatoriamente em três grupos de 20 animais. No primeiro grupo removeu-se um dos músculos, no segundo, ambos e o terceiro grupo, controle, não foi submetido à cirurgia. Após 180 dias os animais foram sacrificados e submetidos a dois tipos de avaliação: aumento progressivo da pressão intracavitária, com o auxílio de um balão de silicone, para a observação do surgimento de abaulamentos ou hérnias, e teste de tração em dinamômetro, para quantificar a resistência da parede abdominal à tração. O segmento operado das paredes abdominais foi submetido à análise histológica. Constatou-se no primeiro teste não haver diferença significativa entre os três grupos. No teste da tração, as paredes abdominais submetidas à cirurgia apresentaram resistência significativamente maior do que as do grupo controle. A histologia evidenciou fibrose cicatricial madura, uniformemente distribuída, e fibras musculares em posição anatômica. Na análise estatística, para comparar os valores da pressão de ruptura (mmHg) e da Tração-Força Máxima (N) dos três grupos foi utilizada Análise de Variância de um fator. Quando o resultado do teste F foi estatisticamente significante, aplicou-se o Post-Hoc de Tukey para se identificar as diferenças. Concluiu-se que, no modelo utilizado, a remoção cirúrgica dos MRA não provoca redução na resistência da parede abdominal. / This experimental study was carried out in rats, with the purpose to evaluate the effect of the surgical ablation of the rectus abdominis muscles (RAM), in the patterns of the TRAM flap, on the resistance of the abdominal wall. Sixty male Wistar rats were used, divided randomly in three groups of twenty animals. In the first group, one of the muscles was removed, in the second, both and the third group, the control group, was not submitted to the surgery. After 180 days the animals were killed and submitted to two types of evaluation: an increase in the intracavitary pressure, with the help of a silicone balloon, to observe the emergence of bulge or hernia, and a test in a dynamometer to quantify the resistance of the abdominal wall to traction. The operated segment of the abdominal walls was submitted to histological analysis. In the first test, it was testified that there was no significant difference between the three groups. In the traction test, the abdominal walls submitted to the surgery showed a resistance significantly greater than the ones on the control group. Histology evidenced mature cicatricial fibrosis, evenly distributed, and muscular fibers in anatomical position. In the statistical analysis, to compare the values of rupture pressure (mmHg) and the Maximum Traction-Force (N) of the three groups it was used one-way Analysis of Variance. When the F test result showed to be statistically significant, the Tuckey test was applied to identify the differences. It was concluded that, in the used model, the surgical removal of the RAM didn’t cause a reduction in the abdominal wall resistance.

<p>Aim</p><p>The aim of this study was to evaluate the activity recorded with electromyography (EMG) fine-wire electrodes, in transversus abdominis (TrA) and rectus abdominis (RA) while performing various stabilization exercises, and to investigate how the level of activation was affected by specific instructions</p><p>Method</p><p>Ten physically active women (27.1 ± 5.5year, 1.74 ± 0.05 m, 67.1 ± 8.6 kg) performed six different stabilization exercises (four lying supine with bent knees and hips and two in four point kneeling). They performed two sets of exercises, the first without and the second with specific instructions. The specific instruction was “abdominal hollowing to activate” TrA. The fine-wire electrodes were inserted bilateral into TrA and RA with an injection needle with guidance from an ultrasound. EMG was recorded during the middle second (while the subjects were asked to withhold the final position) and data was normalized to maximal voluntary contraction (MVC) and value at rest.</p><p>Results</p><p>The effects from instructions were significant while looking upon muscle and exercise (p<0,05). All exercises but exercise number 4 (unilateral bridgening) were significant effected by instructions in TrA, but none of the exercises were effected in RA (p>0,05). The mean of the activity in TrA varied without instructions between 2,9% (± 4,4) to 39,5 % (± 20,0) and with instructions 15,2 % (± 14,7) to 45,6 % (± 23,5). In RA the mean of the activity varied without instructions between 0,3% (± 0,8) to 9,8 % (± 27,4) and with instructions between 2.4 % (± 2,9) to 11,3% (± 28,5).</p><p>Conclusion</p><p>It is possible to selectively increase the activity in TrA in the majority of selected stabilization exercises with supine position with bent knees and hips, and in four point kneeling.</p> / <p>Syfte</p><p>Syftet med denna studie var att med intramuskulär elektromyografi utvärdera aktiveringsgraden i transversus abdominis (TrA) och rectus abdominis (RA) vid utförandet av olika stabiliseringsövningar samt att undersöka hur graden av aktivering påverkas av specifika instruktioner.</p><p>Metod: Tio kvinnliga, fysiskt aktiva personer (27.1 ± 5.5 år, 1.74 ± 0.05 m, 67.1 ± 8.6 kg) fick utföra sex olika stabiliseringsövningar (fyra i ryggliggande och två i knäfyrfota) med tre repetitioner på varje övning. Försökspersonen (fp) fick utföra övningarna i två omgångar. Omgång ett utan och omgång två med specifik instruktion, den specifika instruktionen var; ”dra in den nedre delen av magen, den under naveln” (abdominal hollowing) för att aktivera Tr A. Intramuskulära trådelektroder fördes in bilateralt i TrA och RA med hjälp av en injektionsnål under guidning av ultraljud. Elektromyografi (EMG) mättes under den mittersta sekunden av övningen (i kvarhållen slutposition) och normaliserades mot maximal viljemässig kontraktion (MVC) och vilovärde.</p><p>Resultat: Effekten av instruktion var signifikant i betraktandet av muskel och övning (p<0,05). I samtliga övningar utom övning 4 (unilateralt bäckenlyft) påverkade instruktioner signifikant muskelaktiviteten i TrA (p<0,05), men inte i någon av övningarna i RA (p>0,05).</p><p>Medelvärdet av den normaliserade EMG-aktiviteten i TrA varierade i övning 1 till 6 utan instruktioner mellan 2,9 % (± 4,4) och 39,5 % (± 20,0). Med instruktion varierade den procentuella aktiviteten i TrA mellan 15,2 % (± 14,7) och 45,6 % (± 23,5). I RA varierade medelvärdet utan instruktioner mellan 0,3% (± 0,8) till 9.8 % (± 27,4) och med instruktioner 2.4 % (± 2,9) till 11,3% (± 28.5).</p><p>Slutsats; Det går att med hjälp av instruktioner selektivt öka aktiveringsgraden i TrA i majoriteten av valda stabiliseringsövningar i krokligg och knäfyrfota.</p>

Aim The aim of this study was to evaluate the activity recorded with electromyography (EMG) fine-wire electrodes, in transversus abdominis (TrA) and rectus abdominis (RA) while performing various stabilization exercises, and to investigate how the level of activation was affected by specific instructions Method Ten physically active women (27.1 ± 5.5year, 1.74 ± 0.05 m, 67.1 ± 8.6 kg) performed six different stabilization exercises (four lying supine with bent knees and hips and two in four point kneeling). They performed two sets of exercises, the first without and the second with specific instructions. The specific instruction was “abdominal hollowing to activate” TrA. The fine-wire electrodes were inserted bilateral into TrA and RA with an injection needle with guidance from an ultrasound. EMG was recorded during the middle second (while the subjects were asked to withhold the final position) and data was normalized to maximal voluntary contraction (MVC) and value at rest. Results The effects from instructions were significant while looking upon muscle and exercise (p&lt;0,05). All exercises but exercise number 4 (unilateral bridgening) were significant effected by instructions in TrA, but none of the exercises were effected in RA (p&gt;0,05). The mean of the activity in TrA varied without instructions between 2,9% (± 4,4) to 39,5 % (± 20,0) and with instructions 15,2 % (± 14,7) to 45,6 % (± 23,5). In RA the mean of the activity varied without instructions between 0,3% (± 0,8) to 9,8 % (± 27,4) and with instructions between 2.4 % (± 2,9) to 11,3% (± 28,5). Conclusion It is possible to selectively increase the activity in TrA in the majority of selected stabilization exercises with supine position with bent knees and hips, and in four point kneeling. / Syfte Syftet med denna studie var att med intramuskulär elektromyografi utvärdera aktiveringsgraden i transversus abdominis (TrA) och rectus abdominis (RA) vid utförandet av olika stabiliseringsövningar samt att undersöka hur graden av aktivering påverkas av specifika instruktioner. Metod: Tio kvinnliga, fysiskt aktiva personer (27.1 ± 5.5 år, 1.74 ± 0.05 m, 67.1 ± 8.6 kg) fick utföra sex olika stabiliseringsövningar (fyra i ryggliggande och två i knäfyrfota) med tre repetitioner på varje övning. Försökspersonen (fp) fick utföra övningarna i två omgångar. Omgång ett utan och omgång två med specifik instruktion, den specifika instruktionen var; ”dra in den nedre delen av magen, den under naveln” (abdominal hollowing) för att aktivera Tr A. Intramuskulära trådelektroder fördes in bilateralt i TrA och RA med hjälp av en injektionsnål under guidning av ultraljud. Elektromyografi (EMG) mättes under den mittersta sekunden av övningen (i kvarhållen slutposition) och normaliserades mot maximal viljemässig kontraktion (MVC) och vilovärde. Resultat: Effekten av instruktion var signifikant i betraktandet av muskel och övning (p&lt;0,05). I samtliga övningar utom övning 4 (unilateralt bäckenlyft) påverkade instruktioner signifikant muskelaktiviteten i TrA (p&lt;0,05), men inte i någon av övningarna i RA (p&gt;0,05). Medelvärdet av den normaliserade EMG-aktiviteten i TrA varierade i övning 1 till 6 utan instruktioner mellan 2,9 % (± 4,4) och 39,5 % (± 20,0). Med instruktion varierade den procentuella aktiviteten i TrA mellan 15,2 % (± 14,7) och 45,6 % (± 23,5). I RA varierade medelvärdet utan instruktioner mellan 0,3% (± 0,8) till 9.8 % (± 27,4) och med instruktioner 2.4 % (± 2,9) till 11,3% (± 28.5). Slutsats; Det går att med hjälp av instruktioner selektivt öka aktiveringsgraden i TrA i majoriteten av valda stabiliseringsövningar i krokligg och knäfyrfota.

Made available in DSpace on 2015-07-22T20:50:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-11-24 / Introdução: O defeito na parede abdominal na área doadora do retalho musculocutâneo transverso do reto do abdome – retalho TRAM - é extenso, complexo e predispõe ao surgimento de hérnia, abaulamento e fraqueza abdominal. A reconstrução da parede abdominal deve ser anatômica e funcional, preferencialmente com tecidos autólogos, materiais de síntese resistentes e mínima tensão na sutura. As técnicas de descolamento músculo-aponeurótico seletivo da parede abdominal permitem uma reconstrução com tecido autólogo e tensão reduzida. Apesar dos relatos clínicos e avaliações em cadáveres, não foram encontrados estudos com a finalidade de comprovar, de maneira objetiva, a eficácia das manobras de descolamento músculo-aponeurótico seletivo na área doadora do retalho TRAM. Objetivo: Avaliar a resistência à tração dos componentes músculo-aponeuróticos na área doadora do retalho TRAM bipediculado. Métodos: No período de Maio de 2006 a Maio de 2008, foram estudadas 20 pacientes, com idade entre 29 e 58 anos, submetidas a reconstrução mamária com retalho TRAM bipediculado. A resistência à tração medial dos componentes músculo-aponeuróticos na área doadora do retalho TRAM foi medida, bilateralmente, com um dinamômetro analógico que foi fixado à margem lateral da lâmina anterior da bainha do músculo reto do abdome 3 cm inferior ao umbigo. Os coeficientes de tração foram comparados em três fases: Fase inicial sem qualquer incisão ou descolamento adicional na área doadora do retalho; Fase 1 incisão sobre a margem lateral da bainha do reto; Fase 2 descolamento do músculo oblíquo externo até a linha axilar anterior. Para a análise estatística foram utilizados os testes de Wilcoxon e o teste de t para dados emparelhados na comparação dos coeficientes de tração direito e esquerdo nas Fases inicial, 1 e 2. O teste de Friedman e teste post hoc de Dunn foram utilizados para comparar os coeficientes de tração das Fases inicial, 1, 2 no lado direito e no esquerdo. Resultados: Houve redução estatisticamente significante da resistência à tração após cada fase do descolamento seletivo. Conclusão: A resistência à tração medial dos componentes músculo-aponeuróticos na área doadora do retalho musculocutâneo transverso do reto do abdome diminuiu, após a incisão na margem lateral interna da bainha do músculo reto do abdome e após o descolamento do músculo oblíquo externo. / Introduction: The defect on the abdominal wall in the transverse rectus abdominis myocutaneos flap -TRAM flap- donor site is extensive, complex and predisposes the emergence of hernia, bulging and abdominal weakness. The closure of the abdominal wall must be anatomic and functional, preferably with autologous tissues, resistance synthesis material and minimal tension suture. The selective musculoaponeurotic undermining of the abdominal provide a abdominal wall closure with autologous tissue and reduced tension. Despite many clinical studies, no experimental researches prove the real efficacy of selective musculoaponeurotic undermining in the TRAM flap donor site. Objective: The aim of this study is to evaluate the resistance to medial traction of the musculoaponeurotic components in the bipedicled TRAM flap donor site. Methods: In the period of May of 2006 until May of 2008, 20 patients, with ages from 29 to 58 years old, submitted to mammary reconstruction with bipedicled TRAM flap were studied. The resistance to medial traction of the musculoaponeurotic components in the bipedicled TRAM flap donor site was measured with a dynamometer that was fixed in the lateral edge of the defect, 3 cm below the umbilicus. The traction coefficients obtained were compared in three situation: Initial Stage - with no incision or additional underminig in the flap donor site; Stage 1 - incision above the lateral edge of the rectus sheath; Stage 2 - undermining of the external oblique muscle. To the statistical analyses it was used the Wilcoxon and the t test to paired data in the comparison of the right and left traction coefficients in Initial Stage, Stage 1 and Stage 2. The Friedman test and the post hoc of Dunn test was used to compare traction coefficients in initial Stage, stage 1 and Stage 2, in the right and left sides. Results: There was a significant reduction of traction resistance after each stage of the dissection. Conclusion: The incision on the internal lateral edge of the rectus sheath and the external oblique undermining reduce the medial traction resistance of the musculoaponeurotic components in the TRAM flap donor site. / TEDE / BV UNIFESP: Teses e dissertações

Hyperlordosis or anterior pelvic tilt is a common non-neutral spinal posture associated with weak core stability, low back pain and altered lumbopelvic muscle activation patterns. Yet the effects of altered lumbopelvic posture and core stability on muscle activation patterns have not been evaluated during a functional movement. The main purpose of this study was to determine the relationship between pelvic tilt, core stability and muscle activation patterns during non-weighted squats in U/19 university-level rugby union players. A total of 49 rugby union players participated in this study. Pelvic tilt (dominant side) was measured from a digital photo with clear reflector markers on the anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS) using the Kinovea video analysis software programme (version 0.8.15). Flexibility of the hamstrings, hip flexors and knee extensors was assessed with goniometry. Core stability was assessed using the pressure biofeedback unit and muscle onset times during the ascent phase of non-weighted squats. The onset times of the transverse abdominis (TrA), erector spinae (ES), gluteus maximus (GM) and biceps femoris (BF) muscles were measured using electromyography (EMG). Players were then grouped according to pelvic tilt (anterior and neutral) and by playing position (forwards and backs). The between group differences were evaluated for the abovementioned variables using p-value (statistical significance) and d-value (practical significance) measures. Muscle activation patterns and firing order were determined using descriptive statistics. The mean pelvic tilt of all participants (N=49) was an anterior tilt of 15.35°. When grouped by pelvic tilt, the anterior tilt group showed a mean pelvic tilt of 17.83° (n=27) and the neutral pelvic tilt group showed a mean pelvic tilt of 11.75° (n=22). Despite the differences in pelvic tilt, there was no significant difference in flexibility between the groups. Another controversial result is that the anterior tilt group showed practical significantly better core stability (d=0.54) than the neutral tilt group (46.93° vs 56.3°). During the double leg squat the muscle activation patterns were consistent between the groups. TrA activated first, followed by ES. Thereafter, the BF muscle activated, followed by the GM. The first place activation of TrA is consistent with the literature stating that the deep abdominal stabilisers of individuals with good core stability activate before the movement is initiated. The early onset of muscle activity of ES points to a focus on back extension during the ascent of the squat. Because the pelvic tilt was measured during static standing only, it is unclear whether the players in the neutral tilt group were able to hold the neutral pelvic tilt posture throughout the movement. Research has shown that there is an increased focus on trunk extension during the ascent phase of the squat which is not present during the descent. Future research should focus on assessing the pelvic tilt at the beginning of the ascent phase of the squat to ensure accurate results. The delay in GM activation during the ascent of the squat is concerning. GM acts as a lumbopelvic stabilizer, and its slow activation points to a decrease in lumbopelvic stability. This is very important in weight training, because weight training increases the strain on the lumbar spinal structures, which decreases performance and increases the risk of injury. / MSc (Biokinetics), North-West University, Potchefstroom Campus, 2014

Hyperlordosis or anterior pelvic tilt is a common non-neutral spinal posture associated with weak core stability, low back pain and altered lumbopelvic muscle activation patterns. Yet the effects of altered lumbopelvic posture and core stability on muscle activation patterns have not been evaluated during a functional movement. The main purpose of this study was to determine the relationship between pelvic tilt, core stability and muscle activation patterns during non-weighted squats in U/19 university-level rugby union players. A total of 49 rugby union players participated in this study. Pelvic tilt (dominant side) was measured from a digital photo with clear reflector markers on the anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS) using the Kinovea video analysis software programme (version 0.8.15). Flexibility of the hamstrings, hip flexors and knee extensors was assessed with goniometry. Core stability was assessed using the pressure biofeedback unit and muscle onset times during the ascent phase of non-weighted squats. The onset times of the transverse abdominis (TrA), erector spinae (ES), gluteus maximus (GM) and biceps femoris (BF) muscles were measured using electromyography (EMG). Players were then grouped according to pelvic tilt (anterior and neutral) and by playing position (forwards and backs). The between group differences were evaluated for the abovementioned variables using p-value (statistical significance) and d-value (practical significance) measures. Muscle activation patterns and firing order were determined using descriptive statistics. The mean pelvic tilt of all participants (N=49) was an anterior tilt of 15.35°. When grouped by pelvic tilt, the anterior tilt group showed a mean pelvic tilt of 17.83° (n=27) and the neutral pelvic tilt group showed a mean pelvic tilt of 11.75° (n=22). Despite the differences in pelvic tilt, there was no significant difference in flexibility between the groups. Another controversial result is that the anterior tilt group showed practical significantly better core stability (d=0.54) than the neutral tilt group (46.93° vs 56.3°). During the double leg squat the muscle activation patterns were consistent between the groups. TrA activated first, followed by ES. Thereafter, the BF muscle activated, followed by the GM. The first place activation of TrA is consistent with the literature stating that the deep abdominal stabilisers of individuals with good core stability activate before the movement is initiated. The early onset of muscle activity of ES points to a focus on back extension during the ascent of the squat. Because the pelvic tilt was measured during static standing only, it is unclear whether the players in the neutral tilt group were able to hold the neutral pelvic tilt posture throughout the movement. Research has shown that there is an increased focus on trunk extension during the ascent phase of the squat which is not present during the descent. Future research should focus on assessing the pelvic tilt at the beginning of the ascent phase of the squat to ensure accurate results. The delay in GM activation during the ascent of the squat is concerning. GM acts as a lumbopelvic stabilizer, and its slow activation points to a decrease in lumbopelvic stability. This is very important in weight training, because weight training increases the strain on the lumbar spinal structures, which decreases performance and increases the risk of injury. / MSc (Biokinetics), North-West University, Potchefstroom Campus, 2014