SHORT TITLE – “UTILISATION OF CONCURRENT MUSCLE ACTIVITY IN INFERENCE OPTIMISATION”

¹SRM Institute of Science and Technology, Translational Medicine and Research, Kattankulathur, Chennai, Tamil Nadu, India

Background:Long Title -"Analysis of Concurrent muscle activity in Lower back and neck region using pressure gauge device, while measuring Hamstring tightness in 120 college students to assist clinical decision making in treatment plans"- A Pilot Study.
Hamstring length plays a significant role in a spectrum of clinical entities ranging from injury prevention and gait dysfunction to posture correction. Recent evidence suggests that the prevalence of hamstring tightness/reduced length is increasing. Active Straight Leg Raise (ASLR) and Active Total Knee Extension (ATKE) along with Seated Total Knee Extension (STKE) are the standard methods used in practice to evaluate the severity of Hamstrings Tightness(HT). However, despite the number of tests, HT is still functional diagnosis. In addition, these tests provide a preliminary evaluation of concurrent muscle usage. Therefore, evaluating concurrent muscle usage and incorporating it will add value to clinical decision-making skills.

Purpose: Although many concurrent muscles are activated with each testing procedure, this study focuses on the lumbar and cervical regions to demonstrate the significance of assessing concurrent muscle usage, with the goal of developing and designing a unique customized treatment protocol.

Methods: Pilot data from 120 student volunteers (aged 17 to 25) were collected. First, all three tests, ASLR, ATKE, and STKE, were carried out without a pressure gauge. Next, pressure gauges were placed to align with the natural lumbar and cervical curvatures in supine lying while testing ASLR and ATKE. Four therapists, in two groups, collected the data. One therapist in each group noted the angles of test results, while the other recorded the change in pressure gauge numbers. All therapists were blinded to the results until the completion of the study.

Results: Results of ASLR and ATKE, both with and without pressure gauge, indicate a high prevalence rate, whereas results of STKE show no prevalence. Changes in the pressure gauge values indicated concurrent muscle usage. A positive change represents the curve's flattening, indicating the flexor group muscles working, and a negative change represents the arching of the curve, showing extensor group muscles are working.

Conclusions: Most healthcare professionals and fitness trainers prefer STKE in regular practice due to the ease of the testing procedure, whereas physiotherapy professionals always test HT with SLR and TKE, either active or passive. And in particular, therapists focus on reducing the usage of concurrent muscle activation. Though reduction is possible, incorporating the levels of use of these muscles enriches the amount of data collected with a particular test. Directing co-professionals on their choice of tests is challenging, whereas providing the knowledge about concurrent muscle use paves the way for creating relevant treatment plans. For instance, high negative values of change in pressure in the lower back region may prompt the therapist to relax or stretch the lower back first before incorporating hamstrings stretches.

Implications: Identifying multiple muscular factors and the pattern of their dependency in future studies will help develop better clinical decision-making tools and improve health outcomes.

Funding acknowledgements: None

Keywords:
Hamstring tightness
Concurrent muscle use
pressure gauge

Topics:
Research methodology, knowledge translation & implementation science
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: SRM Medical College Hospital and Research centre

Committee: Institutional Ethics Committee

Ethics number: 8378/IEC/2022