Developing a dynamic elastomeric fabric orthosis to aid return to sport after lumbopelvic injury
Martin J. Matthews, MPhil, L Sawle, J Freeman, J Marsden,
Lumbopelvic pain (LPP) often results from trauma or overuse that can lead to conditions including adductor tears, sacroiliac joint dysfunction and osteitis pubis. Such injuries are often refractory to treatment and can limit the return to competitive sport. Previous research shows that selective compressive forces applied transversely to the pelvis can result in improved lumbopelvic stability and reduced pain, and, compression shorts may aid in preventing athletic lumbopelvic injury. This study applies transverse and diagonal compressive forces to the pelvis in athletes with LPP, and investigates the effects on pain and function. Participants with athletic LPP were screened using five clinical tests. They were included if at least two tests provoked pain. Transverse and diagonal circumferential forces were applied via a belt. Four belt arrays (anterior superior iliac spines (ASIS), right-left across the pelvis, left-right across the pelvis and in combination) and a "no-belt condition" were assessed with the order of presentation randomised. A force of 50 N was applied (determined using a load cell lying in series with the belt). The effect of the belt array on rest pain, pain associated with an active straight leg raise (ASLR) and a 1-m broad jump was assessed using a numerical rating scale. During resisted bilateral hip adduction the onset of pain was indicated using a hand held switch; the maximal force of adduction determined via a load cell. Data were analysed using paired t tests. Preliminary data on 12 participants (9 females, mean 37±10 years) indicate that different belt arrays can alleviate pain both at rest and during active tasks. Pain during ASLR (ipsilateral to the pain) improved with combined belts compared to an ASIS belt (p=0.025). Preliminary results suggest the direction and angle of force application relative to the laterality of pain is important in determining the degree and pattern of pain relief. A larger sample is needed to confirm this (required sample of 31 based on effect size of 0.51 and 80% power). Results will inform the design of a dynamic elastomeric fabric orthosis whose effect on athletic LPP and function will be assessed.
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