3D golf swing kinematics of male amateur golfers with and without low back pain

129 Pages·2015·3.7 MB·English

by  Aloysius Chan

3D golf swing kinematics of male
amateur golfers with and without low
back pain

Chan Weiren, Aloysius
A thesis submitted in partial fulfilment of the requirement for the
degree of Bachelor of Physiotherapy (Honours)

University of South Australia
Division of Health Sciences
School of Health Sciences

August 2015
Table of Contents

Table of Contents ..................................................................................... ii
List of Tables........................................................................................... vii
List of Figures ........................................................................................ viii
Declaration ............................................................................................... ix
Planned dissemination ............................................................................. x
Acknowledgements ................................................................................. xi
Operational Definitions .......................................................................... xii
Glossory of Abbreviations .................................................................... xiv
Summary ................................................................................................. xv
Chapter 1 Background ............................................................... 1
1.1 Introduction ........................................................................................... 1
1.2 The golf swing and measurement of golf swing motion ........................ 1
1.3 Research on 3D golf swing kinematics in healthy populations ............. 2
1.4 The golf swing and possible links to low back pain ............................... 3
1.4.1 Epidemiology of LBP in golfers ....................................................... 4
1.5 Physical characteristics and swing mechanics differences in golfers
with and without LBP: a systematic review ................................................. 5
1.5.1 Introduction ..................................................................................... 5
1.5.2 Methods .......................................................................................... 6
1.5.2.1 Research question .................................................................. 6
1.5.2.2 Search strategy ....................................................................... 6
1.5.2.3 Eligbility criteria ....................................................................... 7
1.5.2.4 Study selection ........................................................................ 8
1.5.2.5 Quality assessment ................................................................. 9
1.5.2.6 Data extraction ........................................................................ 9
1.5.2.7 Data synthesis ....................................................................... 10
ii
1.5.3 Results .......................................................................................... 10
1.5.3.1 Description of included studies .............................................. 11
1.5.3.2 Risk of bias ............................................................................ 15
1.5.3.3 Physical characteristics of golfers with and without LBP........ 18
1.5.3.3.1 Trunk characteristics ....................................................... 18
1.5.3.3.2 Hip characteristics ........................................................... 19
1.5.3.4 Swing mechanics of golfers with and without LBP ................. 22
1.5.3.4.1 EMG ................................................................................ 22
1.5.3.4.2 3D kinematics .................................................................. 23
1.5.4 Discussion ..................................................................................... 27
1.5.4.1 Relationship of physical characteristic findings and LBP in
golfers ................................................................................................ 27
1.5.4.2 Relationship of swing mechanics findings and LBP in golfers 29
1.5.4.2.1 EMG ................................................................................ 29
1.5.4.2.1 3D kinematics .................................................................. 30
1.5.4.3 Strengths and limitations ........................................................ 30
1.5.4.4 Future directions .................................................................... 31
1.5.5 Conclusion .................................................................................... 31
1.6 Rationale for this primary study ........................................................... 32
1.7 Aims of study ....................................................................................... 33
1.7.1 Primary aim ................................................................................... 33
1.7.2 Secondary aim .............................................................................. 33
1.7.3 Tertiary aim ................................................................................... 33
1.8 Research Questions ............................................................................ 33
1.8.1 Primary research question ............................................................ 33
1.8.2 Secondary research question ....................................................... 33
1.8.3 Tertiary research question ............................................................ 33
1.9 Hypotheses ......................................................................................... 34
1.9.1 Primary hypothesis ....................................................................... 34
iii
1.9.2 Secondary hypothesis .................................................................. 35
1.9.3 Tertiary hypothesis ....................................................................... 36
Chapter 2 Methods ................................................................... 37
2.1 Ethics .................................................................................................. 37
2.2 Study Design ...................................................................................... 37
2.3 Sample Size ........................................................................................ 37
2.4 Recruitment and eligibility ................................................................... 38
2.5 Instrumentation ................................................................................... 39
2.5.1 3D apparatus and other equipment .............................................. 39
2.5.2 3D apparatus training ................................................................... 40
2.6 Study Protocol .................................................................................... 40
2.6.1 Procedure and consent ................................................................ 40
2.6.2 Sensor electrode placement ......................................................... 41
2.6.3 Calibration .................................................................................... 42
2.6.3.1 Inter-rater reliability testing of calibration process ................. 43
2.6.3.2 Intra-rater reliability testing of calibration process ................. 44
2.6.4 Data collection .............................................................................. 44
2.6.4.1 Data collection locations ........................................................ 44
2.6.4.2 Briefing .................................................................................. 45
2.6.4.3 6-iron and Driver data collection ............................................ 45
2.6.4.4 Post data collection ............................................................... 46
2.7 Variables ............................................................................................. 46
2.8 Statistical analysis .............................................................................. 47
Chapter 3 Results ..................................................................... 49
3.1 Recruitment and participant characteristics ........................................ 49
3.2 Results of inter-rater reliability testing for calibration process ............. 50
3.3 Results of intra-rater reliability testing for calibration process ............. 50
3.4 Primary analyses ................................................................................ 51
3.4.1 Comparison of 3D kinematics between groups (NLBP vs LBP) ... 51
iv
3.4.2 Confounding variables .................................................................. 55
3.4.2.1 Age ........................................................................................ 55
3.4.2.2 Years of golfing ...................................................................... 55
3.5 Secondary analyses ............................................................................ 55
3.6 Tertiary analyses ................................................................................. 56
Chapter 4 Discussion ............................................................... 58
4.1 Primary research question: Does the 3D kinematics of the golf swing
differ between male amateur golfers with and without LBP? ..................... 58
4.1.1 Confounding variables – age and years of golfing ........................ 61
4.2 Secondary research question: Does the 3D kinematics of the golf swing
differ between two different golf clubs (6-iron and driver) for male amateur
golfers with and without LBP? ................................................................... 62
4.3 Tertiary research question: Does the 3D kinematics of the golf swing of
male amateur golfers (handicap ≤ 18) with and without LBP match with the
Golf BioDynamics software-reported ideal corridors? ............................... 63
4.4 Clinical implications ............................................................................. 64
4.5 Strengths of study ............................................................................... 64
4.6 Limitations of study ............................................................................. 65
4.6.1 Polhemus 3D system .................................................................... 65
4.6.2 Study protocol ............................................................................... 66
4.7 Future directions ................................................................................. 66
4.8 Conclusion .......................................................................................... 67
References ............................................................................................... 68
Appendices .............................................................................................. 74
Appendix 1.1 Search strategy (24 February 2015) ................................ 74
Appendix 1.2 Database search results .................................................. 76
Appendix 1.3 Effective Public Health Practice Project (EPHPP) Quality
Assessment Tool for Quantitative Studies ............................................. 77
Appendix 1.4 Detailed quality assessment of included studies .............. 81
Appendix 2.1 Ethics Approval ................................................................ 82
v
Appendix 2.2 Recruitment Flyer ............................................................ 83
Appendix 2.3 Participant information sheet ........................................... 84
Appendix 2.4 Consent form ................................................................... 87
Appendix 2.5 Participant demographics form ........................................ 89
Appendix 2.6 Sensor electrodes landmarks .......................................... 96
Appendix 3.1 Group demographics in Excel .......................................... 97
Appendix 3.2 Inter- and intra-reliability raw data in Excel ...................... 99
Appendix 3.3 Group raw data in Excel ................................................ 101
Appendix 3.4 Summary of t-test results for between and within group
comparison .......................................................................................... 109
Appendix 3.5 Impact of confounding variables .................................... 110

vi
List of Tables

Tables within systematic review
Table 1. Search strategy (MEDLINE). ............................................................ 7
Table 2. Eligibility Criteria. .............................................................................. 8
Table 3. Summary of study characteristics for included studies (n=10). ....... 13
Table 4. Quality appraisal of individual studies (n=10). ................................ 17
Table 5. Summary of outcome measures and results of included studies with
physical characteristic outcomes (n=7). ....................................................... 20
Table 6. Summary of outcome measures and results of included studies with
swing mechanic outcomes (n=6). ................................................................. 25

Tables within primary study
Table 7. Inclusion and exclusion criteria. ...................................................... 38
Table 8. 3D variables analysed in study and interpretation of values in Golf
BioDynamics report for a right-handed golfer. .............................................. 47
Table 9. Participant demographics. .............................................................. 49
Table 10. Descriptive statistics of all 3D kinematic variables for both groups.
..................................................................................................................... 52
Table 11. Comparison with Golf BioDynamics software-reported ideal
corridors. ...................................................................................................... 57

vii
List of Figures

Figures within systematic review
Figure 1. Phases of the golf swing ................................................................. 1
Figure 2. PRISMA flowchart for systematic reviews. .................................... 11
Figure 3. Quality appraisal results of all included studies (n=10) ................. 16

Figures within primary study
Figure 4. Pelvic thrust at impact. .................................................................. 34
Figure 5. Pelvic tilt and sway and head rotation at impact. .......................... 35
Figure 6. Pelvic and upper torso rotation at impact. ..................................... 35
Figure 7. Polhemus Liberty electromagnetic system (Polhemus Inc,
Colchester, VT, USA). .................................................................................. 40
Figure 8. Sensor electrodes placement on golfer. ........................................ 41
Figure 9. Screenshot of kinematic variables after calibration process with
participant in neutral upright position. .......................................................... 43
Figure 10. Calibration process reliability testing flowchart............................ 44
Figure 11. Data collection locations. ............................................................ 45
Figure 12. Head rotation at finish. ................................................................ 53
Figure 13. Upper torso rotation at finish. ...................................................... 53
Figure 14. Pelvic rotation at finish. ............................................................... 54
Figure 15. Pelvic sway at finish. ................................................................... 54
Figure 16. Finishing position of the golf swing. ............................................ 59
Figure 17. 6-iron (left) and driver (right) ....................................................... 62

viii
Declaration
This thesis presents work carried out by myself and does not incorporate
without acknowledgment any material previously submitted for a degree or
diploma in any university; to the best of my knowledge it does not contain any
materials previously published or written by another person except where
due reference is made in the text; and all substantive contributions by others
to the work presented, including jointly authored publications, are clearly
acknowledged.

Signed,

Aloysius Chan 25th August 2015

ix
Planned dissemination
The two studies (systematic review and case-control study) in this thesis will
be converted to individual manuscripts and submitted for publication. At the
time of print, both studies are in the early stages of manuscript preparation.
x