AzTrials
AzTrials

Hip Functional RestrictionRELHAMNCT07123012

RELATIONSHIP OF REDUCED HAMSTRING FLEXIBILITY WITH LUMBOPELVIC RHYTHM AND MUSCLE ACTIVATION

An observational study of Hip Functional Restriction and Lumbar Spine Biomechanics, run by Sahmyook University at 1 site in South Korea.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Key Findings (narrative form) The study examined how hamstring flexibility influences the way the lumbar spine and pelvis share movement during forward bending and how this affects muscle activity. 1. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
How many people
38 participants
Where
1 siteSouth Korea
Study dates
14 Apr 2025to 27 Jun 2025
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: The study population consists of healthy young adults aged 18 - 40 years. Participants will be recruited from the local community and university settings. Individuals included are those without any known musculoskeletal or neurological impairments, specifically with no history of lumbar or lower limb disorders, and who voluntarily agree to participate after providing informed consent.

Who may be able to join

  • Healthy adults without musculoskeletal or neurological impairments
  • Individuals without lumbar spine and lower limb disorders
  • Participants who provided voluntary written informed consent

Who cannot join

  • History of lumbar surgery or significant trauma
  • Presence of acute or chronic pain conditions in lumbar or hip regions
  • Neurological or orthopedic disorders affecting lumbar and hip functions
  • Pregnancy
  • Individuals unable to perform the required physical activities safely

Trial locations and contacts

1 site in 1 country.

South Korea1 site
  • Sahmyook University

    Seoul, Nowon-gu, 01795

Other trials in South Korea

About this study

Official title: RELATIONSHIP OF REDUCED HAMSTRING FLEXIBILITY WITH LUMBOPELVIC RHYTHM AND MUSCLE ACTIVATION: A CROSS-SECTIONAL BIOMECHANICAL ANALYSIS

Key Findings (narrative form) The study examined how hamstring flexibility influences the way the lumbar spine and pelvis share movement during forward bending and how this affects muscle activity.

  1. Flexibility and lumbar contribution When participants had tighter hamstrings, their lower back took on a larger share of the bending motion. In the full forward-bend task this relationship was strong, while in the partial bend it was still clearly evident. In other words, limited hamstring length forces the spine to bend more to reach the same position.
  2. Meaningful flexibility thresholds Participants were divided into three straight-leg-raise (SLR) groups:
Read more
  • ≤ 60 ° (short hamstrings)
  • 61-79 ° (moderate flexibility)
  • ≥ 80 ° (good flexibility) Those in the ≤ 60 ° group showed a significantly higher lumbar contribution in both bending tasks than their more flexible peers. Once SLR exceeded roughly 60 °, additional gains in flexibility produced only modest further improvement in spine-pelvis balance, suggesting that 60 ° is a clinically important threshold.
  1. When the differences appear The greatest gap between flexibility groups occurred during the first half of the bend-particularly as participants began to lean forward. As they returned to upright, the differences narrowed. This indicates that early-phase movement is the critical moment when tight hamstrings shift load onto the lumbar spine.
  2. Impact on muscle activity Better hamstring flexibility was linked to a more even distribution of work between the lumbar extensor muscles and the hamstrings themselves. Participants with looser hamstrings did not have to activate their spinal muscles as forcefully, whereas gluteus maximus activity remained low in all groups because the tasks were unloaded.

Practical Take-Aways

  • Hamstrings shorter than about 60 ° on the SLR "lock" the pelvis and make the lower back bend excessively, increasing spinal strain.
  • Improving hamstring length shifts motion back toward the pelvis, reducing demand on lumbar joints and muscles.
  • Even small everyday bends-such as reaching for an object on a chair-follow the same pattern, so stretching benefits daily life, not just sports performance.
  • Patients and families can adopt simple hamstring-stretch routines; clinicians should consider targeted flexibility training whenever SLR is 60 ° or below before progressing to heavy lifting or core-stability programs.

Limitations The study involved healthy young adults and measured only unloaded forward bending. Outcomes may differ in older individuals, manual laborers, or tasks that involve twisting or weight. Long-term research is needed to confirm that stretching actually prevents low-back pain.

Bottom Line Flexible hamstrings let the pelvis and lower back "share the job." If your hamstrings are tight, your spine must work harder, which may invite discomfort or injury over time. A regular stretching program that brings SLR above roughly 60 ° can restore a healthier, more balanced bending pattern and help protect the lower back.

Read the detailed description

This cross-sectional biomechanical study investigates how reduced hamstring flexibility alters sagittal lumbopelvic rhythm and trunk-hip muscle activation during forward bending. All procedures are completed in a single laboratory visit and do not involve any clinical intervention or longitudinal follow-up.

Study setting and oversight Testing is conducted in a university motion-analysis laboratory equipped with force-isolated flooring, adjustable height fixtures, and electromagnetic shielding. The protocol was approved by the Institutional Review Board of Sahmyook University (IRB #SYU-2025-03-033-002). Written informed consent is obtained before any study-related activity, and the identity of participants is coded to protect confidentiality.

Participant allocation and sample size

A priori power analysis (one-way ANOVA, effect size f = 0.55, α = 0.05, power = 0.80) indicated that at least 36 participants were required; 38 healthy adults were enrolled to offset potential attrition, and 37 completed the protocol. Participants are not assigned to treatment arms but are retrospectively stratified into three flexibility categories based on their dominant-limb straight-leg-raise (SLR) angle:

(1) ≤ 60° (short group), (2) 61-79° (moderate group), (3) ≥ 80° (long group). Eligibility criteria-including absence of low-back pain in the preceding six months-are recorded in a separate module.

Instrumentation and calibration

  • Inertial-measurement units (IMUs; Xsens MTw Awinda, 60 Hz) are affixed to T12, S2, and the posterior thigh with double-sided tape and elastic wraps after a two-point static calibration that aligns sensor axes with anatomical reference frames.
  • Surface electromyography (EMG; Delsys Trigno, 1 000 Hz) records bilateral erector spinae at L3, multifidus at L5, biceps femoris long head, and gluteus maximus. Skin is shaved, abraded, and cleaned with 70 % alcohol; electrode pairs are placed parallel to muscle fibers following SENIAM guidelines.
  • Maximal voluntary contractions (MVCs) for each muscle are collected for normalisation. All raw data are synchronised via a hardware trigger and stored in a de-identified repository.

Experimental tasks

After warm-up, participants perform two tasks in random order, three trials each, barefoot and with knees extended:

  1. a full-range forward bend from upright to maximum comfortable flexion and return, and
  2. a partial bend from upright to the point where fingertips touch the patella and return.

A metronome (80 beats · min-¹) standardises angular velocity. Verbal instructions avoid coaching specific pelvic or lumbar strategies.

Primary technical outcomes Sagittal lumbar and pelvic angles are derived from IMU quaternions and filtered with a fourth-order Butterworth filter (6 Hz). The Relative Contribution Index (RCI) is calculated as the percentage of total trunk excursion attributable to the lumbar spine, sampled at 10 % increments of the flexion and extension phases. Higher RCI indicates greater lumbar-dominant motion.

Secondary outcomes EMG envelopes are obtained via 20-450 Hz band-pass filtering, full-wave rectification, and 50 ms moving RMS smoothing, then normalised to MVC. Variables include phase-specific RMS amplitude, median-frequency shift (fatigue index), and onset latency relative to movement initiation (5° pelvic tilt threshold).

Quality assurance and data integrity A detailed standard-operating-procedure manual governs sensor placement, calibration, and data extraction. Two investigators independently inspect raw signals for artefacts such as sensor dropout, cable motion (EMG), or excessive noise (> 2 SD from baseline). Automated scripts perform range and consistency checks (e.g., lumbar angle cannot exceed 90°; EMG RMS must be below 100 % MVC in unloaded tasks). Raw and processed files are archived on an encrypted server with automated daily backup.

Source-data verification is performed on 15 % of records by an auditor who cross-checks digital files against paper consent and data-capture sheets. A project-level data dictionary (CSV format) defines every variable, its unit, permissible range, and coding scheme. Version-controlled MATLAB and Python scripts are maintained in a private Git repository, and changes trigger a checksum comparison to detect unintended alterations.

Plan for missing or unusable data Trials with sensor artefact, loss of synchrony, or premature task termination are repeated once immediately; if unusable, they are marked "missing." If < 10 % of RCI values are missing, single-imputation using predictive mean matching is applied; otherwise, the participant is excluded from that analysis. EMG values with motion artefact are processed by wavelet-based denoising; segments that remain unusable are set to missing and handled as above.

Statistical analysis The primary hypothesis (hamstring flexibility influences RCI) is tested with one-way ANOVA, followed by Bonferroni-corrected pairwise comparisons. Phase-specific differences are explored with mixed-effects models (fixed = group × phase, random = subject). Pearson or Spearman correlations (based on Shapiro-Wilk normality) quantify relations between SLR angle and continuous RCI or EMG variables. Significance is set at p < 0.05; effect sizes are reported as partial η² or r. Statistical analyses are performed in R (v4.3.2) with the "lme4" and "effectsize" packages.

Safety monitoring and adverse-event reporting The biomechanical tasks are low-risk; however, any adverse sensation (e.g., back discomfort) prompts immediate cessation and optional referral to on-campus physical-therapy services. Adverse events are documented in the electronic case-report form and reviewed weekly by the principal investigator; serious adverse events would be reported to the IRB within 24 hours, although none are anticipated.

Patient-registry considerations This investigation is not a patient registry; therefore, external certification, on-site audits, and participant-year calculations do not apply. Should future registry expansion occur, the quality-assurance framework described above provides the foundation for broader surveillance.

Keywords
hamstring muscles, Lumbar vertabrae, Pelvis, Electromyography, Range of Motion

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT07123012
Study groupRoleWhat they receive
ShortIndividuals with an SLR of 60 ° or less
NormalIndividuals with an SLR between 60 ° and 80 °
Normal longIndividuals with an SLR of more than 80 °

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Lumbar Relative Contribution Index (RCI) During Full-Range Forward Bend

    Sagittal-plane RCI is defined as the percentage of total trunk excursion attributable to lumbar-spine motion while participants bend forward from upright to maximal comfortable flexion and return. Higher values indicate greater lumbar dominance. Mean RCI will be compared across three hamstring-flexibility groups (SLR ≤ 60°, 61-79°, ≥ 80°).

    Measured: Single assessment session (one day)

  2. Lumbar Relative Contribution Index (RCI) During Partial Forward Bend

    The sagittal-plane RCI is defined as the percentage of total trunk-flexion excursion attributable to lumbar-spine motion while the participant bends forward only until the fingertips touch the patella and then returns to upright. IMU data (T12, S2) are filtered at 6 Hz and processed to compute lumbar and pelvic angles; RCI is sampled at 10 % increments of the flexion and extension phases. Mean RCI values will be compared across three hamstring-flexibility groups (SLR ≤ 60°, 61-79°, ≥ 80°).

    Measured: Single laboratory visit; data captured during a ~15-minute test session for each participant.

Secondary outcomes (1)
  1. Mean Normalised RMS EMG Amplitude of Lumbar Erector Spinae During First Half of Full-Range Forward Bend

    Surface EMG signals are recorded bilaterally from the L3-level erector-spinae muscles (Delsys Trigno, 1 000 Hz). Signals are band-pass filtered (20-450 Hz), full-wave rectified, and smoothed with a 50 ms moving RMS window, then normalised to each participant's maximal voluntary contraction (%MVC). The outcome is the average %MVC amplitude measured during the first 50 % of the flexion phase of a full-range forward bend. Group differences between hamstring-flexibility strata will be analysed using one-way ANOVA followed by Bonferroni post-hoc tests.

    Measured: Single laboratory visit; data captured during a ~15-minute test session for each participant.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Aug 2025
  2. Study start14 Apr 2025
  3. Primary completion27 Jun 2025
  4. Study completion27 Jun 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Cross-sectional
Enrolment
38 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07123012
Sponsor's protocol ID
SYU 2025-03-033-002
Acronym
RELHAM
Status last verified
Aug 2025
First submitted
7 Aug 2025
Last updated
22 Aug 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

An observational study of Hip Functional Restriction and Lumbar Spine Biomechanics, run by Sahmyook University at 1 site in South Korea.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in South Korea. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Lumbar Relative Contribution Index (RCI) During Full-Range Forward Bend (time frame: Single assessment session (one day)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Aug 2025.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in