Neuromuscular Effects of Coordinated Locomotor Training on Core Stability and Postural Control in Athletes (CLT-CORE)

Neuromuscular Effects of Coordinated Locomotor Training on Static and Dynamic Core Stability and Postural Control in Novice Runners: A Randomized Clinical Trial

Core stability and postural control are essential for athletic performance. They affect how efficiently an athlete moves, maintains balance, and avoids injuries. However, researchers have not yet fully explored how coordinated locomotor training - a movement approach that uses walking patterns combined with sprinter and skater positions - changes the way an athlete's nerves and muscles work together. This study aims to compare the effects of coordinated locomotor training versus traditional plyometric exercises on core stability and balance control in novice runners.

The study will enroll 28 novice runners between 18 and 30 years of age. Participants must run less than 10 miles per week and have less than one year of consistent running experience. They will be randomly assigned to either the coordinated locomotor training group or the plyometric training group. The intervention lasts 8 weeks with two sessions per week. Each session runs for about 60 minutes. The researchers will measure core endurance using the Mcgill core endurance tests and the Sahrmann core stability test. Dynamic balance will be assessed using the Star Excursion Balance Test. Postural control will be evaluated using the Romberg test.

The researchers expect that athletes who undergo coordinated locomotor training will show greater improvements in core muscle activation and postural control compared to those who perform plyometric exercises. If proven effective, this training method could provide coaches and trainers with an evidence-based strategy to enhance athletic performance and reduce injury risk.

Study Overview

• Status: Active, not recruiting
• Conditions: Core Stability; Postural Control Deficits
• Intervention / Treatment: Other: Coordinated Locomotor Training; Other: Plyometric Training

Detailed Description

Coordinated locomotor training (CLT) was developed by Britta from Germany. This exercise technique visualizes and simplifies human movement by combining walking - which is the most coordinated human action - into a pattern with two forms: a sprinter position and a skater position. Research by Meardon and colleagues (2016), Hwang and colleagues (2017), and Lee (2021) has shown promising applications of CLT in various populations. However, only a few investigations have looked at the relationship between core stability and sport-specific skills, particularly in runners.

The overall incidence of running overuse injuries has been observed to range from 19.4% to 79.3%. Due to rigorous training, exhaustion, and biomechanical abnormalities, athletes frequently experience decreased postural control and core stability. This raises their risk of injury and impairs their performance. According to Chaudhari and colleagues (2020), coordinated locomotor training may enhance neuromuscular function, core stability, and postural control in athletic populations.

Study Objectives:

The primary objective is to determine the neuromuscular effects of coordinated locomotor training on static core stability, dynamic core stability, and postural control in novice runners. The secondary objective is to compare these effects against a plyometric training protocol.

Hypotheses:

Null hypothesis (H0): There will be no statistically significant difference in neuromuscular effects between coordinated locomotor training and plyometric training on static and dynamic core stability and postural control in novice runners.

Alternative hypothesis (H1): There will be a statistically significant difference in neuromuscular effects between coordinated locomotor training and plyometric training on static and dynamic core stability and postural control in novice runners, with the CLT group showing greater improvements.

Study Design:

This is a randomized, double-blind clinical trial. The study will be conducted at three universities in Faisalabad, Pakistan: the University of Faisalabad, Government College University of Faisalabad, and Agriculture University of Faisalabad. The study population consists of novice runners from these universities.

Sample Size and Sampling:

A total of 28 participants will be enrolled, as calculated using Epitool software. Simple random sampling will be used to select participants. The sample size is based on previous research by Chaudhari and colleagues (2020).

Eligibility Criteria:

Inclusion Criteria: (1) Age between 18 and 30 years; (2) Running less than 10 miles per week; (3) Not participating in running sports (such as soccer) more than once per week; (4) Less than one year of consistent running experience; (5) Both male and female novice runners.

Exclusion Criteria: (1) History of musculoskeletal injury in the past six months; (2) Diagnosed neurological or vestibular disorders; (3) Presence of current pain, discomfort, or functional limitation during normal or athletic activities; (4) Presence of cardiovascular or respiratory disorders that restrict moderate to high intensity physical activity; (5) Regular use of medications that affect neuromuscular performance, coordination, or balance; (6) Pregnant women.

Intervention Details:

Group A (Coordinated Locomotor Training):

Each session begins with a 5-minute warm-up to familiarize participants with the sprinter and skater techniques. Participants actively perform both movements in a standing position. The main CLT session lasts 60 minutes and is conducted twice per week for 8 weeks, totaling 16 sessions. Participants perform coordinated movement training in four positions: supine, crawling, sitting, and standing. Each position includes 10 repetitions per set, with 3 sets completed, taking approximately 30 minutes. The remaining time includes transition, rest, and cool-down activities.

Group B (Plyometric Training):

The warm-up consists of 2 series of 30 seconds of stimulation including 30 seconds of cool-down with multi-directional jumps. There is a 5-second interval between each jump within each series. The plyometric training protocol consists of 6 series of squat jumps with 30 seconds of activation and 30 seconds of relaxation. There is a 2-second interval between each jump within each series. Participants jump onto a box with a height of 45 centimeters.

Outcome Measures and Assessment Tools:

Static Core Stability: Assessed using the Mcgill core endurance tests (trunk flexor test, trunk extensor test, right side bridge test, left side bridge test) and the Sahrmann core stability test (5 levels).

Dynamic Core Stability and Postural Control: Assessed using the Star Excursion Balance Test (SEBT) which measures reach distance in eight directions normalized to leg length, and the Romberg test (eyes open and eyes closed conditions).

Randomization and Blinding:

Participants will be randomly assigned to either group using a computer-generated random sequence. The study is double-blind: both the outcome assessors and the data analysts will be unaware of group assignments. Participants cannot be blinded due to the nature of the interventions.

Data Collection Procedure:

After obtaining informed consent, researchers will record baseline measurements for all outcome measures. The same measurements will be repeated at the end of the 8-week intervention period. All assessments will be conducted by trained physical therapists who are blinded to group allocation.

Statistical Analysis:

Data will be analyzed using SPSS version 22. Descriptive statistics will be calculated for demographic variables. Within-group comparisons will be performed using paired t-tests (if data are normally distributed) or Wilcoxon signed-rank tests (if non-normal). Between-group comparisons will be performed using independent t-tests or Mann-Whitney U tests. Statistical significance will be set at p < 0.05.

Ethical Considerations:

Ethical approval has been obtained from the Research Ethics/Technical Committee of the University of Faisalabad. Written informed consent will be obtained from all participants before enrollment. Participants may withdraw from the study at any time without penalty.

• Study Type: Interventional
• Enrollment (Estimated): 28
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Faisalābad, Punjab Province, Pakistan, 3800
      • The University of Faisalabad

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age between 18 and 30 years
• Running less than 10 miles (approximately 16 kilometers) per week
• Not participating in running sports (such as soccer, track, or cross-country) more than once per week
• Less than one year of consistent running experience
• Male and female novice runners
• Willing to provide written informed consent

Exclusion Criteria:

• History of musculoskeletal injury (including fractures, ligament tears, or muscle strains) in the past six months
• Diagnosed neurological disorders (such as stroke, multiple sclerosis, or Parkinson's disease)
• Diagnosed vestibular disorders (such as benign paroxysmal positional vertigo or labyrinthitis)
• Presence of current pain, discomfort, or functional limitation during normal daily activities or athletic activities
• Presence of cardiovascular disorders (such as uncontrolled hypertension or heart disease) that restrict moderate to high intensity physical activity
• Presence of respiratory disorders (such as severe asthma or COPD) that restrict moderate to high intensity physical activity
• Regular use of medications that affect neuromuscular performance, coordination, or balance (including sedatives, muscle relaxants, or antiepileptic drugs)
• Pregnancy
• Any condition that, in the opinion of the investigator, would preclude safe participation in exercise training

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Coordinated Locomotor Training Group; Participants in this arm receive coordinated locomotor training (CLT) consisting of sprinter and skater position exercises performed in supine, crawling, sitting, and standing positions. Each session lasts 60 minutes, twice weekly for 8 weeks (16 sessions total).	Other: Coordinated Locomotor Training; Coordinated locomotor training is an exercise technique that visualizes and simplifies human movement by combining walking patterns with sprinter and skater positions. The intervention includes: (1) A 5-minute warm-up familiarizing participants with sprinter and skater techniques in standing position; (2) Main CLT session of 60 minutes performed in supine, crawling, sitting, and standing positions; (3) Each position requires 10 repetitions per set, with 3 sets completed; (4) Total of 16 sessions conducted over 8 weeks, twice per week. The training is supervised by trained physical therapists.; Other: Plyometric Training; Plyometric training consists of: (1) Warm-up with 2 series of 30 seconds stimulation and 30 seconds cool-down with multi-directional jumps, with 5-second intervals between jumps; (2) 6 series of squat jumps onto a 45 cm box, with 30 seconds activation and 30 seconds relaxation, with 2-second intervals between jumps; (3) Total of 16 sessions conducted over 8 weeks, twice per week. Each session is supervised by trained physical therapists.
Active Comparator: Plyometric Training Group; Participants in this arm receive plyometric training consisting of multi-directional jumps and squat jumps onto a 45 cm box. Each session includes warm-up, activation series, and cool-down. Sessions are conducted twice weekly for 8 weeks.	Other: Plyometric Training; Plyometric training consists of: (1) Warm-up with 2 series of 30 seconds stimulation and 30 seconds cool-down with multi-directional jumps, with 5-second intervals between jumps; (2) 6 series of squat jumps onto a 45 cm box, with 30 seconds activation and 30 seconds relaxation, with 2-second intervals between jumps; (3) Total of 16 sessions conducted over 8 weeks, twice per week. Each session is supervised by trained physical therapists.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Mcgill Core Endurance Test Scores	The Mcgill core endurance tests consist of four subtests: trunk flexor test, trunk extensor test, right side bridge test, and left side bridge test. For each test, participants hold a specific position for as long as possible. The time in seconds is recorded for each position. Longer hold times indicate better core endurance.	Baseline (Week 0) and Week 8 (post-intervention)
Change in Sahrmann Core Stability Test Level	The Sahrmann core stability test consists of 5 progressive levels. Participants start with Level 1 (lifting one leg to 90 degrees hip and knee flexion) and progress through increasing difficulty to Level 5 (lowering both legs simultaneously without heels touching the table). The highest level successfully completed without compensatory movement is recorded. Higher levels indicate better core stability.	Baseline (Week 0) and Week 8 (post-intervention)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Romberg Test Performance	he Romberg test assesses postural control by measuring body sway during standing. Participants stand with feet together, arms at sides, first with eyes open for 30 seconds, then with eyes closed for 30 seconds. The amount of body sway or loss of balance is recorded. Increased sway or inability to maintain position indicates poorer postural control.	Baseline (Week 0) and Week 8 (post-intervention)

Collaborators and Investigators

• Sponsor: University of Faisalabad

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2026
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): July 15, 2026

Study Registration Dates

• First Submitted: June 6, 2026
• First Submitted That Met QC Criteria: June 6, 2026
• First Posted (Actual): June 11, 2026

Study Record Updates

• Last Update Posted (Actual): June 11, 2026
• Last Update Submitted That Met QC Criteria: June 6, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Neuromuscular Training; Athletes; Postural Control; Core Stability; Coordinated Locomotor Training
• Additional Relevant MeSH Terms: Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Therapeutics; Physical Therapy Modalities; Patient Care; Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Physical Conditioning, Human; Exercise; Plyometric Exercise
• Other Study ID Numbers: TUF/EIRB/ 196 /26

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No