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

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.