Altered inter-joint coordination strategies of the lower extremity and pelvis in elite rowers with chronic low back pain

Abstract

Rowing is a highly coordinated, cyclic task that requires efficient inter-joint coordination across the lower extremities and pelvis to optimize force transmission and performance. Chronic low back pain (CLBP) is prevalent among elite rowers and may alter neuromuscular control strategies; however, its effects on inter-joint coordination patterns and coordination variability during rowing remain insufficiently understood. The purpose of this study was to compare lower-extremity and pelvis inter-joint coordination patterns and coordination variability between elite rowers with and without chronic low back pain during rowing at different intensity levels. Fourteen elite rowers from the Iranian National Rowing Team participated in this study. Participants were classified into a CLBP group or a healthy group based on self-reported pain criteria. Three-dimensional kinematic data were collected using a motion capture system during an incremental rowing ergometer protocol at two intensity levels. Inter-joint coordination patterns were quantified using a modified vector coding technique, and coordination variability was assessed across the rowing stroke cycle. Group- and intensity-related differences were examined using two-way mixed-design ANOVA and statistical parametric mapping (SPM). Increasing rowing intensity significantly influenced coordination pattern distributions across multiple joint couplings in both groups. However, rowers with CLBP exhibited distinct coordination strategies compared with healthy rowers, particularly characterized by altered proximal–distal dominance and greater involvement of transverse-plane joint couplings. In contrast, coordination variability did not differ significantly between groups or intensity levels across the rowing stroke. Elite rowers with chronic low back pain adopt modified inter-joint coordination strategies during rowing, despite maintaining overall coordination variability. These findings emphasize the importance of assessing coordination patterns to better understand movement adaptations associated with chronic low back pain and may inform targeted rehabilitation and training interventions in rowing.