Effects of core stabilization exercises on pulmonary function, respiratory muscle strength, and functional capacity in adolescents with substance use disorder: Randomized controlled trial

The efficacy of core stabilization exercise in mild and moderate adolescent idiopathic scoliosis: a systematic review and meta-analysis

BACKGROUND

Adolescent idiopathic scoliosis (AIS) is one of the most prevalent spinal abnormalities. Core stabilization exercise (CSE) has become a common approach in the treatment of AIS. However, the efficacy of CSE in AIS remains a subject of debate.

OBJECTIVE

To determine the efficacy of CSE in the patients with AIS in comparison with different intervention programs.

METHODS

A comprehensive search was conducted across PubMed, Embase, The Cochrane Library, Web of Science, Wan Fang, Wei Pu, and CNKI databases, encompassing literature from their inception through December 31st, 2024. Two independent reviewers screened the studies, with inter-rater agreement evaluated via kappa scores. Randomized control trials that focus on the efficacy and safety of CSE in AIS population were included in this systematic review. The risk of bias assessment was performed utilizing the National Institutes of Health Quality Assessment Tools (NIH-QAT). After quality assessments and information extraction, the meta-analysis was conducted with Review manager and the standard mean difference (SMD) was pooled among the measurement data derived from different studies. Cobb angle, angle of trunk rotation, apical vertebral rotation, Walter Reed Visual Assessment Scale, Posterior Trunk Symmetry Index, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, SRS-22,, were focused as outcomes.

RESULTS

A total of 10 studies involving 449 subjects were included in this systematic review. The average Cobb angle was 22.86° ± 8.79°, and the intervention duration varied from 8weeks to 6months. The kappa score was 0.93. Subgroup analyses were performed based on the different control groups, National Institutes of Health Quality Assessment Tools (NIH-QAT) results, and intervention durations. The results indicated that CSE could have greater effect sizes than the blank control group on Cobb angle (MD = -4.37, P < 0.05), angle of trunk rotation (MD = -1.07, P < 0.05), apical vertebral rotation (MD = -0.44, P < 0.05), quality of life as SRS-22 (MD = 0.22, P < 0.05). Notably, the efficacy of CSE appears to be weaker than that of the three-dimensional exercise group in terms of Cobb angle (MD = 3.95, P < 0.05), angle of trunk rotation (MD = 1.69, P < 0.05) and WASRS scores (MD = 0.89, P < 0.05). Other subgroup analyses yielded no statistically significant differences.

CONCLUSIONS

The present study showed that core stabilization exercise may be beneficial for the patients with mild to moderate adolescent idiopathic scoliosis, albeit less effective than three-dimensional exercises following short-term follow-up. The evidence on the efficacy of CSE is limited due to heterogeneity, small sample sizes, and multiple comparisons. The clinical trials focusing on patient compliance and training quality with long-term follow-up are warranted.

PROSPERO REGISTRATION NUMBER

CRD 42022367714.

Exercise intolerance, oxidative stress, and irisin in pediatric cystic fibrosis: Can telehealth-based exercise training make a difference?

BACKGROUND

Patients with cystic fibrosis (CF) experience increased oxidative stress. Tele-exercise can be a new method to improve exercise in CF.

OBJECTIVE

This study aimed to investigate the effect of telehealth-based exercise training using different modalities (combined exercise training group, CombG, core stabilization exercise group, SG), in comparison with control group (CG), on exercise capacity, oxidative stress, and irisin in children with CF.

METHODS

Thirty-nine children with CF (mean age=11.41±2.18 years, mean FEV1(z-score)=-0.66±1.96) were included in the study. The children were randomly allocated to groups. The CombG and SG performed core stabilization exercises (CS) 3 days per week for 8 weeks. The CombG also performed aerobic exercises 3 days per week in addition to CS. Physical activity (PA) recommendations were provided to the CG. Exercise capacity was evaluated using the Modified Shuttle Test (MST). Oxidative stress was assessed using total antioxidant status (TAS), total oxidant status (TOS), Oxidative Stress Index (OSI), malondialdehyde (MDA), and superoxide dismutase (SOD). The irisin level was also measured.

RESULTS

Children's baseline sex, age, BMI, and FEV1 z-scores were similar (p > 0.05). The MST distance (p = 0.047,np2=0.157) and%MST distance (p = 0.045, np2=0.159) significantly improved in the CombG compared with the SG and CG. Although TAS and SOD decreased over time (p < 0.05), no significant changes were observed for TAS, TOS, OSI, MDA, SOD, and irisin parameters between the groups after training (p > 0.05).

CONCLUSIONS

Combining aerobic exercise training with core stabilization applied using telehealth improved exercise capacity more than core stabilitation training only or PA recommendations in children with CF.

Dyspnea, respiratory muscle strength, cough capacity, and sleep quality in individuals with substance use disorder

There is evidence that substance use and smoking cause some adverse effects on the respiratory system. The aim of this study was to assess dyspnea severity, respiratory muscle strength, cough capacity, and sleep quality in people with substance use disorder (SUD). Forty eight individuals with SUD and 28 active cigarette smokers participated in the study. Participants' dyspnea severity was assessed using the Modified Medical Research Council Scale, respiratory muscle strength was measured with a portable electronic mouth pressure device, peak cough flow was assessed with a Peak Flow Meter, and sleep quality was determined using the Pittsburgh Sleep Quality Index (PSQI). The amount of daily cigarette smoking and dyspnea severity were significantly higher in individuals with SUD (p < .001). Peak cough flow values, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), MIP (%predicted), and MEP (%predicted) were not significantly different between the SUD patients and the active cigarette smokers (p > .05). However, PSQI sub-parameters such as subjective sleep quality, sleep latency, habitual sleep efficiency, use of sleeping medication, and total scores showed significant differences between the SUD patients and the active cigarette smokers (p < .05, p < .001, p = .03, p < .001, p < .001, respectively). Individuals with SUD were found to have higher dyspnea and poorer sleep quality than active smokers. However, respiratory muscle strength and cough capacities were similar.

The Effect of Computerized Wobble Board and Core Stabilization Exercises on Balance Performance and Exercise Capacity in Patients With Heart Failure: A Randomized Controlled Trial

OBJECTIVE

To investigate the effects of computerized wobble board exercise training (CWBET) and core stabilization exercise training (CSET) on balance performance, and exercise capacity in patients with heart failure (HF).

DESING

Single-blind randomized controlled prospective study.

SETTING

Cardiology department of a local university hospital.

PARTICIPANTS

Fifty-one patients with HF with reduced ejection fraction, whose clinical status and medication had been stable for the previous 3 months, were included (N=51). Nine patients could not complete the follow-up period due to personal reasons. No patient experienced any adverse events during exercise training.

INTERVENTIONS

Patients were randomized to CWBET, CSET, and control group. CWBET and CSET groups participated in their own exercise programs, 3 days a week for 8 weeks. The control group received no exercise program.

MAIN OUTCOME MEASURES

All patients were evaluated at baseline and after 8 weeks. Postural stability, static and functional balance, and exercise capacity were evaluated with the Sensamove Balance Test Pro with Miniboard, the one-leg stance test (OLS), the Berg Balance Scale (BBS), and the six-minute walk distance (6MWD), respectively. Core stabilization and health-related quality of life (HRQOL) were assessed with OCTOcore app, and Minnesota Living with Heart Failure Questionnaire, respectively.

RESULTS

A mixed model repeated-measures ANOVA revealed significant group × time interaction effect for static postural stability performance (P<.001, ηp2=0.472), vertical (P<.001, ηp2=0.513), horizontal performance (P<.001, ηp2=0.467), OLS (P<.001, ηp2=0.474), BBS (P<.001, ηp2=0.440) scores, 6MWD (P<.001, ηp2=0.706), and HRQOL. Post hoc analysis revealed CWBET and CSET groups had similar improvements balance performance, exercise capacity, and HRQOL and both groups significantly improved compared with control group (P<.001). Core stabilization was significantly improved only in CSET group after 8 weeks.

CONCLUSION

CWBET and CSET programs were equally effective and safe for improving balance performance and exercise capacity in patients with HF.

Peak expiratory flow, core performance and physical activity in normal-weight, overweight, and obese adolescents

The objectives of this study were to (1) compare peak expiratory flow (PEF), physical activity (PA), and core performance among normal-weight, overweight, and obese adolescents and (2) explore the relationships between PEF, physical activity, core performance, and anthropometric measurements across these groups. Ninety adolescents aged 10-13 yr were categorized based on BMI: normal weight (n = 30, 5th to < 85th percentile, BMI-Z score -2 to < 1), overweight (n = 30, 85th to < 95th percentile, BMI-Z score 1 to < 2), and obese (n = 30, > 95th percentile, BMI-Z score > 2). PEF and percent-predicted values of PEF (PEF% pred) values were calculated. Waist and neck circumferences were measured. Physical activity levels were assessed using the Physical Activity Questionnaire for Older Children (PAQ-C), from which total and subscores were derived. Core performance was evaluated through modified push-up (MPU) and sit-up tests. The PEF% pred and PAQ-C scores showed no significant differences between groups (p > 0.05). However, MPU repetition rates were significantly lower in obese adolescents compared to overweight (p = 0.019) and normal-weight peers (p < 0.001). There was a significant correlation between PEF% pred and PAQ-C total scores (p = 0.014), as well as out-of-school subscores (p = 0.039) in overweight adolescents. Similarly, PEF% pred was linked to MPU repetitions in obese adolescents (p = 0.029). Obese adolescents exhibited decreased core performance relative to their overweight and normal-weight counterparts, which correlated with the PEF% pred. Physical activity was associated with PEF% pred exclusively in overweight adolescents.

The Effects of Core Stabilization Exercises on Respiratory Muscle Strength, Respiratory Functions, and Postural Control in Children With Hearing Loss: A Randomized Controlled Trial

OBJECTIVES

To evaluate the effects of core stabilization training on respiratory muscle strength, respiratory functions, and postural control in children with hearing loss.

DESIGN

We conducted a randomized controlled trial at Bezmialem Vakif University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation. Thirty children with hearing loss who were diagnosed with prelingual sensorineural hearing loss were randomly allocated to the study (n = 15, 12.20 ± 1.69 years) and control (n = 15, 11.87 ± 2.20 years) groups. Core stabilization training protocol was performed by the study group for 8 weeks, 5 days/week, whereas the control group received no training. The primary outcome measure was respiratory muscle strength. The secondary outcome measures were: spirometry, postural control tests on Biodex Balance System, and Balance Error Scoring System (BESS). Exercise adherence was recorded via a diary for home sessions. Outcomes were assessed at baseline and the end of the 8 weeks.

RESULTS

In the study group, a significant improvement was observed in force vital capacity, peak expiratory flow of the spirometry test, maximum inspiratory pressure/expiratory pressure (MEP) of the respiratory muscle strength test; postural stability test except "anterior/posterior stability index", limits of stability test except "backward" and "forward/right", all parameters of the Modified Clinical Test for Sensory Interaction and Balance (mCTSIB) test except "eyes closed firm surface" of the Biodex Balance System, and total score of BESS. Group × time interaction was found in MEP, "overall" stability index in postural stability test, "overall," "left," and "backward left" of limits of stability test, all parameters of the mCTSIB, and BESS total.

CONCLUSIONS

Core stabilization exercises were effective in improving respiratory muscle strength, spirometry, and postural control in children with hearing loss.

ERS International Congress 2023: highlights from the Allied Respiratory Professionals Assembly

This article summarises some of the outstanding sessions that were (co)organised by the Allied Respiratory Professionals Assembly during the 2023 European Respiratory Society International Congress. Two sessions from each Assembly group are outlined, covering the following topics: Group 9.01 focuses on respiratory physiology techniques, specifically on predicted values and reference equations, device development and novel applications of cardiopulmonary exercise tests; Group 9.02 presents an overview of the talks given at the mini-symposium on exercise training, physical activity and self-management at home and outlines some of the best abstracts in respiratory physiotherapy; Group 9.03 highlights the nursing role in global respiratory health and presents nursing interventions and outcomes; and Group 9.04 provides an overview of the best abstracts and recent advances in behavioural science and health psychology. This Highlights article provides valuable insight into the latest scientific data and emerging areas affecting the clinical practice of Allied Respiratory Professionals.

Investigation of the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in unilateral breast cancer surgery survivors: a cross-sectional study

PURPOSE

Despite the research on structural and functional changes that may occur in breast cancer survivors, no study has investigated the relationship between spinal characteristics and the respiratory system. Therefore, we aimed to investigate the relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions in breast cancer patients who have completed their treatment METHODS: This cross-sectional study included 38 female breast cancer surgery survivors. Participants underwent the following evaluations: Chest wall mobility with a tapeline; postural assessments (spinal curvature, spinal mobility, and spinal inclination) with a non-invasive, computer-assisted electromechanical device; and pulmonary function test and respiratory muscle strength with a portable digital spirometer device. The relationship between spinal posture and mobility to respiratory muscle strength and pulmonary functions was analyzed by the bivariate correlation analysis.

RESULTS

Increased thoracic curvature angle was associated with decreased FEV1 (r=-0.360, p=0.026) and decreased subcostal mobility (r=-0.385, p=0.017), and the increase in thoracic frontal mobility was associated with decrease in PEF (r=-0.342, p=0.036). Increased lumbar mobility was associated with increased FVC (r=0.324, p=0.047), and increased total spinal inclination mobility was associated with decreased MIP (r=-0.396, p=0.017). Chest wall mobility was associated with postural assessments at varying rates (the r value ranged from -0.357 to 0.661, p<0.05).

CONCLUSION

The changes in spinal posture and mobility of women who have undergone unilateral breast cancer surgery were associated with respiratory parameters and thoracic cage mobility. These patients' spinal posture and mobility should be taken into account in conjunction with respiratory functions for a comprehensive assessment.

Effects of Core Stabilization Training on the Cobb Angle and Pulmonary Function in Adolescent Patients with Idiopathic Scoliosis

Objective

To observe the effects of core stabilization training on the Cobb angle, respiratory muscle strength (maximum inspiratory pressure, MIP; maximal expiratory pressure, MEP), and pulmonary function (forced vital capacity, FVC; forced expiratory volume, FEV1.0; FEV1.0/FVC%) in adolescent patients with idiopathic scoliosis (AIS) and offer practical-based evidence for the rehabilitation treatment for AIS patients.

Methods

36 AIS patients were assigned to the core stability training (CST) group (n = 18) and control group (n = 18); the CST group participated in three sessions of core stabilization exercise per week for 12 weeks and the control group did not perform regular physical training during 12 weeks of study. Then, the Cobb angle, respiratory muscle strength (MIP and MEP), and pulmonary function (FVC, FEV1.0, and FEV1.0/FVC%) were measured before and after core stabilization training.

Results

After 12 weeks of core stabilization training, compared with the pretest, the Cobb angle showed a significant decrease, FVC, FEV1, MIP, and MEP a significant increase (P < 0.01 respectively), and there was no statistical difference in FEV1/FVC in the CST group; there was no significant difference (P > 0.05 respectively) before and after an experiment in the control group except MEP decreased significantly (P < 0.01, P < 0.05). After 12 weeks of core stabilization training, compared with the control group, the Cobb angle significantly decreased (P < 0.01), FVC, FEV1, MIP, and MEP significantly increased (P < 0.05 respectively) in the CST group, but there was no significant difference (P > 0.05, respectively) in FEV1/FVC between the control group and CST group.

Conclusions

Core stabilization exercise can be considered to have a positive effect on the normal physiological curvature of the spine in AIS patients, as it decreases the Cobb angle and strengthens respiratory muscle strength and pulmonary function.