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Ipsilateral versus contralateral static endurance- balance abilities among healthy college students. J Taibah Univ Med Sci 2024; 19:321-326. [PMID: 38299117 PMCID: PMC10828453 DOI: 10.1016/j.jtumed.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/25/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024] Open
Abstract
Objectives This study sought to determine the association and the difference, if any, between the levels of the contralateral and between the levels of the ipsilateral sides during static endurance-balance exercise. Methods One hundred twelve healthy active- college students (55 females and 57 males) participated in this cross-sectional study. Each participant performed the contralateral (raising one arm and opposite-side leg) quadruped bird dog exercise and balanced in static condition. Side bridge exercise was performed from lying on your side then engaging your core muscles and lifting your upper body and hips off the ground, maintaining a straight line and holding this position as long as tolerated. Results Wilcoxon signed rank test showed significant difference (p = 0.004) between the contralateral right and left quadruped bird dog but insignificant difference (p = 0.059) between the ipsilateral right and left side bridge endurance-balance exercises. Mann-Whitney U test showed that the holding time was significant across gender for the contralateral but was insignificant for the ipsilateral endurance-balance exercise. Mann-Whitney U test was insignificant (p > 0.05) between those being recreationally active or inactive. Kruskal-Wallis test revealed insignificant difference between body mass index categories. Spearman's rho correlation coefficient showed strong positive correlation equals 0.85 and 0.75 (p < 0.001) of the contralateral quadruped bird dog and the ipsilateral side bridge exercises respectively. Conclusions A significant difference was observed for contralateral, while no significant difference was found for ipsilateral endurance-balance abilities. Therefore, clinicians and rehab specialist should consider these findings when assessing the endurance-balance abilities to properly devise appropriate exercise progression of different trunk stabilizers.
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Effects of core stability and feedback music on upper body mediolateral movements during cycling. BMC Sports Sci Med Rehabil 2024; 16:29. [PMID: 38509568 PMCID: PMC10956249 DOI: 10.1186/s13102-024-00822-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 01/22/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Asymmetry in involuntary trunk motion during voluntary movements of the lower extremities is a risk factor for musculoskeletal injuries and may be related to core stability. Core stability plays a pivotal role in maintaining postural stability during distal segment movements. Because mediolateral head motion partially represents trunk motion during rhythmic movements, controlling it can help ensure symmetric trunk motion. This study aimed to investigate the relationship between core stability and asymmetric trunk motion during rhythmic movements, and to evaluate the effects of feedback music on mediolateral head motion. METHODS We developed a system that uses a wireless earbud and a high-resolution inertial measurement unit sensor to measure head angle and provide feedback music. When the head angle exceeds a predefined threshold, the music is muted in the earbud on the side of the head tilt. In our lab-based study, we measured head angles during cycling at 70% of maximum speed using this self-developed system, and compared them between individuals with good (Sahrmann core stability test: 2-5 level) and poor core stability (0-1 level). The amplitude of mediolateral head motion was represented by the difference between the left and right peak angles, and the symmetry in mediolateral head motion was represented by the average of left and right peak angles. RESULTS Individuals with poor core stability demonstrated significantly greater amplitude of, and less symmetry in, mediolateral head motion than those with good core stability. Additionally, feedback music significantly reduced the amplitude of mediolateral head motion in both the good- and poor-core-stability groups. CONCLUSION Our findings indicate that core stability is crucial for maintaining symmetric head motion during rhythmic movements like cycling. Feedback music could serve as an effective tool for promoting symmetry in head motion and thus preventing musculoskeletal injuries.
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Exploring the relationship between core stability and vertical jump in recreationally active male college students based on a suite of novel core stability assessments. Heliyon 2024; 10:e25236. [PMID: 38322848 PMCID: PMC10845920 DOI: 10.1016/j.heliyon.2024.e25236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/08/2024] Open
Abstract
Various assessments have contributed to inconsistent findings regarding the correlation between core stability and vertical jumps. Therefore, this study aimed to re-examine this correlation based on novel core stability assessments. Twenty-one recreationally active male college students (age, 21.7 ± 2.1 years; stature, 174.9 ± 6.7 cm; body mass, 67.7 ± 7.8 kg; leg length, 88.9 ± 4.8 cm; arm length, 87.8 ± 4.0 cm) participated in this experiment. Core stability was divided into static and dynamic core stabilities, with the static core stability measured using the Eight-Level Prone Bridge and Five-Level Side Bridge tests and the dynamic core stability measured using the Y Balance Test (YBT). These tests comprehensively evaluate core stability as it is defined. Kinematic and kinetic data on vertical jumps were collected to provide process information beyond the outcome performance. Subsequently, these data were correlated with core stability for a deeper insight into the relationship between core stability and the process and outcome performance of vertical jumps. The main results revealed that the Eight-Level Prone Bridge demonstrated moderate to substantial correlations with Δ F y ‾ , Δ I y , Δ D l e f t k n e e z , and Δ D l e f t a n k l e y (-0.62 ≤ r ≤ 0.52); the Five-Level Side Bridge exhibited moderate correlations with Δ F x ‾ , Δ F y ‾ , Δ I x , Δ I y , Δ D l e f t k n e e z , and Δ D l e f t a n k l e y (-0.52 ≤ r ≤ 0.59); YBT displayed moderate correlations with F z ‾ , F l e f t z ‾ , Δ D l e f t a n k l e y , Δ D r i g h t a n k l e y , Δ D l e f t a n k l e z , Δ D r i g h t a n k l e z , NΔ T a n k l e y ‾ , and N T l e f t a n k l e z ‾ (-0.54 ≤ r ≤ 0.54) during the propulsive phase of vertical jumps. However, no significant correlations were observed between static/dynamic core stability and jumping height. Therefore, individuals with greater core stability should experience improved process performance (better movement quality), although this benefit is ineffective in translating into jumping height improvement due to impaired explosive features. Coaches may consider core stability in training to trigger an improved process performance of the vertical jump when the technique is the key issue to be solved, although future studies are required to verify this further.
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Clarifying the relationships between trunk muscle endurance, respiratory muscle strength and static/dynamic postural control in Latin dancers. Sports Biomech 2024:1-14. [PMID: 38193516 DOI: 10.1080/14763141.2024.2301984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/30/2023] [Indexed: 01/10/2024]
Abstract
Sufficient study has not been performed to clarify the role of trunk/respiratory muscles strength/endurance in providing postural control in dancers. The purpose of this study was to identify predictors affecting static/dynamic postural control in Latin dancers and to compare these measurements with non-dancers. The study included 38 (26F; 12 M) Latin dancers and 33 (21F; 11 M) non-dancers. Static/dynamic postural control, trunk muscle endurance, respiratory muscle strength/pulmonary functions, flexibility, and reaction tests were assessed with a force platform system, the McGill battery, spirometer, sit-and-reach test and Nelson-reaction-tests, respectively. Trunk muscle endurance times, respiratory muscle strength, FEV1/FVC, gender, hours of training per week and dancing experience were significant predictors of static/dynamic postural control in dancers (p < 0.05). All the trunk muscle endurance times, reaction tests results, and maximal inspiratory pressure were higher in the dancers compared to the non-dancers (p < 0.05). The limits of stability for forward and backward directions were higher, and anteroposterior sway in normal stability with eyes open was lower in the dancers compared to the non-dancers (p < 0.05). Trunk muscles endurance, respiratory muscle strength, dancing experience, and hours of training per week were positively associated with static/dynamic postural control. These predictors should be taken into consideration to improve postural control in dancers.
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Trunk muscle activation in prone plank exercises with different body tilts. J Back Musculoskelet Rehabil 2024; 37:743-750. [PMID: 38217576 DOI: 10.3233/bmr-230209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
BACKGROUND Body tilt changes could affect the intensity/difficulty of core stability exercises, but there is still a lack of knowledge about its impact. OBJECTIVE To analyse the trunk muscles activation during prone plank exercises at different body tilts. METHODS Twenty-four young adults who performed recreational gymnastic activities participated in this study. Electromyography activity of the rectus abdominis (RA), external oblique (EO), internal oblique (IO) and erector spinae (ES) was recorded during the performance of six variations of the prone plank exercise (planking with feet supported on the ground [conventional horizontal position] and planking with feet supported on wall bars at five different heights increasing the angle tilt) and an inverted position exercise. RESULTS The RA, EO and IO activation in all prone plank variations were higher than those observed in the conventional prone plank. In addition, the coefficient of variation of the muscle activation increased with the declination angle, reaching the highest values in the inverted position for the RA and ES muscles. CONCLUSION The results seem to indicate that the body tilt variation could be used as an easy and inexpensive strategy for modulating the neuromuscular demands and the motor control challenge during planking exercises.
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Diaphragmatic breathing combined with abdominal drawing-in maneuver for walking function in post-stroke patients: a randomized controlled study protocol. Trials 2023; 24:677. [PMID: 37858261 PMCID: PMC10588227 DOI: 10.1186/s13063-023-07690-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 09/29/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Patients with stroke frequently experience walking dysfunction. Core training can help improve balance and walking function in patients with stroke. However, core training movements in clinical practice are numerous and differently targeted. Therefore, this study will investigate the improvement of walking function in patients with combined diaphragmatic breathing maneuver (DBM) and draw-in breathing technique (ADIM) training. METHODS This single-blind, randomized controlled preliminary will analyze the viability of DBM combined ADIM training versus routine rehabilitation therapy in patients with stroke with early to mid-stroke. Patients will be randomly assigned to either the DBM and ADIM training or the routine rehabilitation training. We will recruit 42 stroke inpatients from the Second Rehabilitation Hospital of Shanghai who meet the trial criteria and measure the balance and walking functions and improvement of that after 4 weeks of intervention. The primary outcome is the 10 m maximum walking test (10MWT). The secondary outcomes indices include the limits of stability test (LOS), Berg balance scale test (BBS), Functional Ambulation Categories test (FAC), Timed Up and Go test (TUG), trunk impairment scale test (TIS), ultrasound indicators of the diaphragm and transversus abdominis (UI), rhythmic weight shift test (RWS), walk across test (WA), Fugl-Meyer assessment of lower extremity (FMA-LE), and Barthel index of ADL test. DISCUSSION The primary objective of this project was to investigate the effects of DBM combined with ADIM on balance capacity and walking function for patients with early to mid-stroke. The outcomes of this study will hold significant implications for future clinical applications in rehabilitation. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR), ID: ChiCTR2100054897. Registered on 28 December 2021.
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Core training and performance: a systematic review with meta-analysis. Biol Sport 2023; 40:975-992. [PMID: 37867742 PMCID: PMC10588579 DOI: 10.5114/biolsport.2023.123319] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/21/2022] [Accepted: 12/14/2022] [Indexed: 10/24/2023] Open
Abstract
The purposes were to synthesize as much scientific evidence as possible to determine the effect of core training on balance, throwing/hitting velocity or distance, and jumping in healthy subjects, identify the possible differences between isolated and combined core training on performance and study training and sample variables related to performance. PRISMA guidelines were followed, and a systematic search was performed in the Scopus, Web of Science, Sports Discuss, and PubMed databases with no date restrictions until November 2022. The studies were considered for this meta-analysis following PICO; a) randomized control trials and randomized allocation studies with healthy subjects and > 12 years old b)isolated or combined core training programs with a minimum of 4 weeks in length; c) athletic performance outcomes for balance, throw/hit, and jump variables should be measured; d) sufficient data to calculate effect sizes. The Cochrane Collaboration Risk of Bias Tool and the Grading of Recommendations Assessment, Development, and Evaluation approach were used for assessing methodological quality. A total of 3223 studies were identified, 22 studies were included in the systematic review and 21 for the meta-analysis. We observed that core training improved balance outcomes (ES = 1.17; p < 0.0001), throwing/hitting velocity (ES = 0.30; p = 0.14), throwing/hitting distance (ES = 3.42; p = 0.03), vertical jumping (ES = 0.69; p = 0.0003), and horizontal jump (ES = 0.84; p = 0.01). Our findings indicate that core training improved different variables of performance such as balance, throw/hit, and vertical and horizontal jump.
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Diaphragm and core stabilization exercises in low back pain: A narrative review. J Bodyw Mov Ther 2023; 36:221-227. [PMID: 37949564 DOI: 10.1016/j.jbmt.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 05/03/2023] [Accepted: 07/04/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Core stabilization is a vital concept in clinical rehabilitation (including low back pain rehabilitation) and competitive athletic training. The core comprises of a complex network of hip, trunk and neck muscles including the diaphragm. AIMS The paper aims to discuss the role of the diaphragm in core stability, summarize current evidence and put forth ideal core training strategies involving the diaphragm. METHOD Narrative review RESULTS: The diaphragm has a dual role of respiration and postural control. Evidence suggests that current core stability exercises for low back pain are superior than minimal or no treatment, however, no more beneficial than general exercises and/or manual therapy. There appears to be a higher focus on the transversus abdominis and multifidi muscles and minimal attention to the diaphragm. We propose that any form of core stabilization exercises for low back pain rehabilitation should consider the diaphragm. Core stabilization program could commence with facilitation of normal breathing patterns and progressive systematic restoration of the postural control role of the diaphragm muscle. CONCLUSION The role of the diaphragm is often overlooked in both research and practice. Attention to the diaphragm may improve the effectiveness of core stability exercise in low back pain rehabilitation.
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Recovery of two elite footballers from adductor strain with dry needling and eccentric strengthening: Two case studies. J Bodyw Mov Ther 2023; 35:332-336. [PMID: 37330790 DOI: 10.1016/j.jbmt.2023.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/10/2023] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Groin injuries are common in sports, almost 68% adductor strain among them, which generally more prone in football, soccer, hockey, and other games. The available literature well describes the rehabilitation phase of adductor strain but an application of dry needling on adductor injuries are not yet established. CASE DESCRIPTION Two national-level younger football players were clinically diagnosed with the adductor strain. They had severe pain on medial aspect of the thigh, aggravated with kicking and functional activity (VAS- 8/10, LEFS 58/80, 69/80). The therapist assessed the patients and designed their rehabilitation protocol as per their findings of the examination. OUTCOME The lower extremity functional scale (LEFS), global rating scale, and VAS were used as outcome variables. The total intervention was given for 10-12 weeks, follow up had been taken for 4 months. DISCUSSION The application of dry needling reduced the pain, improved and relieved the symptoms. The eccentric strengthening of the adductors and core stability improved the strength as well as functional activity of the lower limb. The case study is not generalized the effect of treatment. Thus, a randomized control trial is suggested for further study.
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Trunk Impairment Scale for Predicting Lumbar Spine Bone Mineral Density in Young Male Patients With Subacute Stroke. Ann Rehabil Med 2023; 47:98-107. [PMID: 37070284 PMCID: PMC10164518 DOI: 10.5535/arm.23005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/24/2023] [Indexed: 04/19/2023] Open
Abstract
Objective To investigate the relationship between Trunk Impairment Scale (TIS) and lumbar spine bone mineral density (BMD) in subacute stroke patients. Methods Twenty-three subacute male stroke patients under the age of 65 were prospectively enrolled to exclude both postmenopausal and senile effects on BMD. The TIS, Berg Balance Scale, the Korean version of the Modified Barthel Index, and manual muscle test were measured at admission and 3 months after stroke onset. BMD of the bilateral lower extremities and lumbar vertebrae was measured by dual-energy X-ray absorptiometry 3 months after stroke onset. Results TIS at baseline (TIS_B) and TIS at 3 months after stroke (TIS_3m) showed significant correlations with lumbar BMD (TIS_B, r=0.522; TIS_3m, r=0.517). Through multiple regression analysis, the TIS_B was associated with lumbar BMD (adjusted R2=0.474). However, BMD of the bilateral lower extremities was not correlated with any clinical measurements except body mass index. Conclusion We found a relationship between TIS_B and lumbar BMD in subacute young male stroke patients. Stroke patients with poor trunk control in the early subacute stage would have low BMD of vertebral bones at 3 months. The TIS can be useful for estimating bone fragility in the lumbar vertebrae of subacute stroke patients.
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Effect of Cognitive Load on Anticipatory Postural Adjustment Latency and its Relationship with Pain-Related Dysfunction in Non-specific Chronic Low Back Pain: A Cross-Sectional Study. Pain Ther 2023; 12:723-735. [PMID: 36932302 PMCID: PMC10199985 DOI: 10.1007/s40122-023-00495-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
INTRODUCTION This study aimed to investigate the effect of cognitive load on anticipatory postural adjustment (APA) latency in patients with non-specific chronic low back pain (NCLBP) and its relationship with pain-related functional changes. METHODS A cross-sectional study was conducted from December 15, 2022 to January 25, 2023. Participants were divided into a healthy control group (n = 29) and an NCLBP group (n = 29). Each group was assigned a single task of rapid arm raising and a dual task of rapid arm raising combined with a cognitive load. The cognitive load task was conducted using visual conflict. The APA latency for bilateral trunk muscles was observed using electromyography. The duration of electromyography recording in each task cycle was 28 s. Pain related-functional changes were evaluated using Roland-Morris Disability Questionnaire (RMDQ) before all tasks. RESULTS The APA latency for the right multifidus was significantly delayed in the NCLBP group [25.38, 95% confidence interval (CI) 13.41-37.35] than in the healthy control group (- 5.80, 95% CI - 19.28 to 7.68) during dual task (p = 0.0416). The APA latency for the right multifidus (25.38, 95% CI 13.41-37.35) and transverse abdominis/internal oblique (29.15, 95% CI 18.81-39.50) were significantly delayed compared with on the left side in the NCLBP group during dual task (- 3.03, 95% CI - 15.18-9.13, p = 0.0220; 3.69, 95% CI - 6.81 to 14.18, p = 0.0363). The latency delay of the right and left multifidus APA in the NCLBP group under the dual-task was positively correlated with RMDQ scores (r = 0.5560, p = 0.0017; r = 0.4010, p = 0.0311). CONCLUSIONS Cognitive load could induce APA delay in the right trunk muscles and co-activation pattern changes in bilateral trunk muscle APA in patients with NCLBP. The APA onset delay in multifidus is positively related to pain-related daily dysfunction. Trial Registration ChiCTR2300068580 (retrospectively registered in February 23, 2023).
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Effects of Home-Based Boxing Training on Trunk Performance, Balance, and Enjoyment of Patients With Chronic Stroke. Ann Rehabil Med 2023; 47:36-44. [PMID: 36635885 PMCID: PMC10020051 DOI: 10.5535/arm.22127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/12/2022] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To investigate the effect of 6 weeks of home-based boxing training on trunk performance, balance, fear of falling, and level of therapy enjoyment in individuals with chronic stroke. METHODS Eighteen participants with chronic stroke were randomly divided into boxing and control groups (9 patients per group). The boxing group received home-based boxing training for 25 minutes plus balance and trunk exercise training for 15 minutes, while the control group received only home-based balance and trunk exercise training for 40 minutes, three days a week for 6 weeks. The Trunk Impairment Scale (TIS), Mini-Balance Evaluation Systems Test (Mini-BESTest), Activities-specific Balance Confidence (ABC) scale, and Physical Activity Enjoyment Scale (PACES) were assessed at baseline, and at 2, 4, and 6 weeks post-training. The Wilcoxon signed rank test and Mann-Whitney U-test were used to determine differences between pre- and post-training within and between groups. Statistical significance was set at p<0.05. RESULTS The TIS scores significantly increased from 13 to 17 points in the boxing group (p<0.05) compared to an increase from 15 to 17 points in the control group (p<0.05). The Mini-BESTest scores significantly increased from 14 to 22 points in the boxing group (p<0.05) compared to an increase from 17 to 20 points in the control group (p<0.05). There were no differences in the TIS, Mini-BESTest, ABC, and PACES scores between the two groups. CONCLUSION Home-based boxing training with balance and trunk exercise training had a similar training effect compared to home-based balance and trunk exercise training.
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A comparison of lumbopelvic muscle endurance, stability, mobility, and respiratory functions in children and adolescents with and without nocturnal enuresis. Clin Biomech (Bristol, Avon) 2023; 101:105829. [PMID: 36481745 DOI: 10.1016/j.clinbiomech.2022.105829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Postural deterioration, delayed maturation, and accompanying respiratory diseases in children and adolescents with nocturnal enuresis have been reported in previous studies. This study aimed to compare lumbopelvic muscle endurance, stability, mobility, and respiratory functions in children and adolescents with and without nocturnal enuresis. METHODS Children and adolescents with (n:25, nocturnal enuresis group) and without nocturnal enuresis (n:29, control group) were included. The bladder and bowel dysfunctions with the Bladder and Bowel Dysfunction Questionnaire and voiding diary, lumbopelvic muscle endurance with the McGill trunk muscle endurance tests, lumbopelvic stability with the Sahrmann test, lumbopelvic mobility with the Modified Schober test, and respiratory function with a spirometer were assessed. Independent samples t-test, Mann Whitney U test, and Chi-square tests were used for analysis. FINDINGS Trunk flexor (p = 0.043), extension (p = 0.045), and right (p = 0.008) and left lateral flexion endurance test scores (sec) (p = 0.005), the Sahrmann test score (p = 0.005), and Modified Schober test (p < 0.001) results were lower in the nocturnal enuresis group compared to the control group. However, there were no differences between groups in terms of forced expiratory volume in 1 s (p = 0.415), forced vital capacity (p = 0.522), forced expiratory volume in 1 s/ forced vital capacity (p = 0.970), and peak expiratory flow values (p = 0.495). INTERPRETATION The children and adolescents with nocturnal enuresis had lower lumbopelvic muscle endurance, stability, and mobility compared to those without nocturnal enuresis; however, the respiratory functions were similar. The lumbopelvic structure changes may be taken into consideration for the management of nocturnal enuresis.
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Effect of Dynamic Neuromuscular Stabilization on Balance, Trunk Function, Falling, and Spasticity in People With Multiple Sclerosis: A Randomized Controlled Trial. Arch Phys Med Rehabil 2023; 104:90-101. [PMID: 36206832 DOI: 10.1016/j.apmr.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/01/2022] [Accepted: 09/19/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To compare the effects of core stabilization (CS) and dynamic neuromuscular stabilization (DNS) on balance, trunk function, mobility, falling, and spasticity, in people with multiple sclerosis (PWMS). DESIGN Two-group randomized controlled trial. SETTING General community and referral center. PARTICIPANTS A total of 64 PWMS, between 30 and 50 years old, and an expanded disability status scale between 2 and 5, participated in this study (N=64). INTERVENTIONS Participants were randomly assigned to CS (n=32) and DNS (n=32) groups. Both groups received a total of 15 sessions of CS or DNS exercises, 60 minutes per session, 3 times a week during the 5 weeks. OUTCOME MEASURES Balance function was measured as the primary outcome measure. Trunk function, postural stability, falling rate, fear of falling, falling index, mobility, and spasticity were measured as secondary outcomes. RESULTS DNS group had significant improvement in Berg balance scale, trunk impairment scale, postural stability, activities-specific balance confidence, reduced falling rate, the timed Up and Go (TUG), multiple sclerosis walking scale-12, and multiple sclerosis spasticity scale in PWMS compared with the CS group, (P<.0001) after 5 weeks of intervention and 17 weeks of follow-up. Except for the modified Ashworth scale (MAS), significant improvements were seen in all outcome measures in both groups after 5 weeks of intervention. CONCLUSION This is the first clinical evidence to support the importance of DNS exercise in improving balance, trunk function, and fall prevention in PWMS. This study provides clinical evidence that DNS may be more effective for PWMS than CS.
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Optimizing normalization methods of the external oblique: A cross-sectional study. J Back Musculoskelet Rehabil 2023; 36:1179-1184. [PMID: 37458021 DOI: 10.3233/bmr-220368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
BACKGROUND Adequate normalization methodology to establish maximum voluntary isometric contraction (MVIC) is needed to compare %MVIC values for core exercise completed until discontinuation. Clinicians can use %MVIC classifications to guide their preventative and rehabilitative exercise interventions. OBJECTIVE The aim of this study was to compare %MVIC of the external oblique (EO) between normalization techniques of side-lying lateral trunk flexion and Roman chair lateral trunk flexion. METHODS Twenty-two participants completed two MVIC techniques followed by one repetition of the prone bridge plank (PBP), torso elevated side plank (TESP), foot elevated side plank (FESP), dead bug and bird dog. The average %MVIC during the first 5-seconds, last 5-seconds and overall duration of exercise were included for analysis. ANOVA was used to compare normalized %MVIC from each of the 5 exercises between MVIC techniques. Alpha set a priori p= 0.05. RESULTS The side-lying table technique yielded no %MVIC values above 100%, while the Roman chair technique produced 7 values above 100%. The largest mean difference between techniques was during the last 5-seconds of the torso elevated side plank (57.87 ± 38.51%MVIC, p< 0.001). CONCLUSION The side-lying table technique likely provides the optimal methodology of %MVIC determination.
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Core stability status classification based on mediolateral head motion during rhythmic movements and functional movement tests. Digit Health 2023; 9:20552076231186217. [PMID: 37434735 PMCID: PMC10331090 DOI: 10.1177/20552076231186217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/08/2023] [Indexed: 07/13/2023] Open
Abstract
Objective Core stability assessment is paramount for the prevention of low back pain, with core stability being considered as the most critical factor in such pain. The objective of this study was to develop a simple model for the automated assessment of core stability status. Methods To assess core stability-defined as the ability to control trunk position relative to the pelvic position - we used an inertial measurement unit sensor embedded within a wireless earbud to estimate the mediolateral head angle during rhythmic movements (RMs) such as cycling, walking, and running. The activities of muscles around the trunk were analyzed by an experienced, highly trained individual. Functional movement tests (FMTs) were performed, including single-leg squat, lunge, and side lunge. Data was collected from 77 participants, who were then classified into good and poor core stability groups based on their Sahrmann core stability test scores. Results From the head angle data, we extrapolated the symmetry index (SI) and amplitude of mediolateral head motion (Amp). Support vector machine and neural network models were trained and validated using these features. In both models, the accuracy was similar across three feature sets for RMs, FMTs, and full, and support vector machine accuracy (∼87%) is greater than neural network (∼75%). Conclusion The use of this model, trained with head motion-related features obtained during RMs or FMTs, can help to accurately classify core stability status during activities.
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Effects of core stability on shoulder and spine kinematics during upper limb elevation: A sex-specific analysis. Musculoskelet Sci Pract 2022; 62:102621. [PMID: 35926474 DOI: 10.1016/j.msksp.2022.102621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Upper limb elevation begins with core stabilization, but the effects of core stability on shoulder and spine kinematics are unknown. Sex differences also exist in shoulder kinematics and core stability. OBJECTIVE To clarify the effects of core stability on shoulder and spine kinematics during upper limb elevation by taking sex into account. DESIGN Cross-sectional. METHODS The Sahrmann Core Stability Test, lumbar spine motor control test battery, and Y Balance Test (lower and upper quarters) were performed in 50 healthy young adults. For each test, a principal component (PC) analysis was conducted according to sex; the overall core stability score was calculated. The top and bottom third of the PC scores were defined as high and low score groups, respectively (each group: nine males and eight females). Shoulder and spine kinematics during upper limb elevation were compared separately for males and females. RESULTS Spinal extension was greater in the low score group by a maximum of 1.9° in males (P < .001; η2 = 0.068) and 1.6° in females (P < .001; η2 = 0.141). In the low score group of females, the scapular posterior tilt was a maximum of 5.6° smaller (P < .001; η2 = 0.221) and glenohumeral elevation was a maximum of 4.5° larger (P < .001; η2 = 0.113) than the high score group of females. CONCLUSION Core stability affected spine and female scapular and glenohumeral kinematics during upper limb elevation. Core stability may be one of the potential contributors to shoulder kinematics, particularly in females.
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Core stability-based balance training and kinesio taping for balance, trunk control, fear of falling and walking capacity in patients with multiple sclerosis: A randomized single-blinded study. Mult Scler Relat Disord 2022; 68:104178. [PMID: 36113275 DOI: 10.1016/j.msard.2022.104178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/01/2022] [Accepted: 09/09/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Trunk performance-based therapies are important in the Multiple Sclerosis (MS) rehabilitation process since they have been associated with balance, trunk performance, fall prevention, and walking capacity. Kinesio taping (KT) is a popular approach that has recently been used to treat a variety of musculoskeletal and neuromuscular impairments. Therefore, the aim of this single-blind, randomized controlled study was to investigate the effects of KT combined trunk stabilization-based balance training on balance, trunk control, walking capacity, and fear of falling in patients with MS. MATERIAL AND METHODS Thirty patients diagnosed with MS were randomly assigned to the KT group or the control group. The control group received core stability-based balance training and the KT group was treated with KT applied on global trunk muscles in addition to core stability-based balance training. Balance was measured with the Mini BESTest, trunk control with the Trunk Impairment Scale, fear of falling with the Falls Efficacy Scale and walking capacity with the 2-minute walk test. RESULTS Balance, trunk control, fear of falling, and walking capacity of all the patients improved after treatment (p < 0.05). No superiority was found between the groups in terms of treatment efficacy (p > 0.05). CONCLUSION In conclusion, core stability-based balance training was effective in patients with MS, and the addition of KT had no additional effect in terms of balance, trunk control, fear of falling, and walking capacity.
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Effects of Core Strength Training on Skiing Economy in Elite Junior Cross-Country Skiers. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:608-614. [PMID: 34665683 DOI: 10.1080/02701367.2021.1887441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 02/02/2021] [Indexed: 06/13/2023]
Abstract
Purpose: In cross-country (XC) skiing, the ability to use an efficient technique is essential for performance. The study aimed to compare the effects of supplemental static or dynamic core strength training on skiing economy in elite junior XC skiers. Methods: Twenty-four elite junior XC skiers (14 women, 10 men; 17.8 ± 1.1 years; 67.8 ± 10.0 kg, 173.7 ± 6.4 cm) participated in this study. Participants were allocated either to a static core training (ST) group (n =12) or to a dynamic core training (DT) group (n = 12). Both groups continued their normal aerobic endurance and muscular strength training. Experimental groups performed a 15 minutes, 3 days/week core strength-training program for 9 weeks and in addition to their training. Submaximal and maximal roller ski testing was conducted before and after the 9-week training period. Results: Results showed no significant interaction between groups for energetic costs in any of the submaximal workloads (first, p = .33; second, p =.79; third, p = .25). Pooled data showed a significant improvement in energetic cost pre- to posttesting in the first and third workload (ES 0.40, p = .0006 and ES 0.42, p = .04 respectively). Nine weeks of static or dynamic core strength training in elite junior XC skiers had a small effect on energetic cost in submaximal roller skiing. Conclusion: The type of supplemental core strength training does not seem to affect economy in submaximal roller skiing.
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Efficacy of a 6-Week Suspension Training Exercise Program on Fitness Components in Older Adults. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2022; 15:1168-1178. [PMID: 35991350 PMCID: PMC9362890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The purpose of this study was to determine the efficacy of a 6-week suspension training exercise program on fitness components in older adults. Eleven participants (age = 80 ± 5 yrs) completed a 6-week suspension training exercise program. Pre- and post-fitness assessments comprised of body composition, handgrip dynamometer, functional reach, and balance. The 6-week suspension training intervention required individuals to perform suspension training exercises for fifty minutes, twice per week. A paired sample t-test was used to determine differences from pre-and post-assessments. An improvement was observed in functional reach (57.2 ± 6.4 cm vs 68.6 ± 4.3 cm; p = 0.02) and overall balance score (67.5 ± 2.4 vs 72.2 ± 2.2; p = 0.02). A 6-week suspension training exercise program can be adequate to enhance core stability and overall balance amongst older adults. This paradigm should be explored further to determine the effects on fall-risk and fall prevention.
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A Quiet Unstable Sitting Test to quantify core stability in clinical settings: Application to adults with ventral hernia. Clin Biomech (Bristol, Avon) 2022; 93:105594. [PMID: 35183879 DOI: 10.1016/j.clinbiomech.2022.105594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 02/04/2022] [Accepted: 02/08/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The abdominal core is comprised of the diaphragm, abdominal wall, and pelvic floor, and serves several important functions for balance, movement, and strength. Injury to this area, such as hernia, can have substantial impact. The Quiet Unstable Sitting Test involves individuals seated on the rounded surface of a BOSU® balance trainer placed on top of a force plate and situated on a flat, elevated surface. METHODS An ordinal Quiet Unstable Sitting Test core stability score was calculated from center of pressure measurements, with 0 representing "normal" and < 0 indicating worsening stability. Hernia-Related Quality of Life survey summary scores were assessed (higher scores indicating better quality). FINDINGS A developmental cohort of 32 was used to establish reliability and normative values for the Quiet Unstable Sitting Test. A control group of 32 participants (43.7 ± 16.2 yrs., BMI 29.0 ± 4.9, 66% Female) was then compared to 21 patients with hernia (56.2 ± 12.5 yrs., BMI 29.2 ± 6.3, 24% Female). Hernia patients had median composite score of -2 and median quality of life score of 66, versus median Quiet Unstable Sitting Test of -0.5 and median quality of life of 93 for controls (p ≤ 0.01). Quality of life and Quiet Unstable Sitting Test scores were not correlated (p > 0.05). INTERPRETATION Hernia patients demonstrated significantly worse core stability and quality of life. These assessments were independent of one another across the entire population, indicating each measure's unique constructs of patient function. Core stability can be reliably measured in a clinical setting and may help with patient activation and rehabilitation.
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What is the distribution of trunk impairments and its relationship with disability level in individuals with multiple sclerosis? Mult Scler Relat Disord 2022; 57:103325. [PMID: 35158441 DOI: 10.1016/j.msard.2021.103325] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/27/2021] [Accepted: 10/09/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Trunk control is essential for movement, balance and walking and is ignored in the regular medical follow-up. OBJECTIVE First, to describe the distribution of trunk impairments in the full range of disability levels in individuals with MS. Second, to identify the relationship between trunk control, measured by the Trunk Impairment Scale (TIS 2.0.), and general disability measured by the Expanded Disability Status Scale (EDSS). METHODS 154 individuals with MS were included (mean age 53.6; SD 11.06), EDSS ranging from 1.0- 8.5 (mean 4.47; SD 2.55). The relationship between EDSS and TIS 2.0. was calculated by Spearman correlation coefficient for the total sample and subgroups, EDSS ≤ 4 versus EDSS ≥ 4.5. RESULTS Trunk impairments were detected throughout the full range of disability, including individuals with low disability. Pelvic elevation and lower trunk rotation appeared most difficult to perform. In the total sample, a moderate correlation was found (rho= -0.608**) between disability (EDSS) and trunk performance (TIS 2.0.). Sub-analyses revealed a poor correlation (rho= -0.193) for the EDSS ≤ 4 subgroup and a strong correlation for the EDSS ≥ 4.5 subgroup (rho= -0.712**). CONCLUSION The results advocate for including trunk assessment already at early disease stages of MS, particularly of pelvic elevation and trunk rotation, and dedicated rehabilitation strategies.
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Physical exercises for preventing injuries among adult male football players: A systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:115-122. [PMID: 33188962 PMCID: PMC8847925 DOI: 10.1016/j.jshs.2020.11.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/30/2020] [Accepted: 09/17/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Football is the most practised sport in the world and is associated with the risk of injuries in the players. Some studies have been published that identify injury prevention programs, but there is no review of the full body of evidence on injury prevention programs for use by football coaches. The aim of this article was to carry out a systematic review of published studies on injury prevention programs for adult male footballers, identify points of common understanding and establish recommendations that should be considered in the design of injury prevention strategies. METHODS PubMed and EMBASE databases were used to identify relevant published articles using the following keywords: "soccer" AND "injury" AND "prevention". RESULTS A total of 2512 studies were identified initially, but only 11 studies met the inclusion criteria, and their outcomes are presented. Results revealed that injury prevention programs in football have focused on strength training, proprioceptive training, multicomponent programs (balance, core stability, and functional strength and mobility), and warm-up programs. CONCLUSION Based on results from the studies analyzed, football players can lower the incidence of match and training injuries by participating in dynamic warm-up programs that include preventive exercises before games or during training sessions, and by adding strength, balance, and mobility training to the training sessions.
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Is There a Sex Difference in Trunk Neuromuscular Control among Recreational Athletes during Cutting Maneuvers? J Sports Sci Med 2021; 20:743-750. [PMID: 35321132 PMCID: PMC8488842 DOI: 10.52082/jssm.2021.743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/04/2021] [Indexed: 06/14/2023]
Abstract
Trunk motion is most likely to influence knee joint injury risk, but little is known about sex-related differences in trunk neuromuscular control during changes of direction. The purpose of the present study was to test whether differences in trunk control between males and females during changes of direction exist. Twelve female and 12 male recreational athletes (with at least 10 years of experience in team sport) performed unanticipated changes of direction with 30° and 60° cut angles, while 3D trunk and leg kinematics, ground reaction forces and trunk muscles electromyography were recorded. Trunk kinematics at the time of peak knee abduction moment and directed co-contraction ratios for trunk muscles during the pre-activation and weight acceptance phases were determined. None of the trunk kinematics and co-contraction ratio variables, nor peak knee abduction moment differed between sexes. Compared to the 30° cut, trunk lateral flexion remained unchanged and trunk external rotation was reduced (p < 0.001; η²p (partial eta squared for effect size) = 0.78), while peak knee abduction moment was increased (p < 0.001; η²p = 0.84) at 60°. The sharper cutting angle induced muscle co-contraction during the pre-activation directed less towards trunk flexors (p < 0.01; η²p = 0.27) but more towards trunk medial flexors and rotators opposite to the movement direction (p < 0.001; η²p > 0.46). However, muscle co-contraction during the weight acceptance phase remained comparable between 30° and 60°. The lack of sex-related differences in trunk control does not explain knee joint injury risk discrepancies between sexes during changes of direction. Trunk neuromuscular strategies during sharper cutting angles revealed the importance of external oblique muscles to maintain trunk lateral flexion at the expense of trunk rotation. This provides new information for trunk strength training purposes for athletes performing changes of direction.
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Effects of core stability training program on trunk muscle endurance in deaf children: A preliminary study. J Bodyw Mov Ther 2021; 28:6-12. [PMID: 34776200 DOI: 10.1016/j.jbmt.2021.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/05/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Sport participation is an important for deaf children as participants experience physical, psychological and social benefits; however, the beneficial effect of core stability training on core muscle endurance is unclear. The present study aimed to examine the effects of an 8-week core stability exercise training program on endurance of trunk muscles in deaf children. METHODS Twenty male deaf students (age, 16.5 ± 0.65 y; body mass, 62.08 ± 5.39 kg; BMI, 22.33 ± 2.24 kg/m2) volunteered to participate in this study and were randomly assigned to experimental (EXP, n = 10) and control (CON, n = 10) groups. The subjects in the EXP group performed 3 times a week for 8 weeks period of core stability training program and tested trunk muscle endurance including prone bridge, supine bridge and flexor endurance tests at pre and post 8 weeks intervention. RESULTS The CON group did not show any significant change after training period (p > 0.05). The EXP group showed significantly changes in core stability muscle endurance tests following the 8-week core stability training program (p < 0.05). In addition, the EXP group indicated statistically significant changes than the CON group in truck muscle endurance (p < 0.05). CONCLUSIONS The results indicated that core stability training program improved trunk muscle endurance. Therefore, this training approach can be recommended in deaf rehabilitation programs to improve trunk muscle endurance.
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Is the novel suspension exercises superior to core stability exercises on some EMG coordinates, pain and range of motion of patients with disk herniation? SPORT SCIENCES FOR HEALTH 2021; 18:567-577. [PMID: 34691266 PMCID: PMC8527285 DOI: 10.1007/s11332-021-00848-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/23/2021] [Indexed: 11/11/2022]
Abstract
Information about comparing the effectiveness of exercise methods on management of disk herniation is limited. The aim of this study was to compare the effect of two programs of suspension and core stability exercises on some electromyography (EMG) coordinates, pain and range of motion of patients with disk herniation. Thirty-two men with disk herniation participated in this clinical trial study which was randomly divided into three groups of suspension exercises (n: 12, age: 34.25 ± 8.81, BMI: 24.01 ± 2.7), core stability exercises (n: 10, age: 35 ± 10.3, BMI: 25 ± 2.27) and control (n: 10, age: 34.4 ± 6.67, BMI: 23.76 ± 1.45). Electrical activity of rectus abdominis, internal and external oblique and erector spinae muscles was masured by superficial EMG, back pain by McGill Pain Questionnaire and range of motion by Modified Schober test, one day before and immediately after of intervention period. The experimental groups performed an 8-week training period while the control group was only followed up. Data were analyzed using paired sample t test and analysis of covariance test and statistical significance was set at 0.05. Suspension group showed significant improvement in EMG of rectus abdominis, internal and external oblique muscles (respectively, p = 0.030, p = 0.017, p = 0.022) and pain (p = 0.001) compared to core stability group; but there was no significant difference between two groups in EMG of erector spinae muscle and range of motion. Changes in both training groups were significant in all variables compared to control groups (p ˂ 0.05). Our findings showed that although both exercises were effective in patients with lumbar disk herniation, but the effectiveness of suspension exercises in increasing muscle activation and reducing pain was more pronounced than core stability exercises. Iranian Registry of Clinical Trials (IRCT): IRCT20191016045136N1.
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Abstract
Spinal injury and back pain are a common problem facing patients seeking medical care including athletes, which can lead to significant disability, medical costs, and impaired performance for these patients. Rehabilitation including core muscle stabilization, Kinesio taping, and flexibility have been shown to help with treatment and prevention. Critical factors such as equipment, technique, and rule changes can also be an important part of spine injury prevention.
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Stability threshold during seated balancing is sensitive to low back pain and safe to assess. J Biomech 2021; 125:110541. [PMID: 34198020 DOI: 10.1016/j.jbiomech.2021.110541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/26/2021] [Accepted: 05/31/2021] [Indexed: 11/26/2022]
Abstract
Challenging trunk neuromuscular control maximally using a seated balancing task is useful for unmasking impairments that may go unnoticed with traditional postural sway measures and appears to be safe to assess in healthy individuals. This study investigates whether the stability threshold, reflecting the upper limits in trunk neuromuscular control, is sensitive to pain and disability and is safe to assess in low back pain (LBP) patients. Seventy-nine subjects with non-specific LBP balanced on a robotic seat while rotational stiffness was gradually reduced. The critical rotational stiffness, KCrit, that marked the transition between stable and unstable balance was used to quantify the individual's stability threshold. The effects of current pain, 7-day average pain, and disability on KCrit were assessed, while controlling for age, sex, height, and weight. Adverse events (AEs) recorded at the end of the testing session were used to assess safety. Current pain and 7-day average pain were strongly associated with KCrit (current pain p < 0.001, 7-day pain p = 0.023), reflecting that people experiencing more pain have poorer trunk neuromuscular control. There was no evidence that disability was associated with KCrit, although the limited range in disability scores in subjects may have impacted the analysis. AEs were reported in 13 out of 79 total sessions (AE Severity: 12 mild, 1 moderate; AE Relatedness: 1 possibly, 11 probably, 1 definitely-related to the study). Stability threshold is sensitive to pain and appears safe to assess in people with LBP, suggesting it could be useful for identifying trunk neuromuscular impairments and guiding rehabilitation.
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The effect of core stability-based corrective exercises on gait parameters in elite soccer players diagnosed with Middle Crossed Syndrome. J Bodyw Mov Ther 2021; 27:620-627. [PMID: 34391297 DOI: 10.1016/j.jbmt.2021.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/15/2021] [Accepted: 04/18/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND/AIMS The aim of this study was to investigate the effect of eight weeks of core stability-based corrective exercises, on gait parameters in elite soccer players diagnosed with middle crossed syndrome. METHODS 15 male elite soccer players (aged 18-28) were enrolled in a same-subject intervention trial to assess if the middle crossed syndrome could be influenced through core stability exercise. Core stability-based corrective exercises were completed 3 times per week for 8 weeks and changes in gait parameters (pre- and post- intervention) were measured. RESULTS The results showed that most gait parameters including stride length (p = 0.025), gait speed (p = 0.023), number of strides (p = 0.007), length of shots (p = 0.003), and also soccer players' height (p = 0.011) improved significantly in post-intervention in comparison to pre-intervention. Stride width in post-intervention did not show changes in comparison with pre-intervention (p = 0.083). CONCLUSION The results indicate the significant effectiveness of core stability-based corrective exercises on gait parameters in those with middle crossed syndrome. By doing corrective exercises based on core stability during the study period, gait parameters in the post-intervention surpass the results in the pre-intervention in most parameters. Therefore, it is proposed that corrective exercises based on core stability is a safe and useful method for improving function in those with middle crossed syndrome and it could be used as a therapy to help players identified with this finding. In this regard, it is suggested to researchers and coaches to correct imbalances in order to achieve better results in training programs.
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Transversus Abdominis and Lumbar Multifidus Thickness Among Three Dance Positions in Argentine Tango Dancers. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2021; 14:473-485. [PMID: 34055143 PMCID: PMC8136593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Core muscle function is considered a risk factor for low back pain appearance in dancers. The purpose of this study was to examine the transversus abdominis and lumbar multifidus thickness among Argentine Tango dancers in different functional dance positions. A secondary purpose was to compare muscle thickness at rest and contraction between dancers and untrained participants. Ten trained dancers and ten untrained women aged 33.8 ± 6.09 years participated in this study. Using ultrasonography, the transversus abdominis and lumbar multifidus muscle thickness were measured at rest and during contraction in three different dance positions: Basic in Open embrace, Basic in Close embrace, and Volcada. The results showed a significant increase in muscle thickness during contraction compared to thickness at rest for both muscles (p < 0.05). The group of dancers showed a greater transversus abdominis thickness than the untrained group (p < 0.05). Further, transversus abdominal thickness progressively increased from Basic in Open embrace to Basic in Close embrace position, as well as from Basic in Close embrace to Volcada position in dancers (p < 0.05), while fewer changes between positions were found for the untrained group. Multifidus muscle thickness also differed between positions, but no group differences were observed (p > 0.05). Training exercises in these Argentine Tango positions may be beneficial for the performance and prevention of low back pain, especially in Argentine Tango dancers.
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Impact of yoga in facilitating muscular functioning among asymptomatic male cricket players: Longitudinal randomized controlled study. J Bodyw Mov Ther 2021; 27:287-293. [PMID: 34391247 DOI: 10.1016/j.jbmt.2021.02.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 02/03/2021] [Accepted: 02/28/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cricket is one of the prominent global team sports. With an emergence of Twenty20 tournaments, the physical preparation of elite cricket players has become complex with high match injury incidence. Yoga as a body-mind training is associated with having positive effects on a person's physical and psychological conditions, bringing in better mind-body equilibrium. OBJECTIVES Evaluating the impact of yoga in facilitating muscular functioning and mindfulness among asymptomatic male cricket players. METHOD First-class domestic male cricket players in the age group of 18-35 years were randomized into yoga group n=42 and wait-list control group n=40. Players received the yoga module for five days per week for a duration of six weeks. Primary outcome measures of muscular functioning were core stability, flexibility, range of motion, static balance, dynamic balance and proprioception of the ankle. Assessments were held at baseline, immediate post-intervention, and a follow-up after six months of intervention. RESULTS A statistical significance with p < .001 was observed for most of the variables at T2 and T3. Comparison of the model fit shows a highly significant p < 0.001 difference between the model as compared to the baseline model among most of the variables. CONCLUSION This yoga module was appropriate for enhancing muscular functioning variables of this study. Continuous practice of this yoga module can reinforce sustainable benefits for male cricket players.
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Biomechanics of core musculature on upper extremity performance in basketball players. J Bodyw Mov Ther 2021; 27:127-133. [PMID: 34391223 DOI: 10.1016/j.jbmt.2021.02.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 01/19/2021] [Accepted: 02/28/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Basketball is a dynamic team sport which involves skilled movement and activities. Shooting is considered to be an essential part of the game for scoring points. The core strength is an important preconditioning for the sport, and it influences the performance of the player. METHOD In this study the subjects included thirty-six male basketball players divided into two groups of high and low core groups. The subjects performed one arm hop test and modified upper quarter y balance test (mUQYBT) under with and without core activation condition. The performance of the subjects was evaluated using one way analysis of variance (ANOVA) with Tukeys HSD. Statistical significance was set at p ≤ 0.05 as significant. Value of confidence interval was set at 95%. RESULTS Based on the study, significant difference (p < 0.05) in performance for one arm hop test was observed among all the four groups of core muscles (group 1: high core with core activation, group 2 high core without core activation, group 3 low core with core activation and group 4 low core without core activation). Whereas, no significant difference (p > 0.05) in performance for mUQYBT was observed among all four groups. DISCUSSION Core training is the basis for many functional movements and has become the norm in athletic training programs. Broad benefits of core stabilization have been overlooked, from improving athletic performance to preventing injuries in the sports medicine world. CONCLUSION In the present study, core activation was associated with improved stability and mobility of basketball players during the upper extremity performance test, and the greatest influence of core activation was seen in individuals with lower core scores.
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Effect of Core Stability Exercises on Hand Functions in Children With Hemiplegic Cerebral Palsy. Ann Rehabil Med 2021; 45:71-78. [PMID: 33557483 PMCID: PMC7960954 DOI: 10.5535/arm.20124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/28/2020] [Indexed: 11/05/2022] Open
Abstract
Objective To investigate the effectiveness of core stability exercises on hand functions in children with hemiplegic cerebral palsy. Methods Fifty-two children with hemiplegic cerebral palsy ranging in age from 6 years to 8 years were enrolled in this study. They were randomly assigned to two (control and study) groups. The control group received the selected physiotherapy exercises, and the study group received the same selected physiotherapy exercise program and core stability exercises. Time motor performance, gross manual dexterity, and upper extremity skills assessed using the Jebsen Taylor Hand Function Test, Box and Block Test, and Quality Upper Extremity Skill Test, respectively, were measured before and after 12 weeks of the treatment program. Results There were significant improvements in both groups by comparing the mean values of all measured variables before and after treatment (p<0.05). There were significant differences between the control and study groups with respect to all measured variables when comparing the post-treatment outcomes (p<0.05). Conclusion This study suggests that core stability exercises can be an effective intervention that may improve hand functions in children with hemiplegic cerebral palsy.
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Increased core stability is associated with reduced knee valgus during single-leg landing tasks: Investigating lumbar spine and hip joint rotational stiffness. J Biomech 2021; 116:110240. [PMID: 33494012 DOI: 10.1016/j.jbiomech.2021.110240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/08/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
Knee valgus during landing has been identified as a strong correlate of ACL injury. Inappropriate trunk control during landing contributes to high knee valgus, with neuromuscular factors related to core stability postulated as the mechanism. This investigation probed the influence of trunk and hip mechanics, including joint stiffness, on knee mechanics, particularly high knee valgus. Specifically, this study quantified lumbar spine and hip joint rotational stiffness (a proxy for mechanical joint stability) during single-leg landing tasks known to be associated with injury risk, particularly in females. Kinematics, kinetics, and 24 channels of electromyography spanning the trunk and hip musculature were measured in 18 healthy female participants. Anatomically detailed EMG-driven musculoskeletal models quantified lumbar spine and hip joint rotational stiffness. The links between peak knee abduction angle and moment with lumbar spine and hip joint rotational stiffness were measured. Hip joint rotational stiffness influenced knee abduction across tasks (correlation coefficient ranging from -0.48 to -0.70, p < 0.05) to reduce valgus deviation. Similarly, transverse plane hip joint rotational stiffness during landings reduced knee abduction moment (R = -0.50, P = 0.03; R = -0.49, P = 0.04), and lumbar spine joint rotational stiffness reduced knee abduction angle and moment but did not consistently reach statistical significance. The control system uses stiffness to control motion. This study demonstrates the importance of proximal (lumbar spine and hip) joint rotational stiffness (i.e. core control stability) during single-leg landing to prevent knee abduction motion. Instantaneous core stability is achieved with the coordinated activation and stiffness of both trunk and hip muscles.
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The role of core stability in the development of non-contact acute lower extremity injuries in an athletic population: A prospective study. Phys Ther Sport 2020; 47:165-172. [PMID: 33302113 DOI: 10.1016/j.ptsp.2020.11.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Stability of the core is associated with lower extremity functioning. Consequently, impaired core stability might play a role in developing non-contact acute lower extremity sports injuries. The objective was to investigate components of core stability as potential risk factors for acute lower extremity injuries. DESIGN A cohort study was set up with a follow-up and injury registration period of 1.5 years. PARTICIPANTS 142 male and female physical education students were included. MAIN OUTCOME MEASURES Measures of isometric hip and core muscular strength, endurance, proprioception and neuromuscular control of the core, and postural control were taken at the start of the study. Sports-related injury occurrence was registered during follow-up. RESULTS 27 (19%) injuries of interest occurred during follow-up. After multivariate model building, a significant predictive effect was found for side-to-side hip abduction strength asymmetry (p = .007). The hazard of developing an acute lower extremity injury increased with 6.2% with a 1 unit increase in side-to-side strength imbalance, regardless of gender. CONCLUSION Hip abduction strength imbalance was determined as a risk factor for the development of non-contact, acute lower extremity injuries. Normalizing hip strength imbalances might be beneficial for injury prevention. However, further research is needed to support this claim.
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Postural control quantification in minimally and moderately impaired persons with multiple sclerosis: The reliability of a posturographic test and its relationships with functional ability. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:677-684. [PMID: 33308819 PMCID: PMC7749221 DOI: 10.1016/j.jshs.2018.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 04/25/2018] [Accepted: 06/29/2018] [Indexed: 06/12/2023]
Abstract
BACKGROUND Postural control has been associated with the functional impairment in persons with multiple sclerosis (pwMS). However, there is a need for reliable methods to assess postural control in early stages of the disease, when subtle changes can be difficult to detect. The aims of this study were to assess the absolute and relative reliability of a standing and a sitting posturographic protocol in minimally (Expanded Disability Status Scale ≤ 2) and moderately (2.5 ≤ Expanded Disability Status Scale ≤ 4) impaired pwMS, and to analyze relationships among postural control and functional mobility and gait performance. METHODS To assess postural control in an upright stance, 14 minimally and 16 moderately impaired pwMS performed six 70 s trials in tandem stance, 3 with their weaker leg behind (TSWL) and 3 with their stronger leg behind (TSSL). Additionally, participants completed five 70 s trials using an unstable sitting protocol (US) to assess trunk stability. The mean radial errors of TSWL, TSSL, and US trials were calculated as postural control indexes. Furthermore, participants performed the Timed Up and Go test (TUG) and the Timed 25-foot Walk test (T25FW) to measure their functional mobility and gait speed, respectively. Reliability was evaluated using the intraclass correlation coefficient (ICC3,1) and the standard error of measurement (SEM). Analyses of variances were carried out to assess between-group differences. Hedges' g index (dg) was used to estimate the effect size of differences. Pearson correlation analyses (r) were performed to examine the relationships among the postural control and the functional tests. RESULTS Posturographic tests showed a high reliability in both minimally (0.87 ≤ ICC ≤ 0.92; 9.32% ≤ SEM ≤ 11.76%) and moderately (0.80 ≤ ICC ≤ 0.92; 10.33% ≤ SEM ≤ 15.33%) impaired pwMS. Similarly, T25FW and TUG displayed a high consistency in minimally (0.89 ≤ ICC ≤ 0.94; 3.43% ≤ SEM ≤ 5.17%) and moderately (0.85 ≤ ICC ≤ 0.93; 5.57% ≤ SEM ≤ 6.56%) impaired individuals. Minimally impaired pwMS showed a better performance on the TUG, T25FW, and TSWL than moderately impaired individuals (p < 0.05; dg ≥ 0.8). The TSWL, TSSL, and US variables correlated with TUG scores (0.419 ≤ r ≤ 0.604; p < 0.05), but TSWL also correlated with T25FW scores (r = 0.53; p < 0.01). Furthermore, US scores correlated with both tandem stance parameters (TSWL: r = 0.54, p < 0.01; TSSL: r = 0.43, p < 0.05). CONCLUSION Tandem and sitting posturographic tests provide reliable measures of postural control in pwMS, even in individuals with a homogeneous disease profile. Gait speed, functional mobility, and weaker leg status seem decisive in assessing the degree of physical activity limitation in pwMS. Finally, although trunk stability does not seem to be so affected by the course of the disease, it remains relevant for postural control and functional capacity.
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Quantifying trunk neuromuscular control using seated balancing and stability threshold. J Biomech 2020; 112:110038. [PMID: 32961424 DOI: 10.1016/j.jbiomech.2020.110038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 08/24/2020] [Accepted: 09/01/2020] [Indexed: 11/24/2022]
Abstract
Performance during seated balancing is often used to assess trunk neuromuscular control, including evaluating impairments in back pain populations. Balancing in less challenging environments allows for flexibility in control, which may not depend on health status but instead may reflect personal preferences. To make assessment less ambiguous, trunk neuromuscular control should be maximally challenged. Thirty-four healthy subjects balanced on a robotic seat capable of adjusting rotational stiffness. Subjects balanced while rotational stiffness was gradually reduced. The rotational stiffness at which subjects could no longer maintain balance, defined as critical stiffness (kCrit), was used to quantify the subjects' trunk neuromuscular control. A higher kCrit reflects poorer control, as subjects require a more stable base to balance. Subjects were tested on three days separated by 24 hours to assess test-retest reliability. Anthropometric (height and weight) and demographic (age and sex) influences on kCrit and its reliability were assessed. Height and age did not affect kCrit; whereas, being heavier (p < 0.001) and female (p = 0.042) significantly increased kCrit. Reliability was also affected by anthropometric and demographic factors, highlighting the potential problem of inflated reliability estimates from non-control related attributes. kCrit measurements appear reliable even after removing anthropometric and demographic influences, with adjusted correlations of 0.612 (95%CI: 0.433-0.766) versus unadjusted correlations of 0.880 (95%CI: 0.797-0.932). Besides assessment, trainers and therapists prescribing exercise could use the seated balance task and kCrit to precisely set difficulty level to a percentage of the subject's stability threshold to optimize improvements in trunk neuromuscular control and spine health.
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Systematic reviews evaluating the effectiveness of motor control exercises in patients with non-specific low back pain do not consider its principles - A review. J Bodyw Mov Ther 2020; 26:374-393. [PMID: 33992272 DOI: 10.1016/j.jbmt.2020.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 07/11/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Motor control exercise (MCEs), spinal stabilization or core stability exercises were developed with the aim of restoring the coordination, control, and capacity of the trunk muscles and systematic reviews (SR) evaluating their effectiveness has shown conflicting results. This we hypothesized was due to the non-consideration of principles of neuroplasticity. The objective of this review was to review the operating definitions used in these reviews for these exercises and evaluate if these reviews have considered and satisfied the principles of these exercises in persons with NSLBP, both acute and chronic. METHODS The available evidence to address the research question was sought in the reviews published in English between January 2006 and April 2019 using the population, intervention, comparison, and outcome format. Data were extracted against the following factors: satisfy the principles of specific inclusion criteria; interventions; experience-dependent plasticity; and measure any one of the concepts of motor control. The quality of the evidence obtained was graded using the National Institute for Health and Care Excellence protocol and the quality of SRs evaluated using the R-AMSTAR. RESULTS Eleven reviews on core stability/spinal stabilization exercises and four reviews on MCE were considered in this review. The results showed that most of the studies considered by the reviews did not adhere to the principles of these exercises. CONCLUSION There is wide heterogeneity in the understanding, administration, and progression of exercises. The exercises were implemented without considering the potential for neuroplasticity of the nervous system and the principles of motor learning.
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Effectiveness of LiuZiJue Qigong versus traditional core stability training for poststroke patients complicated with abnormal trunk postural control: study protocol for a single-center randomized controlled trial. Trials 2020; 21:254. [PMID: 32164792 PMCID: PMC7068967 DOI: 10.1186/s13063-020-4117-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 01/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Trunk function in stroke patients with hemiplegia is associated with respiration and core stability and is also found to be associated with balance and postural control and activities of daily living. LiuZiJue Qigong (LQG) is a traditional Chinese method of fitness based on breath pronunciation. The purpose of this study is to compare the clinical efficacy of LQG and traditional core stability training in the treatment of stroke patients with abnormal trunk posture. This protocol is written according to the SPIRIT 2013 statement. METHODS/DESIGN This study is a single-center randomized controlled trial in which 160 stroke patients are randomly divided into a study group and a control group. Patients in the study group will receive LQG combined with conventional rehabilitation therapy, and patients in the control group will receive traditional core stability training combined with conventional rehabilitation therapy. All treatments will be done for 45 min/day, five times per week, for 2 weeks. The primary outcome (Trunk Impairment Scale) and secondary outcomes (Berg Balance Scale, Fugl-Meyer Assessment, Modified Barthel Index, Maximum Phonation Time, Dynamic and Static balance testing, and thickness and the mobile degrees of diaphragm) will be measured at baseline, 2 weeks, and the end of the rehabilitation course. DISCUSSION The aim purpose of this research study is to compare the clinical efficacy of LQG and traditional core stability exercise in the treatment of stroke patients with abnormal trunk posture. TRIAL REGISTRATION Chinese Clinical Trial Register, ChiCTR1800014864. Registered on 24 November 2018.
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Progressions of core stabilization exercises based on postural control challenge assessment. Eur J Appl Physiol 2020; 120:567-577. [PMID: 32048007 DOI: 10.1007/s00421-020-04313-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/01/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The intensity progression of core stabilization exercises (CSEs) is usually based on personal criteria rather than on objective parameters. To develop exercise progressions for four of the most common CSEs based on the postural control challenge imposed on the participants, and to analyze the effect of participants' sex and postural control level on these progressions. METHODS Seventy-six males and females performed five variations of front bridge, back bridge, side bridge and bird-dog exercises on two force platforms. The mean velocity of the center of pressure displacement was calculated to assess exercise intensity through the measurement of the participants' body sway (PBS). RESULTS In general, long bridges produced higher PBS than short bridges, bridging with single leg support produced higher PBS than bridging with double leg support and bridging on a hemisphere ball produced higher PBS than bridging on the floor. The most difficult bridging variations were those performed on a hemisphere ball with single leg support. Regarding the bird-dog, two-point positions produced higher PBS than three-point positions and the positions performed on a hemisphere ball produced higher PBS than those performed on the floor. CONCLUSION The CSE progressions obtained by males and females were very similar. However, the participants with high trunk control showed less significant differences between exercise variations than the participants with low trunk control, which shows the need to individualize the progressions according to the participants' training level. Overall, this study provides useful information to guide the prescription of CSE progressions in young physically active individuals.
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Effect of Core Stability Exercises and Treadmill Training on Balance in Children with Down Syndrome: Randomized Controlled Trial. Adv Ther 2019; 36:2364-2373. [PMID: 31301057 DOI: 10.1007/s12325-019-01024-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Core stability exercises and treadmill training play a crucial role in physical therapy interventions and have an effect on balance in children with Down Syndrome (DS); however, whether core stability exercises or treadmill training has more effect on improving balance has not been investigated yet. The aim of the study was to investigate the effect of core stability training versus treadmill exercises on balance in children with Down Syndrome. METHODS Forty-five children aged 4-6 years with Down Syndrome were included in the study. The children were equally divided randomly into three groups. Group A received traditional physical therapy intervention strategies to facilitate the balance of participating children. Group B received the same as group A and additional core stability exercise training. Group C received the same intervention strategies as group A in conjunction with a treadmill exercise program. The children's balance was evaluated using the Berg balance scale and the Biodex Balance System. Treatment sessions were for 60 min, thrice a week, for 8 consecutive weeks. RESULTS There were significance improvements in the three groups in functional balance and over all stability indices in favor of groups B and C. CONCLUSIONS Core stability and treadmill training improved balance in children with Down Syndrome and should be applied in conjunction with physical therapy programs.
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The effect of two therapeutic interventions on balance in children with spastic cerebral palsy: A comparative study. J Taibah Univ Med Sci 2019; 14:350-356. [PMID: 31488967 PMCID: PMC6717138 DOI: 10.1016/j.jtumed.2019.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/24/2019] [Accepted: 05/29/2019] [Indexed: 01/11/2023] Open
Abstract
Objectives Postural control involves controlling the position of the body in space to achieve stability and orientation. Core stability is needed to improve balance and postural control. Whole-body vibration is a unique strategy for muscle strengthening in various clinical situations. This study compared the effects of whole-body vibration and a core stability program on balance in children with spastic cerebral palsy, with an intervention period of 12 weeks. Methods A total of 72 children with spastic cerebral palsy (hemiplegic and diplegic), of both sexes (age, 5–8 years), were selected from the outpatient clinic of the Faculty of Physical Therapy, Cairo University. The children were randomly assigned to 2 groups. Group A underwent a core stability program for 30 min and group B underwent whole-body vibration training for 10 min, at 3 times a week for 12 weeks for both groups. Balance was assessed using the Biodex Balance System. Results A significant improvement in all variables (p < 0.05) was observed in each group, with greater improvement of all stability indices (anteroposterior, mediolateral, and overall) in group B. There were non-significant differences in all stability indices between hemiplegic and diplegic children (p > 0.05). Conclusion Whole-body vibration and core stability exercises are recommended for the treatment of children with spastic cerebral palsy. Whole-body vibration was more effective than the core stability program in improving balance in children with spastic cerebral palsy.
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The effect of deafness on the physical fitness parameters of elite athletes. J Exerc Rehabil 2019; 15:430-438. [PMID: 31316937 PMCID: PMC6614780 DOI: 10.12965/jer.1938100.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 04/11/2019] [Indexed: 12/02/2022] Open
Abstract
The purpose of this study is to determine the health-related physical fitness parameters of athletes, who are deaf. The study group consisted of 137 deaf athletes (52 females and 85 males with a mean age of 23.99±6.56 years) who have participated in the 2017 Deaflympics games. The assessed parameters included the isokinetic muscle strength, core endurance, balance assessments, grip strength, and body composition. At the end of the study, the following results were obtained. Hamstring/quadriceps ratio was in the range of 53%–54%, which was within 50%–60% of the normal limit. Endurance of the anterior and posterior core muscles was low as compared to the normative data. The athletes’ balance was better with their eyes open than closed; and the grip strength was low as compared to the normative data in the literature. Also, the body fat percentage of deaf female athletes were similar to ones in healthy individuals with sedentary lifestyle, whereas male ones had slightly lower body fat mass percentage. These results can be used as the initial reference parameters to define the training program requirements of deaf athletes.
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THE IMPACT OF LUMBOPELVIC CONTROL ON OVERHEAD PERFORMANCE AND SHOULDER INJURY IN OVERHEAD ATHLETES: A SYSTEMATIC REVIEW. Int J Sports Phys Ther 2019; 14:500-513. [PMID: 31440403 PMCID: PMC6670064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND The lumbopelvic region is utilized in almost all functional tasks and has been proposed to provide dynamic stability to distal extremities. PURPOSE To systematically evaluate the current literature that examined the effect of lumbopelvic control on overhead performance and shoulder injury in overhead athletes. STUDY DESIGN Systematic Review. METHODS A comprehensive systematic electronic search was conducted using PubMed, CINAHL, ProQuest, Scopus, and SPORTDiscus. Articles were considered for inclusion if they included a measure of lumbopelvic control and assessed shoulder pain, disability, injury, or overhead performance outcome. Cohen's d effect size was calculated when necessary statistical data were available to determine the impact of lumbopelvic control. RESULTS The search revealed 3,312 total articles and 2,883 articles were screened after duplicates were removed. After titles and abstracts were screened, 45 full text articles were reviewed. Fifteen full-text articles ultimately met inclusion criteria. Effect sizes ranged from trivial (0.10) to large (0.86), indicating a varying degree of positive effects on performance and shoulder injuries. The majority of included articles concluded individuals with greater lumbopelvic control demonstrated improved performance and decreased occurrence of injury. CONCLUSION Results suggest that improved lumbopelvic control relates to improved athletic performance and decreased shoulder injury. Additional higher quality research is needed to further support these findings, establish a standard measure for lumbopelvic control, and determine preventative factors for injury, pain, and disability. LEVEL OF EVIDENCE 2a.
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Using the single leg squat as an assessment of stride leg knee mechanics in adolescent baseball pitchers. J Sci Med Sport 2019; 22:1254-1259. [PMID: 31285146 DOI: 10.1016/j.jsams.2019.06.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/13/2019] [Accepted: 06/21/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Lack of control of the lower extremity or trunk during single leg tasks is often associated with pathomechanic adaptations during the pitching motion which may increase the risk of pain and injury to the upper extremity. The objectives of the study were to determine the amount of variability in stride knee mechanics accounted for by compensations during a common movement assessment, the single leg squat (SLS) and to establish the usefulness of SLS as a screening tool for at-risk athletes. DESIGN Cross-sectional design. METHODS Sixty-one adolescent baseball pitchers performed a SLS on each leg. Participants performed three fastball pitches to a catcher at a regulation distance. Kinematic data were collected at 100Hz using an electromagnetic tracking device. RESULTS MANOVAs with follow-up one-way ANOVAs were used to examine the amount of variance in pitching knee mechanics explained by SLS compensations. At stride foot contact, there was a significant effect of SLS valgus angle on knee valgus angle (F1,51=23.16, p<0.001, ηp2=0.31) and valgus moment (F1,51=8.28, p=0.006, ηp2=0.14). At ball release (BR), there was a significant effect of SLS valgus angle on flexion angle (F1,51=9.37, p=0.004, ηp2=0.16) and valgus angle (F1,51 = 26.93, p<0.001, ηp2=0.35). Examination of the average values occurring between SFC and BR, revealed a significant effect of SLS valgus angle on knee valgus angle (F1,51=30.91, p<0.001, ηp2=0.38). CONCLUSIONS SLS compensations are potentially a useful screening tool for stride knee mechanics in adolescent baseball pitchers.
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A randomized clinical trial comparing the McKenzie method and motor control exercises in people with chronic low back pain and a directional preference: 1-year follow-up. Physiotherapy 2019; 105:442-445. [PMID: 31204031 DOI: 10.1016/j.physio.2018.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 12/08/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The primary objective of this study was to compare the long-term (1-year follow-up) effects of the McKenzie method and motor control exercises on trunk muscle thickness in people with chronic low back pain (LBP) and a directional preference. DESIGN Randomized controlled trial. SETTING A secondary public health facility in Sydney, Australia. PARTICIPANTS Seventy adults with greater than 3-month history of LBP and a directional preference. INTERVENTIONS Participants were randomized to receive 12 treatments of either the McKenzie method or motor control exercises over 8-weeks. OUTCOME MEASURES Muscle thickness of the transversus abdominis, obliquus internus, and obliquus externus measured from ultrasound images. Secondary outcomes included function, perceived recovery, and pain. Outcomes were collected at baseline, post intervention at 8-weeks, and at 1-year follow-up by blinded assessors. The current paper focuses on the 1-year follow-up. RESULTS Fifty-eight participants completed data collection for the primary outcome at 1-year. There were no significant between group differences for changes in trunk muscle thickness for any of the three investigated muscles: transversus abdominis [3%, 95% confidence interval (CI): -5%, 11%], obliquus internus [-4%, 95% CI: -9%, 2%] and obliquus externus [3%, 95% CI: -4%, 11%]. Similarly, there were no significant differences between groups for the secondary outcomes of function, perceived recovery and pain. CONCLUSION Trunk muscle thickness, function, perceive recovery and pain are similar between patients receiving McKenzie method or motor control exercises at a 1-year follow-up in a population of people with chronic LBP and a directional preference. Clinical Trials Registration number CTRN12611000971932.
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Inter-day reliability of the Upper Body Test for shoulder and pelvic girdle stability in adults. Braz J Phys Ther 2019; 24:161-166. [PMID: 30872005 DOI: 10.1016/j.bjpt.2019.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There are a limited number of tests for the assessment of shoulder and pelvic girdle stability. Reliable instruments are important to evaluate movement dysfunction at these joints in order to provide more objective parameters. OBJECTIVE To evaluate the inter-day reliability of the Upper Body Test in young adults. METHODS A reliability study was carried out with three assessments of the shoulder and pelvic girdle stability within 48-h intervals (Monday, Wednesday, and Friday). The OctoBalance® platform was used to perform the Upper Body Test in 31 active young adults (24.5±8 years). Intraclass Correlation Coefficient (ICC2,2) two-way mixed model, Coefficient of Variation, and Bland-Altman plots were used to verify the reliability of the test. The standard error of measurement (SEM) and the minimum detectable difference (MDD95%) were calculated for clinical applicability. RESULTS The Intraclass Correlation Coefficient ranged from 0.87 to 0.94 - Featuring a mean difference of 0.89 (95%CI=-0.19-1.97) to left and 0.95 (95%CI=-0.38-2.27) for the right side, with a low variation coefficient (3.31-5.91%) between the second and third days of assessment. There was a statistically significant difference between the first assessment day and the other test sessions. The Bland-Altman analyses revealed low bias with scores within the limits of agreement. Minimum detectable difference scores were between 4.02 and 5.10, and standard error of measurement between 1.75 and 2.72, depending on the movement side. CONCLUSION The Upper Body Test presented good inter-day reliability for assessing the stability of the shoulder and pelvic girdle in young active healthy adults.
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The relation between abdominal muscle asymmetry and trunk postural stability: An ultrasound imaging study. J Back Musculoskelet Rehabil 2019; 31:1151-1157. [PMID: 30010100 DOI: 10.3233/bmr-170936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The core stability theory has emphasized symmetric co-contraction of both anterolateral abdominal muscles (AAM), but there is a lack of research on whether the symmetric co-contraction of AAM is related to the postural stability of the trunk. OBJECTIVE This study aimed to investigate the correlation between the symmetric co-contraction of bilateral AAM and trunk angular displacement during sudden trunk perturbation. METHODS Eighteen subjects were asked to maintain half-seated posture against backward trunk perturbation. Muscle thicknesses of external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) were measured using ultrasound imaging. 3D motion analysis system was utilized to calculate the amount of trunk angular displacement during perturbation. RESULTS There were significant differences of side-to-side muscle thickness in TrA (P= 0.02) and EO (P= 0.02), but the difference disappeared during sudden external loading. No significant correlation was identified between the asymmetry of abdominal muscle thickness and the amount of trunk angular displacement. CONCLUSIONS These findings indicate that the side-to-side asymmetry of AAM measured in a static position is rarely related to the core stability because the asymmetry can disappear during trunk stabilization.
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Trunk endurance and gait changes after core stability training in children with hemiplegic cerebral palsy: A randomized controlled trial. J Back Musculoskelet Rehabil 2019; 31:1159-1167. [PMID: 30056415 DOI: 10.3233/bmr-181123] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Weakness of trunk muscles is a common disorder in children with cerebral palsy (CP). They encounter decreased levels of endurance that can lead to diminished capacity of movement. OBJECTIVE To evaluate the effect of core stability training on the endurance of trunk muscles and gait parameters in children with hemiplegic CP. METHODS Thirty children with hemiplegic CP aged 10 to 12 years were randomly assigned to two groups of equal number; control group (A) and study group (B). Both groups underwent the same designed physical therapy program. Moreover, group B underwent core stability training 3 times/week for 8 weeks. Endurance time of trunk muscles and gait parameters were measured before and after the intervention using the trunk endurance tests and the Biodex gait trainer respectively. RESULTS Both groups showed statistically significant improvements in the endurance time of trunk flexors and extensors and gait parameters after treatment but only group B showed statistically significant improvement in the endurance time of lateral trunk muscles. There were post-treatment statistically significant differences between both groups in favor of group B regarding all measured variables. CONCLUSION Addition of core stability exercises to the treatment program can effectively improve the endurance time of trunk muscles and gait in children with hemiplegic CP.
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COMPARISON OF CORE STABILITY AND BALANCE IN ATHLETES WITH AND WITHOUT SHOULDER INJURIES. Int J Sports Phys Ther 2018; 13:1015-1023. [PMID: 30534467 PMCID: PMC6253758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Relationships between core stability and lower extremity injuries have been described in the literature; however, evidence of the relationship between upper extremity injuries and core stability and balance is limited. HYPOTHESIS/PURPOSE The purpose of this study was to compare clinical measures of core stability and balance between athletes with and without non-traumatic shoulder injuries. STUDY DESIGN Cross sectional. METHODS Eighty athletes (54 males, age: 21.2 + 3.3 years) participated in this study. Forty athletes with a current shoulder injury were matched to healthy athletes by age, gender, BMI, and sport. Athletes completed clinical core stability tests including flexor and extensor endurance tests, double leg lower test (°) and balance tests including single leg stance under eyes open and eyes closed conditions, and the Y-balance test. MANOVAs were used to assess group differences. RESULTS No statistically significant differences existed between athletes with and without shoulder injuries for clinical tests of core stability, F(1,78)=0.97, p=0.41; η2 = 0.04. No statistically significant differences existed between injured athletes with and without shoulder injuries for static and dynamic balance measures, F(1,78)=0.86, p=0.53; η2 = 0.07. CONCLUSIONS Although core stability is widely incorporated in rehabilitation of athletes with shoulder injuries, performance on these clinical tests did not differ in the group of athletes assessed in this study. LEVEL OF EVIDENCE 3.
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