Abstract
BackgroundCore-specific sensorimotor exercises are proven to enhance neuromuscular activity of the trunk, improve athletic performance and prevent back pain. However, the dose-response relationship and, therefore, the dose required to improve trunk function is still under debate. The purpose of the present trial will be to compare four different intervention strategies of sensorimotor exercises that will result in improved trunk function.Methods/designA single-blind, four-armed, randomized controlled trial with a 3-week (home-based) intervention phase and two measurement days pre and post intervention (M1/M2) is designed. Experimental procedures on both measurement days will include evaluation of maximum isokinetic and isometric trunk strength (extension/flexion, rotation) including perturbations, as well as neuromuscular trunk activity while performing strength testing. The primary outcome is trunk strength (peak torque). Neuromuscular activity (amplitude, latencies as a response to perturbation) serves as secondary outcome.The control group will perform a standardized exercise program of four sensorimotor exercises (three sets of 10 repetitions) in each of six training sessions (30 min duration) over 3 weeks. The intervention groups’ programs differ in the number of exercises, sets per exercise and, therefore, overall training amount (group I: six sessions, three exercises, two sets; group II: six sessions, two exercises, two sets; group III: six sessions, one exercise, three sets). The intervention programs of groups I, II and III include additional perturbations for all exercises to increase both the difficulty and the efficacy of the exercises performed. Statistical analysis will be performed after examining the underlying assumptions for parametric and non-parametric testing.DiscussionThe results of the study will be clinically relevant, not only for researchers but also for (sports) therapists, physicians, coaches, athletes and the general population who have the aim of improving trunk function.Trial registrationGerman Clinical Trials Register, ID: DRKS00012917. Registered on 22 August 2017.
Highlights
Core-specific sensorimotor exercises are proven to enhance neuromuscular activity of the trunk, improve athletic performance and prevent back pain
The results of the study will be clinically relevant, for researchers and for therapists, physicians, coaches, athletes and the general population who have the aim of improving trunk function
All four exercises will be performed with three sets of 10 repetitions each, with a minimum of 30 s rest in between sets (unpublished material, RCT (MiSpEx), German Clinical Trials Register No DRKS00004977, [13, 14])
Summary
Core-specific sensorimotor exercises are proven to enhance neuromuscular activity of the trunk, improve athletic performance and prevent back pain. One main function of the trunk muscles is the compensation of external forces and unexpected loads in order to ensure stability of the body. Compensation of external loads ensures the stability and performance of the body during daily life as well as in dynamic, high-intensity activities [1,2,3]. Trunk stability, led by neuromuscular activity, is required to control trunk motion during repetitive (dynamic) loading situations and to avoid overloading. Potential factors underlying back pain have been discussed, including repetitive micro traumas and insufficiency of the muscle-tendon complex based on inadequate postural and neuromuscular control, reduced maximum trunk-strength capacity and trunk-muscle fatigue during dynamic loading [9]. Optimizing neuromuscular core stability is considered beneficial for protection against sudden, repetitive and excessive overloading of the trunk [2,3,4, 8]
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