Abstract
The lack of training load control, mainly exercise intensity, is one of the main limitations of core stability (CS) programs, which makes the training individualization and the analysis of the dose-response relationship difficult. The objectives of this study were to assess the inter-and intra-rater agreement when using new observational screening guidelines to decide if a core stability exercise represents an adequate training intensity level for a given participant. Besides, the relationship between experts' ratings based on these criteria and pelvic accelerations recorded with a smartphone accelerometer was also analyzed. Ten healthy physically active participants with a smartphone accelerometer placed on their pelvis were video-taped while performing a progression of seven variations of the front bridge, back bridge, side bridge and bird-dog exercises. Two expert and four non-expert raters watched the videos and used the observational screening guidelines to decide for each exercise variation if it represented an adequate training intensity level or not. In order to analyze the inter-and intra-rater agreement, several Kappa (κ) statistics were used. Receiver operating characteristic (ROC) curves to explore if the accelerometry allowed to establish pelvic acceleration thresholds representing the minimum level of exercise intensity for CS training. Cut-off acceleration values were calculated balancing sensitivity (Se) and 1-specifity (1-Sp) indexes (i.e., Youden index) or minimizing 1-Sp. The intra-and inter-rater analysis showed a substantial-high level of agreement with a prevalence-adjusted bias-adjusted Kappa > 0.69. The ROC curves showed that the acceleration thresholds for the bridging exercises were very similar, with global cut-off values of 0.35 m/s2 (Se = 82%; 1-Sp = 15%) when using the Youden Index and of 0.50 m/s2 when minimizing 1-Sp (Se = 31%), whilst the bird-dog exercise showed lower cut-off values (Youden Index: 0.21 m/s2, Se = 90%, 1-Sp = 16%; minimizing 1-Sp: 0.32 m/s2, Se = 40%). Overall, this study provides observational screening guidelines and smartphone accelerometer thresholds to facilitate the decision-making process when setting the intensity of some of the most popular core stability exercises in young physically active individuals.
Highlights
Based on the results of previous studies, exercises for improving core stability (CS) have frequently been used as an additional training routine for professional and amateur athletes to improve athletic performance (Sato and Mokha, 2009; Sandrey and Mitzel, 2013; Trecroci et al, 2020) and to prevent and rehabilitate musculoskeletal injuries (Gouttebarge and Zuidema, 2018; Khaiyat and Norris, 2018)
Randomized controlled trials on CS training programs usually report that CS exercises are prescribed based on participant’s characteristics, the exercise intensity selection and its progression throughout the training program are normally conducted based on the experience and criteria of the professionals who develop the training programs, rather than on objective and quantifiable CS assessments (CabanasValdés et al, 2016; Fox et al, 2016; Prieske et al, 2016; Doganay et al, 2020)
The prevalence-adjusted biasadjusted Kappa (PABAK) index was ≥0.62 among the four non-expert raters and experts and 0.69 (95% confidence limits (CL) = 0.60–0.77) for multiraters∗experts, which implies a “substantial” agreement
Summary
Based on the results of previous studies, exercises for improving core stability (CS) have frequently been used as an additional training routine for professional and amateur athletes to improve athletic performance (Sato and Mokha, 2009; Sandrey and Mitzel, 2013; Trecroci et al, 2020) and to prevent and rehabilitate musculoskeletal injuries (Gouttebarge and Zuidema, 2018; Khaiyat and Norris, 2018). There are difficulties in establishing whether a prescribed exercise intensity is appropriate for the participant’s level, as well as in determining, after a certain amount of workout sessions, if the given exercises are challenging enough for that participant or if it is necessary to progress toward other more intense exercises In this sense, randomized controlled trials on CS training programs usually report that CS exercises are prescribed based on participant’s characteristics, the exercise intensity selection and its progression throughout the training program are normally conducted based on the experience and criteria of the professionals who develop the training programs, rather than on objective and quantifiable CS assessments (CabanasValdés et al, 2016; Fox et al, 2016; Prieske et al, 2016; Doganay et al, 2020). All these limitations hinder the replication of these interventions and do not allow the dose-response characterization of the CS exercise programs (Barbado et al, 2018)
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