Core Muscle Strengthening Research Articles

Core muscle Strengthening Effect During Spine Stabilization Exercise

Core spinal muscles are related to trunk stability and assume the main role of stabilizing the spine during daily activities; strengthening of core muscles around the spine can therefore reduce the chance of back pain. The objective of the study was to investigate the effect of core muscle strengthening in the spine during spine stabilization exercise using a whole body tilt device. To achieve this, a validated musculoskeletal (MS) model of the whole body was used to replicate the input motion from the whole body tilting exercise. An inverse dynamics analysis was executed to estimate spine loads and muscle forces depending on the tilting angles of the exercise device. The activation of long and superficial back muscles such as the erector spinae (iliocostalis and longissimus) were mainly affected by the forward direction (-40°) of the tilt, while the front muscles (psoas major, quadratus lumborum, and external and internal obliques) were mainly affected by the backward tilting direction (40°). Deep muscles such as the multifidi and short muscles were activated in most directions of the rotation and tilt. The backward directions of the tilt using this device could be carefully applied for the elderly and for rehabilitation patients who are expected to have less muscle strength. In this study, it was shown that the spine stabilization exercise device can provide considerable muscle exercise effect.

Using core muscle strengthening exercise to improve functional status in child with systemic lupus erythematous (SLE): a case report

Background: Systemic lupus erythematous (SLE) is a systemic autoimmune disease that usually occurs in child-bearing age women and non-European descents. The occurrence is relatively rare in children and adolescent, however, the symptoms and signs are various and would cause significant disability than adult cases.

Core Muscle Strengthening’s Improvement of Balance Performance in Community-Dwelling Older Adults: A Pilot Study

To determine the effect of core muscle strengthening on balance in community-dwelling older adults, 24 healthy men and women between 65 and 85 years old were randomized to either exercise (EX; n = 12) or control (CON; n = 12) groups. The exercise group performed a core strengthening home exercise program thrice weekly for 6 wk. Core muscle (curl-up test), functional reach (FR) and Star Excursion Balance Test (SEBT) were assessed at baseline and follow-up. There were no group differences at baseline. At follow-up, EX exhibited significantly greater improvements in curl-up (Cohen's d = 4.4), FR (1.3), and SEBT (>1.9 for all directions) than CON. The change in curl-up was significantly correlated with the change in FR (r = .44, p = .03) and SEBT (r > .61, p ≤ .002). These results suggest that core strengthening should be part of a comprehensive balance-training program for older adults.

Effect of Core Muscle Strengthening on Balance and Quality of Life in Geriatric Patient

Introduction & Rationale: The core stability is capability of the muscles of the trunk to stabilize the lower spine during movement it maintains the human body in stable and erect posture. Aging leads to loss of balance and stability hence Core strengthening program help elderly to independence in life activity & also improve the balance and quality of life. Effect of core muscle strengthening was evaluated in present study.METHODOLOGY Aims and Objectives: To determine the effect of core muscle strengthening on balance with the help of performance oriented mobility assessment (POMA) scale and assess quality of life with SF-12 questionnaire in geriatrics. Study Design: It is a community based longitudinal study Subjects: Inclusion criteria: Both sex and age > 60 year who are clinically stable and functionally independent. Exclusion criteria: Subjects with conditions leading to incapacitation and functional impairment, with neurological conditions having altered balance, peripheral neuropathies, under psychiatric treatment, or impaired cognitive status. Sample Size: Thirty subjects were enrolled in the study Study factors: A routine history and clinical examination was carried out for selecting the subjects and basic demographic data was recorded. Pressure biofeedback was used to teach the subjects, an abdominal 'drawing-in' maneuver and a visual feedback was provided to understand the core muscle activation. Intervention: The subjects underwent a graded core muscle strengthening exercise protocol for 8 weeks period. Outcome Factors: The outcome factors were the effectiveness of core strengthening on balance and quality of life were recorded with the help of POMA scale and SF-12 questionnaire respectively after the interventional exercises for 8 weeks. Results: The mean age of the subjects was 75.3 years, with SD. 6.456. Statistically significant improvements in total score on POMA scale improved from 22.5 to 24.83, p value Conclusion:Core muscle strengthening program is effective in improving balance and quality of life in geriatrics subjects.

Effects of Core Muscle Strengthening Training on Flexibility, Muscular Strength and Driver Shot Performance in Female Professional Golfers

The purpose of this study is to investigate the effect of 12 weeks` combined training in core muscle strengthening on the flexibility, muscular strength, and driver shot performance of the core body parts of the female professional golfers. Subjects were members of the Korea Ladies Professional Golf Association. They were divided into two groups (of whom 9 belonged to the training group, and 8 belonged to the control group). Changes in flexibility (forward flexion and back flexion), maximal muscular strength (back extension and squat), isometric strength (back strength), and core muscle and driver shot performance (ball speed, clubhead speed, and carry distance) were measured before and after 12 weeks` combined training. The results were as follows: in physical fitness parameters, back flexion and maximal strength of back extension and squat increased significantly in training group following 12 weeks` core muscle strengthening training. In driver shot performance, clubhead speed and carry distance increased significantly in training group following 12 weeks` core training. The findings of the present study showed 12 weeks` combined core muscle training had positive effects on flexibility and strength of core muscle. Moreover, it was effective in enhancing driver shot performance in female professional golfers. This suggests that application of specific and scientific core muscle training should be done continuously in female professional golfers.

Core Muscle Activation During Swiss Ball and Traditional Abdominal Exercises

Controlled laboratory study using a repeated-measures, counterbalanced design. To test the ability of 8 Swiss ball exercises (roll-out, pike, knee-up, skier, hip extension right, hip extension left, decline push-up, and sitting march right) and 2 traditional abdominal exercises (crunch and bent-knee sit-up) on activating core (lumbopelvic hip complex) musculature. Numerous Swiss ball abdominal exercises are employed for core muscle strengthening during training and rehabilitation, but there are minimal data to substantiate the ability of these exercises to recruit core muscles. It is also unknown how core muscle recruitment in many of these Swiss ball exercises compares to core muscle recruitment in traditional abdominal exercises such as the crunch and bent-knee sit-up. A convenience sample of 18 subjects performed 5 repetitions for each exercise. Electromyographic (EMG) data were recorded on the right side for upper and lower rectus abdominis, external and internal oblique, latissimus dorsi, lumbar paraspinals, and rectus femoris, and then normalized using maximum voluntary isometric contractions (MVICs). EMG signals during the roll-out and pike exercises for the upper rectus abdominis (63% and 46% MVIC, respectively), lower rectus abdominis (53% and 55% MVIC, respectively), external oblique (46% and 84% MVIC, respectively), and internal oblique (46% and 56% MVIC, respectively) were significantly greater compared to most other exercises, where EMG signals ranged between 7% to 53% MVIC for the upper rectus abdominis, 7% to 44% MVIC for the lower rectus abdominis, 14% to 73% MVIC for the external oblique, and 16% to 47% MVIC for the internal oblique. The lowest EMG signals were consistently found in the sitting march right exercise. Latissimus dorsi EMG signals were greatest in the pike, knee-up, skier, hip extension right and left, and decline push-up (17%-25% MVIC), and least with the sitting march right, crunch, and bent-knee sit-up exercises (7%-8% MVIC). Rectus femoris EMG signal was greatest with the hip extension left exercise (35% MVIC), and least with the crunch, roll-out, hip extension right, and decline push-up exercises (6%-10% MVIC). Lumbar paraspinal EMG signal was relative low (less than 10% MVIC) for all exercises. The roll-out and pike were the most effective exercises in activating upper and lower rectus abdominis, external and internal obliques, and latissimus dorsi muscles, while minimizing lumbar paraspinals and rectus femoris activity. J Orthop Sports Phys Ther 2010;40(5):265-276, Epub 22 April 2010. doi:10.2519/jospt.2010.3073.

Pathological Fracture

HISTORY K.B. is a 13 year-old male with a 6 week history of right knee pain. The pain was progressively worsening and caused him intermittently to limp. The pain was reported as 4/10, with increase during jumping. He denied any mechanical instability. No swelling, erythema or warmth of the knee. There were no constitutional symptoms including no fever, weight loss, rash or night sweats. He had no previous pain in this knee. The patient was not participating in any organized sports other then PE in school. He could not recall any specific event or trauma. The symptoms improved by nonweight bearing and occasionally NSAIDs but did not resolve. The past medical and family histories were normal. PHYSICAL EXAMINATION Obese with BMI >97% with marked gynecomastia, normal testis, Tanner 3 pubic hair and a feminine appearing facies. Weight bearing without limp. Genu valgum bilaterally; VMO decreased tone and bulk right >left; tenderness at medial and lateral femoral condyles, otherwise unremarkable. Hip: ROM normal, tight hamstring with popliteal angle of 95, single leg squat positive for Trendelenburg, 5 hop test abnormal weak with pain on right leg. Foot: Dynamic pes planus with calcaneo valgus bilaterally. DIFFERENTIAL DIAGNOSIS Patellofemoral Dysfunction Distal femoral inflammatory process TEST AND RESULTS Plain radiographs: Osteogenic destructive lesion in the medullary cavity of right distal femur with soft tissue swelling and periosteal new bone formation - consistent with osteogenic sarcoma. CT Chest: Normal MRI of right femur: Nondisplaced fracture of right distal femoral diamethaphysis with no soft tissue mass. Edema of distal femur. Consistent with a post traumatic or pathological fracture; unlikely osteosarcoma. Bone Scan: Right distal femoral abnormality, otherwise normal. Dexa Scan: Bone Mineral Density osteopenia of lumbar spine; normal of total body and proximal femur. Laboratory: CBC, BMP, Mg, Pho, Ca, Liver Panel - WNL TSH - WNL LH, FSH - prepubertal Testosterone, PTH, Estradiol, IGF-1, Cortisol - pending CONSULT Orthopedic specialized in musculoskeletal tumor: Pathological fracture FINAL WORKING DIAGNOSIS Pathological fracture of distal femur of unknown origin TREATMENT AND OUTCOMES Non-weight bearing with crutches until completely pain free gait, then weight bearing as tolerated Home exercise program for VMO and core muscle (gluteus) strengthening and hamstring stretching No physical activity until good bony healing achieved Orthotics Follow up visit showed improved symptoms, will obtain radiographs at next visit Complete further workup for etiology of pathological fracture and possible endocrine disorder

SACRAL STRESS FRACTURE IN A POST PARTUM RUNNER

HISTORY S.S. is a 30 yo. female runner who presented to sports medicine clinic with the chief complaint of hip pain for 5 weeks. Her PMH is significant for sciatica diagnosed clinically in 1995, and two tibial stress fractures. Her history also included amenorrhea three times throughout her life. First at age 13–14 years, second at age 15–16 years, and third in college. Menstruation resumed each time with activity modification only. She had no history of diagnosed eating disorders. The current pain began while running in the third trimester of her pregnancy (30–35 miles per week). The symptoms lessened, but were persistent, one month prior to delivery with discontinuation of running. The pain increased in severity one month after delivery when she began running. ultimately to 40–45 miles per week over a six week time period. The pain was located over the left lower back and sacral area, spread laterally to her left hip, and occasionally radiated to her left buttock. The ROS was negative for fevers, neurologic symptoms, and change in bowel/bladder function. PHYSICAL EXAMINATION Clinical examination findings included diffuse tenderness in the upper gluteal and low back area with focal tenderness along the sacrum. The Patrick (FABER) test was positive on the left. The straight leg raise test was negative. The neurological examination was normal, as was the hip examination. There was no leg length discrepancy. The physical examination was otherwise unremarkable. DIFFERENTIAL DIAGNOSIS The differential diagnosis for this athlete included muscle strain, radiculopathy, stress fracture (pars interarticularis/femoral neck/pelvis), insufficiency fracture (oncologic/metabolic process), osteomyelitis, arthritis, and sacroileitis. TESTS AND RESULTS The initial evaluation included plain films of the hips and pelvis, which were negative for bony lesions. The leading diagnoses at this time included stress fracture versus lumbar disc herniation/nerve impingemen:. The next diagnostic test was an MRI of the lumbosacral spine and pelvis. In the interim a physical therapy program was started targeting core muscle strengthening, specifically the abdominal, peripelvic and lumbar paraspinous muscles. Cross training was encouraged including swimming, stationary bike, and elliptical machine. The T2 weighted fat suppressed coronal MR image of the sacrum revealed a large area of high signal intensity consitent with the history and presentation. The diagnosis for this female distance runner in her post partum course is sacral stress fracture. TREATMENT Conservative management with activity modification and physical therapy were central to her treatment. Changes in strength and body mechanics before and after delivery including peripelvic and abdominal muscle relaxation, increased ligametous laxity, increased frontal weight and alteration in pelvic alignment may have contributed injury development. Serial clinical examinations were followed including lumbosacral palpation and the Patrick test. OUTCOME Clinical follow up at four weeks revealed minimal focal tenderness with palpation over the left sacrum. The Patrick test was negative. The neurologic examination remained normal. Evaluation at six weeks was entirely normal and the patient was cleared to begin running with instructions to increase mileage ≤ 10% per week. CONCLUSION Low back and buttock pain in runners can be frustrating for athletes and diagnostically challenging for sports medicine physicians. Sacral stress fractures can resemble neuropathic processes. They should be considered in all distance runners experiencing low back, hip, and buttock pain. Prenatal and early post partum status may contribute to sacral stress fracture injury occurrence in distance runners.