Reliability of a Trunk Flexion and Extensor Muscle Strength Test with Hand-Held and Isokinetic Dynamometers in Female Athletes.

An accurate trunk muscle strength assessment seems very important to design and individualize training and rehabilitation programs in clinical and sport settings. Hand-held dynamometers (HHDs) are interesting alternatives to isokinetic dynamometers for assessing trunk isometric muscle strength because they are inexpensive instruments and easy to use. This cross-sectional observational study aimed to examine the reliability of two novel sitting tests for assessing trunk flexion and extension isometric strength using an HHD and their relationship with two other novel isometric tests that use an isokinetic dynamometer. Twenty-four female amateur athletes (age: 24.5 ± 2.64 years; body height: 164.45 ± 6.33 cm; body mass: 63.17 ± 10.35 kg) participated in this study. A test-retest design was carried out one-week apart to examine the reliability. The relationship and the degree of agreement between the HHD and the isokinetic dynamometer measurements were analysed using Pearson correlation and Bland-Altman analysis, respectively. In general, the reliability of all isometric strength tests was good, with ICCs ranging from 0.65 to 0.87 and typical error < 15%. Pearson correlations were moderate, with values of r = 0.47 (R2 = 0.22) and r = 0.42 (R2 = 0.18) for flexion and extension strength, respectively. Bland-Altman plots showed no agreement between HHDs and isokinetic measurements. All trunk isometric tests using both, an isokinetic dynamometer and HHDs, provide reliable measurements for assessing trunk flexion and extension strength. According to the comparative analysis, both measurement types are different and cannot be used interchangeably. Health and sport professionals should choose the test that best suits the biomechanical characteristics required for functional goals or success in a given sport.

Exercise Intensity Progressions and Criteria to Prescribe Core Stability Exercises in Young Physically Active Men: A Smartphone Accelerometer-Based Study.

ABSTRACT: Heredia-Elvar, JR, Juan-Recio, C, Prat-Luri, A, Barbado, D, Ríos-Calonge, Jdl, and Vera-Garcia, FJ. Exercise intensity progressions and criteria to prescribe core stability exercises in young physically active men: a smartphone accelerometer-based study. J Strength Cond Res 38(2): 266-273, 2024-The establishment of core stability (CS) exercise intensity progressions in sport and clinical settings is normally based on subjective criteria. Therefore, this study aimed to develop exercise intensity progressions for some of the most common CS exercises through smartphone accelerometry and to analyze the effect of the subjects' lumbopelvic postural control on these progressions. Fifty-seven healthy young physically active male students performed 7 isometric variations of front bridge, back bridge, side bridge, and bird-dog exercises with a smartphone accelerometer placed on the pelvis. Mean pelvic accelerations were calculated during each variation to evaluate the lumbopelvic postural control challenge imposed on the subjects as an index of exercise intensity of difficulty. For the bridge exercises, long bridging produced higher pelvic accelerations than short bridging, bridging with single-leg support was more intense than bridging with double-leg support (even with both legs on a hemisphere ball for the back and front bridge), and the most difficult variations were those performed on a Swiss ball, mainly the variations with single-leg support. For the bird-dog exercise, the 2-point positions were more intense than the 3-point positions, the variations performed with a knee on the hemisphere ball produced higher pelvic accelerations than similar variations performed with the forearm on the hemisphere ball, and the variations with limb motions generated higher pelvic accelerations than similar variations performed without limb motions. Although the CS exercise progressions were very similar across subjects, our results showed the need to individualize the prescription of the CS exercise progressions based on the subjects' lumbopelvic postural control level.

Is the Side Bridge Test Valid and Reliable for Assessing Trunk Lateral Flexor Endurance in Recreational Female Athletes?

The side bridge test (SBT) is one of the most popular tests to assess isometric trunk lateral flexor endurance. The aim of this study was to assess the validity and reliability of the SBT in healthy females. Twenty-four (24.58 ± 3.92 years) physically active (1-2 h of moderate physical activity, 2-3 times a week) females voluntarily participated in this study. The surface electromyography (EMG) of eight abdominal, back, shoulder and hip muscles was measured during the SBT. Normalized median frequency slopes (NMFslope) were calculated to analyze the muscle fatigue. The EMG amplitudes were normalized to maximum EMG values to assess muscle activity intensity. A one-week test-retest design was performed to evaluate the SBT reliability through the ICC3,1 and typical error. Higher NMFslopes and normalized EMG amplitudes were found in deltoids, abdominal obliques, rectus abdominis, and erector spinae in comparison to latissimus dorsi, gluteus medius, and rectus femoris. However, no significant differences were found between the trunk lateral flexors and the deltoids. Linear regression analysis showed that SBT performance could be significantly predicted by external oblique and deltoid NMFslope (adjusted R2 = 0.673) and by body mass and trunk height (adjusted R2 = 0.223). Consistency analysis showed a high intraclass correlation coefficient (0.81) and a relatively high typical error (10.95 s). Despite the good relative reliability of the SBT, its absolute reliability was low and its validity questionable, as the shoulder muscle activation and fatigue and the individuals' anthropometric characteristics played an important role in SBT performance.

Observational Screening Guidelines and Smartphone Accelerometer Thresholds to Establish the Intensity of Some of the Most Popular Core Stability Exercises.

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.

Isokinetic trunk flexion-extension protocol to assess trunk muscle strength and endurance: Reliability, learning effect, and sex differences.

PURPOSE: The purpose of this study was to examine the reliability and the learning effect of an isokinetic trunk flexion-extension protocol designed to simultaneously assess trunk muscle strength and endurance. In addition, the effect of the participants' sex on the reliability data was examined. METHODS: Fifty-seven healthy and physically active young men (n = 28) and women (n = 29) performed the isokinetic protocol 5 times, separated by a week between each of the first 4 sessions and by a month between the last 2 sessions. The protocol consisted of performing 4 trials of 15 maximum flexion-extension concentric exertions at 120°/s (range of trunk motion = 50°). The absolute and relative peak torque and total work were calculated to assess trunk flexion and extension strength. In addition, endurance ratio, modified endurance ratio, fatigue final ratio, recovery ratio, and modified recovery ratio variables were used for the assessment of trunk muscle endurance in both directions. RESULTS: Regarding the absolute reliability, no relevant changes were found between paired-comparison sessions for most strength and endurance variables, except for total work and relative total work variables in the flexion movement in both sexes. In addition, the typical error of the isokinetic variables was lower than 10% in both males and females, and minimum detectable changes ranged from 7% to 20%, with a tendency to be higher in females and in endurance variables. The strength variables showed high-to-excellent intraclass correlation coefficients (ICCs; >0.74); however, for the endurance variables only the endurance ratio and the modified endurance ratio obtained moderate-to-high ICC values (0.57 < ICC < 0.82). In addition, the analysis of the variance reported no significant differences between consecutive pairs of sessions for most variables in both sexes. CONCLUSION: Overall, these findings provide clinicians, trainers, and researchers with a 10-min single-session protocol to perform a reliable muscle strength and endurance evaluation of trunk flexor and extensor muscles, all within the same protocol.

Progressions of core stabilization exercises based on postural control challenge assessment.

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.

Tests to Measure Core Stability in Laboratory and Field Settings: Reliability and Correlation Analyses.

Although core stability (CS) has been assessed through many different tests, the relationships among them are currently unknown. The main objective was to analyze the relationship between 5 representative tests used to assess CS in: (1) laboratory settings: Sudden Loading Test (SLT) and Stable and Unstable Sitting Test (SUST) and (2) field settings: Biering-Sørensen Test (BST), 3-Plane Core Strength Test, and Double-Leg Lowering Test. The reliability of these tests was also examined. In total, 33 recreationally active males performed the tests twice. The relationship between all variables was examined using Pearson correlation coefficient in those variables with a good reliability. Only stiffness and angular displacement in the SLT, dynamic unstable tasks in the SUST, and the holding time in the BST showed good reliability (intraclass correlation coefficient: .63-.91, typical error: 9.8%-21.0%). Few and low correlations were observed between the SLT, SUST, and BST. Despite finding several significant correlations among the dynamic unstable tasks of the SUST (r ≥ .807, P < .01), no correlations were found between the loading directions of the SLT. The absence of correlations between these tests suggests that CS measurements are not generalizable, as they probably assess different dimensions of CS, or in the case of the BST, a different capacity (ie, trunk extensor endurance).

Reliability of the Star Excursion Balance Test and Two New Similar Protocols to Measure Trunk Postural Control.

BACKGROUND: Although the Star Excursion Balance test (SEBT) has shown a good intrasession reliability, the intersession reliability of this test has not been deeply studied. Furthermore, there is an evident high influence of the lower limbs in the performance of the SEBT, so even if it has been used to measure core stability, it is possibly not the most suitable measurement. OBJECTIVE: (1) To assess the absolute and relative between-session reliability of the SEBT and 2 novel variations of this test to assess trunk postural control while sitting, ie, the Star Excursion Sitting Test (SEST) and the Star Excursion Timing Test (SETT); and (2) to analyze the relationships between these 3 test scores. DESIGN: Correlational and reliability test-retest study. SETTING: Controlled laboratory environment. PARTICIPANTS: Twenty-seven physically active men (age: 24.54 ± 3.05 years). METHOD: Relative and absolute reliability of the SEBT, SEST, and SETT were calculated through the intraclass correlation coefficient (ICC) and standard error of measurement (SEM), respectively. A Pearson correlation analysis was carried out between the variables of the 3 tests. MAIN OUTCOME MEASURES: Maximum normalized reach distances were assessed for different SEBT and SEST directions. In addition, composite indexes were calculated for SEBT, SEST, and SETT. RESULTS: The SEBT (dominant leg: ICC = 0.87 [0.73-0.94], SEM = 2.12 [1.66-2.93]; nondominant leg: ICC = 0.74 [0.50-0.87], SEM = 3.23 [2.54-4.45]), SEST (ICC = 0.85 [0.68-0.92], SEM = 1.27 [1.03-1.80]), and SETT (ICC = 0.61 [0.30-0.80], SEM = 2.31 [1.82-3.17]) composite indexes showed moderate-to-high 1-month reliability. A learning effect was detected for some SEBT and SEST directions and for SEST and SETT composite indexes. No significant correlations were found between SEBT and its 2 variations (r ≤ .366; P > .05). A significant correlation was found between the SEST and SETT composite indexes (r = .520; P > .01). CONCLUSIONS: SEBT, SEST, and SETT are reliable field protocols to measure postural control. However, whereas the SEBT assesses postural control in single-leg stance, SEST and SETT provide trunk postural control measures with lower influence of the lower-limbs. LEVEL OF EVIDENCE: III.

Reliability assessment and correlation analysis of 3 protocols to measure trunk muscle strength and endurance.

Different methods have been developed to quantify trunk muscle strength and endurance. However, some important protocol characteristics are still unclear, hindering the selection of the most suitable tests in each specific situation. The aim of this study was to examine the reliability and the relationship between 3 representative tests of the most common type of protocols used to assess trunk muscle strength and endurance. Twenty-seven healthy men performed each test twice spaced 1 month apart.Trunk strength and endurance were evaluated with an isokinetic dynamometer and 2 field tests including Biering-Sørensen test and Flexion-rotation trunk test. All tests showed a good relative consistency (intraclass correlation coefficient [ICC]> 0.75), except for the isokinetic endurance variables which had low-moderate reliability (0.37 < ICC > 0.65). Absolute reliability seemed slightly better in the isokinetic protocol than in the field tests, which showed about 12% of test-retest score increase. No significant correlations were found between test scores. After a familiarisation period for the field tests, the 3 protocols can be used to obtain reliable measures of trunk muscle strength and endurance. Based on the correlation analysis, these measures are not related, which highlights the importance of selecting the most suitable trunk test for each situation.

Dynamic trunk muscle endurance profile in adolescents aged 14-18: Normative values for age and gender differences.

BACKGROUND: The selection and validation of age- and gender-specific criterion-referenced cut-points for abdominal endurance are still unclear. OBJECTIVE: To stablish normative values for abdominal endurance in adolescents by age and gender using the Bench Trunk Curl-up Test (BTC). Additionally, the reliability of the BTC was analyzed. METHODS: Two hundred and sixteen untrained high school students (104 males - 112 females) were grouped into five age strata. Participants performed the BTC twice with a rest period of 72 h. Descriptive statistics and percentile scores were determined for each gender/age strata. RESULTS: Males showed higher BTC scores than females (males: 90.07 ± 32.65 repetitions; females: 73.43 ± 27.74 repetitions), but no significant differences between age strata nor age * gender interaction were found. Significant differences for the BTC scores between sessions were found (T1 = 72.06 ± 26.28 repetitions; T2 = 81.44 ± 31.27 repetitions). The ICC was 0.82, whereas the typical error was 17.2%. CONCLUSIONS: Gender, but not age, is an important factor when abdominal endurance is compared between adolescents. Finally, the BTC is a reliable test, supporting the findings of this study. However, an extensive familiarization period to reduce the learning effect is necessary.

Correction: Trunk Stability, Trunk Strength and Sport Performance Level in Judo.

[This corrects the article DOI: 10.1371/journal.pone.0156267.].

Trunk Stability, Trunk Strength and Sport Performance Level in Judo.

Although trunk muscle function has been suggested to be a determinant of judo performance, its contribution to high-level performance in this sport has been poorly studied. Therefore, several tests were used to assess the differences in trunk muscle function between 11 international and 14 national level judo practitioners (judokas). Trunk strength and endurance were assessed using isokinetic tests and core stability was assessed using two protocols: 1) sudden loading, to assess trunk responses to unexpected external perturbations; 2) stable and unstable sitting, to assess the participants' ability to control trunk balance. No differences between groups were found for trunk flexor isokinetic strength, trunk responses against lateral and posterior loading and trunk control while sitting. However, international level judokas showed significantly higher trunk extensor isokinetic strength (p <0.05) and lower trunk angular displacement after anterior trunk loading (p <0.05) than national level judokas. Few and low (r < 0.512) significant correlations were found between strength, endurance and stability parameters, which suggests that trunk strength and endurance are not limiting factors for trunk stability in competitive judokas. These results support the importance of trunk extensor strength and trunk stability against forward perturbations in elite judo performance.

Mechanical, hormonal and psychological effects of a non-failure short-term strength training program in young tennis players.

This study examined the effects of a 6-week non-failure strength training program in youth tennis players. Twenty tennis players (age: 15.0 ± 1 years, body height: 170.9 ± 5.1 cm, body mass: 63.3 ± 9.1 kg) were divided into experimental and control groups. Pre and post-tests included half squats, bench press, squat jumps, countermovement-jumps and side-ball throws. Salivary cortisol samples were collected, and the Profile of Mood States questionnaire was used weekly during an anatomical adaptation period, a main training period and after a tapering week. The results showed that, after the main training period, the experimental group significantly improved (p<0.05) in mean and peak power output and in the total number of repetitions during the half-squat endurance test; mean force, power and velocity in the half-squat power output test; Profile of Mood States (in total mood disturbance between the last week of the mean training period and the tapering week); and in squat-jump and countermovement-jump height. Moreover, significant differences were found between the groups at the post-tests in the total number of repetitions, mean and peak power during the half-squat endurance test, mean velocity in the half-squat power output test, salivary cortisol concentration (baselines, first and third week of the mean training period) and in the Profile of Mood States (in fatigue subscale: first and third week of the mean training period). In conclusion, a non-failure strength training protocol improved lower-limb performance levels and produced a moderate psychophysiological impact in youth elite tennis players, suggesting that it is a suitable program to improve strength. Such training protocols do not increase the total training load of tennis players and may be recommended to improve strength.

Variable training: effects on velocity and accuracy in the tennis serve.

Variable practice has been shown to be an effective strategy to improve open motor skills. However, the usefulness of this procedure in closed motor skills remains controversial. The following study has the objective of analysing the effects of variability practice in the improvement of a closed skill. The skill studied has been the tennis serve. Thirty young tennis players (13 ± 1.52 years), divided in two groups, took part in this study. One group practiced in variable conditions and the other group in consistency conditions. Both groups performed 12 training sessions (60 serves/session). The variable practice group improved their accuracy significantly compared with the consistency group (F3.25 = 3.078; P = 0.035). The velocity of serve increased after training in both groups (F3.25 = 15.890; P = 0.001). The practice in variable conditions seems to be effective in improving the performance of the tennis serve.

Active hip and spine ROM differs when comparing unconstrained motion with voluntary segmental constraint.

BACKGROUND: Active range of motion trials are frequently used as a baseline for normalizing other data. However, previous research has not focused on methods utilized to achieve maximum active range of motion. METHODS: Twenty-seven males (age 20-38 years) participated in this study. Active hip extension in upright standing was compared to active lumbar extension with regards to degrees of total hip and spine extension obtained. Similarly, active spine rotation whereby participants attempted to constrain associated pelvis and hip rotation was compared to rotation trials in which the pelvis and hips were free to rotate concurrently. An infra-red motion capture system and associated software were used to capture movement and determine joint angles. FINDINGS: Results indicate that average degrees of hip extension did not differ between the two methods (p = 0.138), nor did either method result more frequently in the highest measurement. Spine extension values were significantly greater in the active spine extension manoeuvre compared to the associated back extension that occurred when participants were asked to actively extend their hip (p < 0.001). Average degrees of spine rotation were greater in the unconstrained trials: when concurrent hip and pelvis rotation were allowed to take place (p < 0.001). Of the 27 participants, 23 obtained maximum rotation during the unconstrained trials. INTERPRETATION: To obtain maximum active hip joint extension, both hip and back extension trials should be collected. Maximum spine rotation is more likely to occur when the pelvis and hips are unconstrained.