Effect of the 'Pilates stance' and Pilates-based matwork training on measurements of height, waist circumference, and interscapular distance.

BACKGROUND: Standardised guidelines for stance are used to improve interobserver reliability in anthropometric measurements in clinical practice. A key feature of the stance in Pilates is the 'drawing in and up' of the abdomen. The aim of this study was to study the impact of the Pilates stance on height, waist circumference and interscapular distance, compared to that recommended in clinical practice. METHODS: 48 healthy females (median age 60 years) were assessed before and after 10-week Pilates-based matwork training. One Pilates expert and one novice took independent measurements of weight, height, waist circumference and interscapular distance (ISD). RESULTS: Pilates stance, compared to Normal, increased height by up to 2.7 cm and decreased waist up to 5.2 cm (each P < 0.001, repeated measures ANOVA). ISD decreased up to 14 mm (P < 0.001) and this decrease was greater after training (P < 0.001). After controlling for age and length of time learning Pilates, greater baseline ISD predicted a greater change in ISD after the intervention. Effect of Pilates stance was greater when the expert took the measurements (each P ≤ 0.001). CONCLUSIONS: Activation of trunk muscles in the Pilates stance increases height and decreases waist circumference, compared to the stance recommended in UK healthcare settings. A decrease in ISD was observed, which was greater after a Pilates-based matwork programme. There are significant inter-observer differences, therefore current clinical guidelines for stance are recommended for repeated anthropometry. The value of the Pilates stance in improving posture and the role of ISD as a marker, should be further studied in various contexts, including clinical settings.

Ultrasound imaging of core muscles activity in multiparous women with vaginal laxity: a cross-sectional study.

Vaginal laxity (VL) is a common condition among multiparous women, especially those who have delivered vaginally. Since pelvic floor muscles (PFMs) work synergistically with other core muscles, physical therapy protocols that aim to treat VL should train the PFMs in combination with other core muscles. To investigate the activity of core muscles in multiparous women with and without VL, and its relation to sexual function. An observational, cross-sectional study. The study included 100 multiparous women, who were divided into two groups according to their scores on the vaginal laxity questionnaire (VLQ). Women who scored between 1 and 3 on the VLQ were categorized as having VL (n = 48), while those who scored between 5 and 7 were placed in the control group (n = 52). The primary outcomes were PFM displacement, diaphragmatic excursion, transversus abdominis activation ratio, and lumbar multifidus thickness measured by ultrasound imaging. The secondary outcome was sexual functioning, evaluated using the Arabic female sexual function index (ArFSFI). The VL group had significantly lower PFM displacement (mean difference (MD) - 0.42; 95% confidence interval (CI) - 0.49 to - 0.33; p = 0.001), diaphragmatic excursion (MD - 2.75; 95% CI - 2.95 to - 2.55; p = 0.001), lumbar multifidus thickness (MD - 10.08; 95% CI - 14.32 to - 5.82; p = 0.02), and ArFSFI scores (MD - 9.2; 95% CI - 10.59 to - 7.81; p = 0.001) in comparison to the control group (p < 0.05). Nevertheless, the transversus abdominis activation ratio demonstrated no significant difference between the two groups (MD 0.06; 95% CI - 0.05 to 0.17; p = 0.33). Multiparous women with VL had significantly lower PFM displacement, diaphragmatic excursion, lumbar multifidus thickness, and sexual function index scores than women in the control group. The only exception was transversus abdominis activation, which did not differ significantly between the VL and control groups.

The importance of core strength for change of direction speed.

Change of direction speed (CODS) is determined by several physical aspects, such as linear sprint speed, reactive strength and power of leg muscles. It appears that core strength may also play a role in CODS, however, its relationship to CODS remains unclear. The aim of this narrative review was to analyze the literature addressing a) the relationship between core strength and CODS and b) the effect of core strength training on CODS. This analysis revealed a significant relationship between the parameters of core strength and stability (the pressure of the activated core muscles during lower limb movement and the greatest mean force output of maximum volunteered contraction) and the time in the Agility T-Test. However, this parameter was not significantly related to the strength endurance of core muscles (total time in the plank test). Core training provides a sufficient stimulus for the development of CODS in less-skilled middle-adolescent athletes, while its effectiveness decreases in higher-skilled adult athletes. These findings indicate that core muscle strength contributes significantly to the change of direction speed. Core training is therefore useful for improving CODS.

Effect of core muscles training based on spinal fine-tuning manipulation on lumbar spine function and quality of life in patients with lumbar facet joint disorders / 中国康复理论与实践

ObjectiveTo explore the effect of core muscles training based on spinal fine-tuning manipulation on lumbar facet joint disorders. MethodsFrom February, 2021 to February, 2022, 80 patients with lumbar facet joint disorders in Huadong Hospital Affiliated to Fudan University were randomly divided into control group (n = 40) and observation group (n = 40) randomly. Both groups received routine treatment and spinal fine-tuning manipulation, while the observation group received core muscles training in addition, for six weeks. They were assessed with Japanese Orthopaedic Association (JOA) scores, Short-Form of McGill Pain Questionnaire and World Health Organization Quality of Life-BREF before and after treatment. The recurrence rate was observed after three months follow-up. ResultsThe scores of all the scales improved after treatment (t > 5.751, P < 0.001), and improved more in the observation group than in the control group (t > 2.051, P < 0.05). After three months follow-up, the recurrence rate was 7.89% (3/38) in the observation group, less than 28.13% (9/32) in the control group (χ2 = 5.005, P = 0.025). ConclusionCombination of core muscles training may improve lumbar function, reduce lumbar pain, reduce recurrence and improve quality of life for patients with lumbar facet joint disorders.

Spinal Muscle Thickness and Activation during Abdominal Hollowing and Bracing in CrossFit® Athletes.

Exercises that improve muscle activation are essential for maintaining spinal stability and preventing low back pain. The purpose of this study was to compare the effects of abdominal hollowing and bracing on the activation of the core muscles in CrossFit® participants using ultrasound and electromyography (EMG). Twenty-four healthy adults aged 21 to 42 years old with at least two years of CrossFit® experience performed three core stability exercises (plank, side plank, bridge) with abdominal hollowing and bracing. We measured the ultrasound relative thickness of the local core muscles (transversus abdominis, internal oblique, and lumbar multifidus), and the EMG percentage of maximal voluntary contraction (MVC) of the global core muscles (rectus abdominis, external oblique, and iliocostalis lumborum). Analysis of variance tests showed that the relative thickness of the local core muscles was greater (p = 0.016) during hollowing (range from 26.8 ± 5.33 to 88.4 ± 11.9% of rest) than bracing (range from 15.9 ± 3.54 to 61.2 ± 15.9% of rest), while the EMG of the global muscles was greater (p = 0.001) in bracing (range from 24.4 ± 7.30 to 72.5 ± 9.17% of MVC) than hollowing (range from 16.4 ± 3.70 to 56.6 ± 7.65% of MVC). These results indicate that the recruitment of spinal muscles during popular exercises is achieved with both hollowing and bracing. Nevertheless, it appears that hollowing tends to recruit more of the local muscles, whilst bracing recruits more of the global muscles. The grading of the exercises varied between muscles and varied between maneuvers, especially for the surface abdominals and lumbar muscles. CrossFit® practitioners can choose to use either hollowing or bracing to activate their core muscles more selectively or more appropriately, depending on the goal and purpose of the exercise.

Is the function of the core muscles affected during pregnancy?

INTRODUCTION AND HYPOTHESIS: The aim of our study is to examine the changes in core muscle functions during pregnancy. METHODS: Our study was carried out in 67 primigravida pregnant women. Superficial electromyography (EMG) and non-invasive 2D/3D ultrasonography (USG) were used to evaluate core muscle (diaphragm, transversus abdominus [TA], internal oblique [IO]-external oblique [EO] muscles, pelvic floor muscles, multifidus) function during pregnancy. Pelvic floor muscle strength was also measured by a digital palpation method (PERFECT system). USG was used to measure expected fetal weight and the diastasis recti (DR) distance. Mann-Whitney U test was used to show changes in trimesters in the core muscles, and Spearman correlation analysis was used to determine the relationship. RESULTS: In the third trimester, an nonsignificant increase in EMG parameters was observed in all of the core muscles. Although a statistically significant decrease was observed in muscle thickness values measured by EO and IO USG in the third trimester, DR was found to increase at all levels (p < 0.005). When we evaluated both trimesters and all pregnant women together, no relationship was found between all core muscles and pelvic floor muscles in the data evaluated by EMG and USG. We found a negative correlation in USG values between fetal weight and IO and the upper part of the rectus abdominus muscle, and a positive correlation between the EMG data of the EO and rectus abdominus muscles. CONCLUSIONS: In women, the coactivation relationship between the core muscles may disappear during pregnancy. As the trimesters progress during pregnancy, a decrease in thickness and an increase in muscle activity can be observed in the core muscles. Pregnant women can be given exercise training for core muscles for protection in both the prenatal and postnatal periods. But more research needs to be done.

Isokinetic trunk training on pain, disability, and strength in non-specific low back pain patients: A systematic review and meta-analysis.

BACKGROUND: Low back pain is one of the leading causes of disability globally, with a high economic and social burden. A decrease or imbalance in trunk strength has been associated with the occurrence of low back pain and its severity. Trunk strength training is helpful in the treatment of Non-specific low back pain (NSLBP) patients. However, we do not know the effects of trunk isokinetic training (IKT) on pain intensity, disability, and trunk strength. OBJECTIVE: This systematic review aimed to determine the effects of trunk IKT in NSLBP patients on pain intensity, disability, and trunk flexor and extensor isokinetic strength. METHODS: We searched PubMed, Web of Science, Scopus, CENTRAL, and PEDro, from January 2001 until March 2021 and updated to November 2022. Randomized controlled trials (RCTs) that investigated the effect of IKT in adult participants with NSLBP on pain intensity, disability, or isokinetic trunk strength were included. Mean difference (MD) and 95% confidence intervals (95% CI) were calculated for pain. Bias was assessed using the Cochrane risk of bias (RoB) tool and evidence certainty via Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Among 1750 retrieved articles, eight were included in this review. Meta-analysis comparing IKT (trunk isokinetic training, n= 134) with control groups (conventional exercises, n= 133) revealed that IKT decreases pain intensity (MD -1.50 (95% CI: -2.60; -0.39)) immediately post-intervention, and one month (MD -1.97 (95% CI: -2.92; -1.03)) and at six months follow-up (MD -2.48 (95% CI: -2.77; -2.19)), although with a very low to low quality according to the GRADE rating. Besides, IKT decreases disability and increases isokinetic trunk strength, but with scant evidence. CONCLUSIONS: Trunk IKT could be a novel clinical tool for pain management in patients with NSLBP, although evidence is scarce. In addition, few RCTs exist for IKT on disability or trunk isokinetic strength in patients with NSLBP. Therefore, further research on this topic is needed.

A Case Report on Core Muscles Training for Knee Osteoarthritis Through Core Muscles Activations and Gait Analysis.

Knee osteoarthritis (OA) is a chronic joint disease that can affect all ages, but it is more common in the elderly. Pharmacological and non-pharmacological treatments have been invented evolutionarily over the years to halt this disease. Exercise is one of the first-line treatments for knee OA as well as for prevention. This case study features a 47-year-old man who has grade IV bilateral knee OA and has never had any surgery and takes fish oil daily as a supplement. His walking pattern was significantly impacted by the chronic knee discomfort he had in both legs. Thus, the walking gait of this patient was analyzed together with core muscle activation before and after two weeks of core resistance exercise intervention. The knee pain score was assessed using the Western Ontario and McMaster Universities Index (WOMAC). The outcomes of this research depict that core resistance training has the potential to be used as an alternative, non-surgical and non-pharmacological treatment for a patient with knee OA.

Muscle Quality and Functional and Conventional Ratios of Trunk Strength in Young Healthy Subjects: A Pilot Study.

BACKGROUND: The trunk strength conventional ratio (CR) has been evaluated. However, the functional ratio and the ratio of strength to body weight (BW) or muscle mass (MM) have been poorly explored. Relative strength is a measure of muscle quality. OBJECTIVES: To analyze the trunk strength ratio normalized by BW and MM and compare the trunk's conventional and functional ratios collected in isokinetic and isometric conditions. METHODS: Twenty-seven healthy males (21.48 ± 2.08 years, 70.22 ± 7.65 kg) were evaluated for trunk isometric and isokinetic strength using a functional electromechanical dynamometer. RESULTS: The extensor's strength was greater than the flexors, with a CR of 0.41 ± 0.10 to 0.44 ± 0.10. Muscle quality was higher in eccentric contraction and high velocity for flexors and extensors. The functional flexor ratio (FFR) ranged between 0.41 ± 0.09 and 0.92 ± 0.27. The functional extensor ratio (FER) ranged between 2.53 ± 0.65 and 4.92 ± 1.26. The FFR and FER showed significant differences between velocities when considering the peak strength (p = 0.001) and mean strength (p = 0.001). CONCLUSIONS: Trunk extensors were stronger than the flexors; thus, the CR was less than one. Muscle quality was higher at a high velocity. Unlike CR, FFR and FER behaved differently at distinct velocities. This finding highlights the need to explore the behavior of the functional ratio in different populations.

Correlation between Core Stability and Upper-Extremity Performance in Male Collegiate Athletes.

Background: The purpose of this study was to investigate the correlation of core stability, as measured by the McGill and double-leg lowering (DLL) test, with upper-extremity performance, as measured by the upper-quarter Y-balance test (UQYBT), medicine ball throw test (MBTT) and functional throwing performance index (FTPI) test, in collegiate athletes. Materials and Methods: A sample of 61 collegiate athletes from Imam Abdulrahman Bin Faisal University participated in the study. Their core stability was assessed through their McGill and DLL test scores. Their upper-extremity performance was assessed through their UQYBT, MBTT and FTPI test scores. Results: The McGill test score had a significant strong positive correlation with the MBTT score (p = 0.02, r = 0.67) and a significant moderate positive correlation with the UQYBT score (p = 0.01, r = 0.46). There was no significant correlation between the McGill and FTPI test scores (p ≥ 0.05). The DLL test score was positively correlated with the MBTT score (p = 0.02, r = 0.25) but had no significant correlation with the other sports performance variables (p ≥ 0.05). Conclusion: The study results suggest that core stability measures are positively correlated with most of the upper-extremity athletic-performance measures in collegiate athletes. The MBTT score was found to be the most significantly correlated with the scores in both core stability tests among all the upper-extremity athletic-performance tests in this study. However, due to the nature of this study, a cause-effect relationship cannot be established on the basis of the study's findings, and the study results should be interpreted with caution.

Efficacy of Core Training in Swimming Performance and Neuromuscular Parameters of Young Swimmers: A Randomised Control Trial.

Background: This study aimed to investigate the efficacy of core training in the swimming performance and neuromuscular properties of young swimmers. Methods: Eighteen healthy male swimmers (age: 13 ± 2 years, height: 159.6 ± 14.5 cm, weight: 48.7 ± 12.4 kg) were recruited from the Public Authority for Sports swimming pool in Dammam and randomly assigned to the experimental and control groups. The experimental group performed a six-week core-training program consisting of seven exercises (three times/week) with regular swimming training. The control group maintained its regular training. Swimming performance and neuromuscular parameters were measured pre- and post-interventions. Results: The experimental group benefitted from the intervention in terms of the 50 m swim time (−1.4 s; 95% confidence interval −2.4 to −0.5) compared with the control group. The experimental group also showed improved swimming velocity (+0.1 m.s−1), stroke rate (−2.8 cycle.min−1), stroke length (+0.2 m.cycle−1), stroke index (+0.4 m2·s−1), total strokes (−2.9 strokes), and contraction time for erector spinae (ES; −1.5 ms), latissimus dorsi (LD; −7 ms), and external obliques (EO; −1.9 ms). Maximal displacement ES (DM-ES) (+3.3 mm), LD (0.5 mm), and EO (+2.2 mm) were compared with the baseline values for the experimental group, and TC-ES (5.8 ms), LD (3.7 ms), EO (2.5 ms), DM-ES (0.2 mm), LD (−4.1 mm), and EO (−1.0 mm) were compared with the baseline values for the control group. The intergroup comparison was statistically significant (p < 0.05; DM-ES p > 0.05). Conclusion: The results indicate that a six-week core-training program with regular swimming training improved the neuromuscular properties and the 50 m freestyle swim performance of the experimental group compared with the control group.

An initial study of core muscles using ultrasound in postmenopausal women with osteoporosis.

BACKGROUND: Osteoporosis is a systemic bone disease, resulting in bone pain and fragility fractures. This study sought to explore the ultrasonic characteristics of core muscles in postmenopausal women with osteoporosis. METHODS: A total of 91 participants underwent ultrasound examinations of the lumbar and abdominal core muscles. The participants were divided into the following two groups: group 1 (the normal control group, comprising 20 participants, aged 25-35 years); and the osteoporosis group (comprising 71 participants). The participants in the osteoporosis group were further divided into the following three groups: group II (comprising 20 participants, aged 50-59 years); group III (comprising 30 participants, aged 60-69 years); and group IV (comprising 21 participants, aged 70-87 years). The 2-dimensional (2D) sonographic manifestations, thickness and gray values of the core muscles of the lumbar and abdomen were observed, and a further analysis was conducted that included the bone density of the lumbar vertebrae results. RESULTS: Compared to the control group, the total thickness of the core muscles in the osteoporosis group was significantly decreased (P<0.05), and the gray values were significantly increased (P<0.05). The comparison of the osteoporosis groups showed that in relation to the total thickness of the core muscle, group II > group III > group IV (P<0.05). The 2D ultrasonography showed that the muscles of the participants in group I were full and had an equally low echo. Conversely, in the osteoporosis group, the muscles of the participants were less full, the echo was enhanced, the boundary between the muscle and the fascia was unclear, and the long axis of the rectus abdominis and transverse abdominis tracts were wavy and linear, with reduced tension. CONCLUSIONS: In postmenopausal women with osteoporosis, the core muscles of the waist and abdomen are degenerative, which can be evaluated with ultrasonography via the echo, thickness, and gray value of the muscles.

Reliability of trunk strength measurements with an isokinetic dynamometer in non-specific low back pain patients: A systematic review.

BACKGROUND: Imbalance or decreased trunk strength has been associated with non-specific low back pain (NSLBP). OBJECTIVE: This systematic review aimed (I) to evaluate the quality of evidence of studies evaluating the reliability of trunk strength assessment with an isokinetic dynamometer in NSLBP patients, (II) to examine the reliability of trunk strength assessment using an isokinetic dynamometer in NSLBP patients and (III) to determine the most reliable protocol for trunk strength assessment in NSLBP patients. METHOD: PRISMA guidelines were followed. Three databases were used: PubMed, Scopus, and Web of Science with the following keywords: Isokinetic, Dynamometer, Trunk strength testing, Muscle testing, Isokinetic measurement, CORE, Abdominal muscles, Abdominal wall, Torso, Trunk, Spine, Reliability and, Reproducibility. We included only test-retest studies, focused on the reliability of isometric and isokinetic strength assessed with an isokinetic dynamometer in NSLBP adults' patients, published in English and from inception to March 30, 2021. The methodological quality was evaluated with the CAT scale and QAREL checklist. RESULTS: Five hundred and seventy-seven articles were retrieved, of which five are included in this review. Three articles provide good quality of evidence, the reliability of trunk strength assessment in NSLBP patients is excellent, and the most reliable protocol for isometric assessment is in a seated position (ICC = 0.94-0.98) and for isokinetic strength in standing position, at 60∘/s and 120∘/s (ICC = 0.98). CONCLUSION: There is good quality evidence regarding the trunk strength assessment's reliability. Reliability is excellent in NSLBP patients; however, a familiarization process should be considered to obtain clinically reliable data. The most reliable protocol is in a seated position for isometric strength and a standing position for isokinetic strength.

The core of performance in adolescent cricket pace bowlers: Trunk muscle stability, maybe, but not strength-endurance and thickness.

Background: The trunk connects the upper and lower limbs and transfers energy during movement. Exploring the role of the trunk muscles in bowling performance affords us the opportunity to uncover potential mechanisms to improve bowling performance. Objectives: To investigate the association between bowling performance and trunk muscle stability, strength-endurance and thickness in adolescent pace bowlers. Methods: Adolescent pace bowlers participated in this cross-sectional study. Trunk muscle stability was measured using Sahrmann's Stability Scale, strength-endurance using the Bourbon Trunk Muscle Strength Test and thickness of the abdominal wall and lumbar multifidus muscles using ultrasound imaging. Results: Forty-six pace bowlers with a mean age of 15.9 ±1.2 years participated. The average ball release speed was 109.2±11.8 km.h-1. This measurement was higher in level four of stability than in level two (mean difference 22.2 ± SD 6.8 km.h-1; p= .018). No link between ball release speed and strength-endurance could be found. Multiple correlations of moderate strength (r > 0.4) exist between ball release speed and absolute trunk muscle thickness with height and weight as confounding factors. The relationship between accuracy and the trunk muscle variables investigated in this study is weak. Conclusion: Bowlers with better trunk muscle stability bowled faster than those with a lower level of trunk stability, irrespective of their age, height and weight. Trunk muscle thickness correlated with ball release speed; however, confounding factors such as height and weight play a role and therefore, findings need to be interpreted with caution.

Prestroke VO2max by the Jurca prediction index as a predictor of functional outcomes in stroke patients.

BACKGROUND: Prestroke cardiopulmonary fitness (CPF) levels can affect post-stroke respiratory function and functional status, including gait and activities of daily living (ADL). OBJECTIVES: To investigate the prestroke CPF level measured by the Jurca prediction index as a predictor of functional outcomes after stroke and to evaluate the association between estimated prestroke CPF and respiratory function after stroke. METHODS: This was a prospective observational study involving 71 inpatients with first-time subacute stroke between June 2017 and July 2019. The prestroke VO2max was assessed using the Jurca prediction index, which was calculated from age, sex, resting heart rate, body mass index, and physical activity level. Linear regression analysis was performed to determine the relationship between the Jurca prediction index, functional outcomes, pulmonary functions, and cough strength variables. RESULTS: The estimated prestroke VO2max was significantly associated with the post-stroke Berg Balance Scale (ß=1.199, P<0.001), Trunk Impairment Scale (ß=0.308, P=0.006), and Functional Independence Measure score (ß=1.102, P=0.004) at admission, and these relationships remained significant at the follow-up evaluation after 1 month of conventional rehabilitation (P<0.001). Among the respiratory function variables, only peak cough flow (PCF) (ß=0.696, P=0.037) was significantly associated with the estimated prestroke VO2max. CONCLUSIONS: Prestroke CPF likely affects the stability of core muscles that are related to PCF and the functional status, including balance function and ADL after stroke. Regular exercise to increase the CPF level should be encouraged in patients with risk factors for stroke, not only for primary prevention but also for functional improvement after stroke.

Comparison of linea alba length and core-muscles engagement during core and lower back orientated exercises.

BACKGROUND: A comparison of Linea Alba (LA) length and engagement of the Transverse Abdominis (TrA), External Oblique (EO) and Internal Oblique (IO) between core-orientated and lower back orientated exercises (e.g. glute bridge and hip extension) is lacking. Therefore, the aim of this study was to compare the length of the LA and the engagement of TrA, EO and IO when performing the prone plank, bird dog, dead bug, lateral plank, glute bridge and hip extension. METHODS: Thirteen apparently healthy participants volunteered to this study. Ultrasound scanning of the anterior and antero-lateral abdominal walls at baseline and whilst performing prone plank, bird dog, dead bug, lateral plank, glute bridge and hip extension exercises was performed. LA length and thickness of the TrA, EO and IO were measured from ultrasound images. RESULTS: LA length (p = 0.77) and TrA thickness (p = 0.23) were not different between exercises. EO thickness was larger for the lateral plank compared to the bird dog (p = 0.01, d = 1.73), glute bridge (p < 0.01, d = 2.64), and hip extension (p < 0.01, d = 1.89). The dead bug was also larger in comparison to the glute bridge (p < 0.01, d = 2.05) and to the hip extension (p = 0.01, d = 1.45). For the IO thickness, the lateral plank was larger than the bird dog (p = 0.03, d = 1.21) and the dead bug (p = 0.04, d = 1.12). CONCLUSION: No difference was observed between exercises for the length of the LA or for the thickness of the TrA, which suggests that this muscle is similarly engaged in the assessed exercises, leading to a consistent stretch for the LA.

Effects of stabilization exercises on disability, pain, and core stability in patients with non-specific low back pain: A randomized controlled trial.

BACKGROUND: Many studies have emphasized the importance of stabilization exercises (SE) for the management of non-specific low back pain (NSLBP), yet there is no study assessing all aspects of core stability in comparing SE and other exercises. OBJECTIVE: To investigate the effects of SE on pain and core stability by using core stability tests that focus on all aspects of core stability in patients with NSLBP. METHODS: Thirty-seven individuals with chronic NSLBP were randomly divided into two groups as SE and conventional exercises (CE). Both groups underwent the progressive exercise program three days per week for six weeks. The assessments were conducted before and after the exercise programs. The outcome measures included pain, disability, trunk strength, trunk flexor, extensor and lateral flexor endurance, function, flexibility, and motor control during eyes open/closed. RESULTS: All assessment parameters except motor control during eyes open improved after SE (p < 0.05). Also, all assessment parameters except motor control during eyes open/closed and lateral trunk endurance improved after CE (p < 0.05). When comparing groups for gain scores, there were more significant improvements in pain during activity, endurance and function after SE (p < 0.05). CONCLUSIONS: SE is more effective than CE in reducing pain during activity and improving core stability regarding functionality and endurance.

Comparative analysis of core muscle activation according to the use of props and the different knee angle during the modified Pilates Hundred.

BACKGROUND: There are not so many Pilates studies related to muscle activation. Since the effectiveness and efficiency of the Pilates Hundred to muscle activation has recently emerged, it is necessary to investigate the effects of the Pilates Hundred on core muscles. OBJECTIVES: The purpose of this study was to determine what difference occurs in the muscle activity, during the Pilates Hundred, to suggest the optimal props for muscle function improvement and then to provide data for the efficient exercise program. METHODS: Twenty-eight men in their twenties who were able to fully conduct Pilates Hundred. According to the difference between the small tool application (no prop: NP, soft ball mini: SB, Pilates ring: PR) and the knee joint angle (90° and 180°), muscle activations of rectus abdominis (RA), external oblique (EO), rectus femoris (RF), lateral muscle (vastus lateralis: VL), medial muscle (vastus medialis: VM), biceps femoris (BF), and semitendinosus (ST) were measured by the using surface electromyography (EMG) while different exercise conditions. RESULTS: During Pilates Hundred, the use of tools was found to be more effective in activating the core muscle (NP < SB < PR). During Pilates Hundred, 180° of knee angle had more influence on core muscle activation than 90°, and knee angle and props use showed an interaction for activating core muscles. CONCLUSION: The Pilates Hundred with PR and 180° knee angle intervention can increase core muscle activation, and this leads to effective Pilates exercise program for those who need to enhance core muscle volume and function and to rehabilitate core muscles.

Isokinetic Trunk Strength in Acute Low Back Pain Patients Compared to Healthy Subjects: A Systematic Review.

BACKGROUND: The purpose of this systematic review was to: (I) determine the quality of evidence from studies assessing trunk isokinetic strength in subjects with acute low back pain (ALBP) compared to healthy subjects and (II) establish reference values of isokinetic trunk strength in subjects with ALBP. METHODOLOGY: Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statements were followed using keywords associated with trunk, strength and low back pain. Four databases were used: PubMed, Web of Science, Scopus and SPORTDiscus. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). RESULTS: A total of 1604 articles were retrieved, four included in this review. All were evaluated as high risk of bias (Rob). Due to the high Rob and the diversity of protocols, instruments and variables used, it was not possible to determine reference values for subjects with ALBP, we can only establish a range of flexion peak torque (PT) between 175.1 and 89.7 Nm at 60°/s and between 185 and 81.5 Nm at 120°/s, and for extension PT between 240.0 and 91.5 Nm at 60°/s and between 217.5 and 69.2 Nm at 120°/s in subjects with ALBP. CONCLUSIONS: Due to the low quality of the evidence and the diversity of protocols used when measuring trunk isokinetic strength, it is necessary to carry out new high-quality research to establish reference values of trunk strength in subjects with ALBP.

The Effect of the Activation of the Core Muscles on Tremor in a Patient with Multiple Sclerosis.

BACKGROUND: Trunk stabilization is important in providing postural control and extremity movements, and is maintained by the muscles called "core". OBJECTIVE: The aim of this report was to demonstrate the effect of core muscles contraction on upper extremity tremor. MATERIALS AND METHODS: A 22-year-old Multiple Sclerosis patient with right extremity ataxia was included in this report. Scale of Assessment and Rating Ataxia (SARA), Expanded Disability Status Scale (EDSS), Accelerometric Tremorogram and Purdue Peg Board Test (PPBT) were performed. Assessments were made with and without the core muscles contraction. RESULTS: The total score of SARA decreased from 16 to 14 due to the reduction of dysmetria and tremor scores. Tremor amplitude decreased with contraction in tremorogram. At the 1st position, the tremor amplitude changed from -14.6 before the contraction to -18.3 after the contraction. At position 2, 6 Hz tremor was disappeared with contraction. In the PPBT, ataxic extremity performance increased from 5 to 7. CONCLUSION: Contraction of core muscles reduced postural tremor and improved upper extremity performance. It should be considered planning the training program of ataxic MS patients.