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Core stability: evaluation of a therapeutic intervention followed by two progression exercises

Jones, Karen, Wray, Jonathan Marc, Price, Vonda Estelle, McBride, Mark Berrie, Donohoe, Joanne and Eddy, Suzanne 2007. Core stability: evaluation of a therapeutic intervention followed by two progression exercises. Presented at: 6th Interdisciplinary World Congress on Low Back & Pelvic Pain, Barcelona, Spain, 7-10 November 2007.

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Abstract

Purpose: To investigate trunk muscle activity in sitting i) baseline to facilitated segmental extension (FSE) ii) from FSE evaluating two progression exercises (1) bilateral arm raise and (2) unilateral leg lift. Relevance: Segmental extension of the lumbar spine is required when rehabilitating core stability (Edwards, 2002). This may activate local muscle stabilisers, multifidis and transversus abdominus (Akuthota and Nadler, 2004). FSE is utilised in neurological physiotherapy, however, there is no objective evidence regarding its effectiveness. The evidence is also scant in relation to the effectiveness of exercise progressions from FSE in sitting. Methods: Healthy volunteer subjects (mean (SD) age 46.45 years ±5.25 (n = 22; 13 female) were recruited. Average normalised SEMG of bilateral Multifidis (M), Transverse abdominus/internal oblique (TA/IO), external oblique (EO), erector spinae (ES) was obtained for baseline sitting, post intervention (FSE) and following the progressions of bilateral arm raise and right leg lift. Local ethical approval was obtained. Analysis: A paired t test (alpha ≤ 0.05) evaluated pre and post intervention muscle activity. A repeated measures ANOVA (alpha ≤ 0.05) evaluated muscle activity from the FSE (new baseline) to progressions 1 and 2. Results: Results for pre to post intervention show a statistically significant increase in muscle activity in all trunk muscles. Left M (p=0.000), right M (p=0.002), left ES (p=0.029), right ES (p=0.015), left TA/IO (p=0.000), right TA/IO (p=0.000), left EO (p=0.008), right EO (p=0.044). Results from FSE to bilateral arm raise showed a statistically significant increase in Left M (F=79.02 p=0.000), right M (p=0.000), left ES (p=0.000), right ES (p=0.000). Values for the abdominal muscles were not significant, left TA/IO (p=0.899), right TA/IO (p=0.666), left EO (p=0.131), right EO (p=0.144). Results from FSE to right leg lift showed a statistically significant increase in Left M (p=0.000), right M (p=0.001), left TA (p=0.000), right TA (p=0.000), left EO (p=0.000), right EO (p=0.000). Results for ES were not significant, left ES (p=0.174), right ES (p=0.057). Conclusions: The results show that FSE activates local and global trunk stabilisers in sitting. During a bilateral arm raise (1) there is increased muscle activity in the stabilisers of the back but not the abdominals. With a unilateral leg lift (2) increases in all abdominals and bilateral Multifidis provide justification for its use as a progression. Limitations include the use of a small sample and healthy subjects. Future work should focus on patient populations. Implications: Clinically, this study provides evidence for the use of FSE as a therapeutic intervention and of a right leg lift as an exercise progression. Justification of a bilateral arm raise is only evidenced if specific rehabilitation of back extensors is required.

Item Type: Conference or Workshop Item (Poster)
Date Type: Completion
Status: Unpublished
Schools: Healthcare Sciences
Subjects: R Medicine > RM Therapeutics. Pharmacology
Last Modified: 05 Jan 2018 20:55
URI: http://orca.cf.ac.uk/id/eprint/15298

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