Post on 04-Feb-2021
Physical Medicine & Rehabilitation
Core Strength:How Does It Impact Low Back and Lower Extremity
Injuries?Andrea Aagesen, DOAssistant Professor
Department of Physical Medicine and RehabilitationOctober 2, 2019
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• I have no financial disclosures.
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Objectives
• By the end of this session you should be able to:• Explain the relationship between core strength and stability and lower limb and back injuries
• Accurately asses core strength/stability in a clinical setting
• Prescribe rehab program for core deficits• Incorporate core and biomechanical evaluation in your clinical assessment
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Outline
What is the core?
How do you measure?
Does it matter?
Is it related to injuries?
How do you improve?
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Measuring Core Strength
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Measuring Core Strength
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0 10 20 30 40 50 60 70 80 90 100
% Maximal Voluntary Contraction
Rhomert’s Curve
Non‐linear relationship
between %MVC and holding time
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Core Strength/Stability and Injuries
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Measuring Core Stability
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Seated hip flexion
Clinical Screen for Core stability
Single leg squat
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Pelvic Tilt Progression
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Advanced Post Stability/ Strength
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Plank Progression
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Side Plank Progression
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Functional Movements
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Thank You!
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References
• LEETUN, DT, ML IRELAND, JD WILLSON, BT BALLANTYNE, and IM DAVIS. Core Stability Measures as Risk Factors for Lower Extremity Injury in Athletes. Med. Sci. Sports Exerc., Vol. 36, No. 6, pp. 926–934, 2004
• Arokoski JP, Valta T, Airaksinen O, Kankaanpää M: Back and abdominal muscle function during stabilization exercises. Arch Phys Med Rehabil 2001;82:1089‐1098.
• Bouisset S: Relationship between postural support and intentional movement: Biomechanical approach [French]. Arch Int PhysiolBiochim Biophys 1991;99:A77‐A92.
• Abdelraouf, O. R., & Abdel‐Aziem, A. A. (2016). The Relationship between Core Endurance and Back Dysfunction in Collegiate Male Athletes with and without Nonspecific Low Back Pain. Int J Sports Phys Ther, 11(3), 337‐344.
• Ambegaonkar, J. P., Mettinger, L. M., Caswell, S. V., Burtt, A., & Cortes, N. (2014). Relationships between core endurance, hip strength, and balance in collegiate female athletes. Int J Sports Phys Ther, 9(5), 604‐616.
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References
• Ayhan, C., Unal, E., & Yakut, Y. (2014). Core stabilisation reduces compensatory movement patterns in patients with injury to the arm: a randomized controlled trial. Clin Rehabil, 28(1), 36‐47. doi:10.1177/0269215513492443
• Butowicz, C. M., Ebaugh, D. D., Noehren, B., & Silfies, S. P. (2016). Validation of Two Clinical Measures of Core Stability. Int J Sports Phys Ther, 11(1), 15‐23.
• Calatayud, J., Casana, J., Martin, F., Jakobsen, M. D., Colado, J. C., & Andersen, L. L. (2017). Progression of Core Stability Exercises Based on the Extent of Muscle Activity. Am J Phys Med Rehabil. doi:10.1097/PHM.0000000000000713
• Cooper, N. A., Scavo, K. M., Strickland, K. J., Tipayamongkol, N., Nicholson, J. D., Bewyer, D. C., & Sluka, K. A. (2016). Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. Eur Spine J, 25(4), 1258‐1265. doi:10.1007/s00586‐015‐4027‐6
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References:
• Macadam, P., Cronin, J., & Contreras, B. (2015). An Examination of the Gluteal Muscle Activity Associated with Dynamic Hip Abduction and Hip External Rotation Exercise: A Systematic Review. Int J Sports Phys Ther, 10(5), 573‐591.
• Salamat, S., Talebian, S., Bagheri, H., Maroufi, N., Jafar Shaterzadeh, M., Kalbasi, G., & O'Sullivan, K. (2017). Effect of movement control and stabilization exercises in people with extension related non ‐specific low back pain‐ a pilot study. Journal of Bodywork and Movement Therapies. doi:10.1016/j.jbmt.2017.02.005
• Suehiro, Tadanobu et al. Individuals with chronic low back pain demonstrate delayed onset of the back muscle activity during prone hip extension. Journal of Electromyography and Kinesiology , Volume 25 , Issue 4 , 675 ‐ 680
• Villafane, J. H., Gobbo, M., Peranzoni, M., Naik, G., Imperio, G., Cleland, J. A., & Negrini, S. (2016). Validity and everyday clinical applicability of lumbar muscle fatigue assessment methods in patients with chronic non‐specific low back pain: a systematic review. Disabil Rehabil, 38(19), 1859‐1871. doi:10.3109/09638288.2015.1107777
• Wilk, K. E., Arrigo, C. A., Hooks, T. R., & Andrews, J. R. (2016). Rehabilitation of the Overhead Throwing Athlete: There Is More to It Than Just External Rotation/Internal Rotation Strengthening. PM R, 8(3 Suppl), S78‐90. doi:10.1016/j.pmrj.2015.12.005
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References• Denteneer, L., Stassijns, G., De Hertogh, W., Truijen, S., & Van Daele, U. (2017). Inter‐
and Intrarater Reliability of Clinical Tests Associated With Functional Lumbar Segmental Instability and Motor Control Impairment in Patients With Low Back Pain: A Systematic Review. Arch Phys Med Rehabil, 98(1), 151‐164 e156. doi:10.1016/j.apmr.2016.07.020
• Hebert, J. J., Koppenhaver, S. L., Teyhen, D. S., Walker, B. F., & Fritz, J. M. (2015). The evaluation of lumbar multifidus muscle function via palpation: reliability and validity of a new clinical test. Spine J, 15(6), 1196‐1202. doi:10.1016/j.spinee.2013.08.056
• Joyce, A. A., & Kotler, D. H. (2017). Core Training in Low Back Disorders: Role of the Pilates Method. Curr Sports Med Rep, 16(3), 156‐161. doi:10.1249/JSR.0000000000000365
• Lee, S. W., & Kim, S. Y. (2015). Effects of hip exercises for chronic low‐back pain patients with lumbar instability. J Phys Ther Sci, 27(2), 345‐348. doi:10.1589/jpts.27.345