Andrea Aagesen Oct 2 2019 Core Strength How Does It Impact Low Back … · 2019. 9. 30. ·...

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

Physical Medicine & RehabilitationPhysical Medicine & Rehabilitation

• I have no financial disclosures.


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


Outline

What is the core?

How do you measure?

Does it matter?

Is it related to injuries?

How do you improve?


Measuring Core Strength


0

20

40

60

80

100

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


Core Strength/Stability and Injuries


Measuring Core Stability


Seated hip flexion

Clinical Screen for Core stability

Single leg squat


Pelvic Tilt Progression


Advanced Post Stability/ Strength


Plank Progression


Side Plank Progression


Functional Movements


Thank You!


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.


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


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


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

Andrea Aagesen Oct 2 2019 Core Strength How Does It Impact Low Back … · 2019. 9. 30. ·...

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