Rajiv Gandhi University of Health Sciences, Karnataka
Bangalore
ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. / Name of the Candidate & Address / LEENA BHAGCHANDANI24 Rajesh Bhavan
Babunivas gali
Nanpura
Surat-395001
2. / Name of the Institution / K.T.G. College of Physiotherapy,
Hegganahalli Cross, Peenya 2nd stage,
Sunkadakatte Main Road, V.N.Post
Bangalore-91
3. / Course of Study Subjects / MASTERS IN PHYSIOTHERAPY
(Musculoskeletal Disorders and Sports Physiotherapy)
4. / Date of Admission to the Course / 14/10/2010
5. / Title of the Topic:
“The differential effects of core stabilization exercise regime and conventional physiotherapy regime to prevent sports injuries in atheletes”
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8. / BRIEF RESUME OF INTENDED WORK:
6.1 Need of the study:
Since the fitness boom of the 1980s, different exercise methodologies have been presented and marketed with varying levels of success. However, sometimes what appears to be a new exercise methodology is really not new at all; but just a new per- spective that seeks to improve on an old methodology based on current trends. This appears to be the case with core stability training, a trend that has become popular in commercial fitness centers and athletic strength and conditioning facilities1,2.
A core stability exercise can be defined as “any exercise that channels motor patterns to ensure a stable spine through repeti- tion”3. Based on this definition, athletes have been performing core stability exercises for many years. For example, any type of exercise that is performed while standing and holding or supporting a weight across the shoulders would qualify as a core stability exercise. Examples of such exercises may include the back squat, deadlift, overhead press, Olympic lifts, and uni- lateral variations of these exercises performed while standing4
During the last five years, a great amount of research has been published to examine the validity of these claims for healthy in- dividuals and athletes Although this research is still in its infancy, sports scientists have reached some tentative conclusions on how core stability exercises should be prescribed based on individual needs and yearly training cycles. Therefore, the purpose of this brief review is to present the latest research on core stability training and make recommendations concerning how exercise prescription might be improved to address core stability in athletes5.
Core stability training should receive some attention in the training programs of all athletes. The ability to stabilize the core region allows for efficient transfer of force between links in the kinetic chain Thus, from a scientific perspective, core stability in athletes should be addressed with varying methods, depending on the phase of training and the health status of the athlete5,6.
Importance of Core Stability for Sports Performance the core of the body is a term used to refer to the trunk or more specifically the lumbopelvic region . Several muscles attach to the lumbar spine or pelvis and may function as stabilizers or prime movers depending on the nature of the task being per- formed. Muscular support in this region is critical to maintain the integrity of the spine to support body mass plus additional loads that are supported during resistance training and sports activities
Hypothesis :
Alternative Hypothesis :-
There will be a significant difference between corestability exercises and other theraputic regime in atheletes
Null Hypothesis :-
There will be no significant difference between corestability exercises and other theraputic regime in atheletes
6.2 Review of Literature :
LI Chun-lei,XIA(2009)Core strength training is known as functional training or core stability training in Europe and America.It can be a very good method for athelete to improve muscle strength of the core region and stability.Initially,core strength training is only used for a few items such as swimming field and so on.In recent years,with introuducing of the kinematic chain theory and the neuromuscular system training and ontology sensitivity training,many people found that core training are vital to most sports.Physical fitness is very important to Track and Field athletes.And physical strength are the core projects in physical fitness.No matter what fields events or the tracks events requestes athletes have a good ability to control the body11
Fredericson Michael (2008) Core stability is essential for proper load balance within the spine, pelvis, and kinetic chain. The so-called core is the group of trunk muscles that surround the spine and abdominal viscera. Abdominal, gluteal, hip girdle, paraspinal, and other muscles work in concert to provide spinal stability. Core stability and its motor control have been shown to be imperative for initiation of functional limb movements, as needed in athletics. Sports medicine practitioners use core strengthening techniques to improve performance and prevent injury. Core strengthening, often called lumbar stabilization, also has been used as a therapeutic exercise treatment regimen for low back pain conditions10
Christopher Standaert (2008)Although there are a wide variety of therapeutic exercises that have been proposed as treatments for low back pain (LBP), the last 20 years have seen the development of a substantial focus on the use of exercises that are intended to address intersegmental stability in the lumbar spine. These exercise programs are varyingly referred to as lumbar stabilization, segmental stabilization, or core stabilization, among other terms, and are aimed at improving the neuromuscular control, strength, and endurance of a number of muscles in the trunk and pelvic floor that are believed to play important roles in the dynamic stability of the spine. Although it is difficult to quantify, there appears to have been a tremendous degree of penetration of these treatment concepts into the therapeutic arena, the medical literature, and the lay press. Despite this, there are few prospective studies on patients with LBP, and there is even more limited discussion of the concepts of patient selection, dose-response, and long-term outcome associated with these approaches. There also is a significant lack of uniformity regarding the meaning of “core stabilization” and what therapeutic exercises may be most effective. Jason M. Friedrich12
Krabak Brian (2008) Athletic injuries to the lumbar spine are relatively common, depending upon the specific sport. With proper management, the majority of injuries resolve quickly and allow for rapid return to sport. However, some of these injuries occur because of improper mechanics that adversely affect the core stability of the spine, or conversely these injuries cause instability of the spine through disruption of the spinal support mechanisms. Development of an appropriate treatment plan depends on a thorough understanding of the structures providing core stability and the exercises to correct identifiable deficits. A comprehensive rehabilitation program should include correction of flexibility and strength deficits, with subsequent progression to functional and sports-specific exercises13
Willardson, Jeffrey (2007)Core stability exercises have become main stream, with rehabilitative methodologies now being applied to healthy athletes. A popular trend has been to perform resistance exercises on unstable equipment. However, resistance exercises performed on unstable equipment are not effective for the development of core strength and power due to the light loads, long tension times, and low velocities that characterize such lifts. Based on the current literature, performance of groundbased free weight movements might be better for the development of core strength and power due to the force, velocity, and core stabilizing requirements that are similar to the demands of sports skills.14
Griggs M (2007) Lumbar-stabilization exercise programs have become increasingly popular as a treatment for low-back pain. In this article, we outline an evidence-based medicine approach to evaluating patients for a lumbar-stabilization program. We also discuss typical clinical components of this type of program and the rationale for including these particular features based on the medical literature16.
Roger Adams (2006) Adequate trunk muscle endurance may play an important role in injury-free performance among athletes. However, reliability of tests of isometric trunk muscle endurance in common use has not been clearly established and few studies have reported normative data for athletes. This study first examined intra-rater and inter-rater reliability of the side bridge endurance test and a test of trunk flexor endurance in a group of non-athletes, then measured performance of a group of elite athletes on tests of trunk muscle endurance commonly used in the clinic. The side bridge endurance test and the trunk flexor endurance test were found to have high intra-rater and inter-rater reliability, albeit with relatively large standard error of measurement (S.E.M.) values. In contrast with previous studies of non-athletes, male athletes had equivalent holding times on the Biering–Sørensen trunk extensor endurance test to those of female athletes. However, female athletes had significantly lower holding times on the side bridge endurance tests than their male counterparts. The implication of the significant difference in endurance performance between male and female athletes in some muscle groups but not others is that testing and training of trunk muscle endurance should be ‘multidirectional’ for all athletes who aim to optimise performance and minimise injury risk17.
Barr KP (2005) The factors that affect lumbar stability have been an area of extensive research. The clinical application of this research in the form of lumbar stabilization exercise programs has become a common treatment of low back pain and is also increasingly used by athletes to improve performance and by the general public for health and the prevention of injury. This article includes a review of the key concepts behind lumbar stabilization. The literature regarding how those with low back pain differ in their ability to stabilize the spine from those without low back pain is discussed, and an overview of current research that assesses the benefits of a lumbar stabilization program to treat low back pain is provided9.
Akuthota Nadler SF (2004) Core strengthening has become a major trend in rehabilitation. The term has been used to connote lumbar stabilization, motor control training, and other regimens. Core strengthening is, in essence, a description of the muscular control required around the lumbar spine to maintain functional stability. Despite its widespread use, core strengthening has had meager research. Core strengthening has been promoted as a preventive regimen, as a form of rehabilitation, and as a performance-enhancing program for various lumbar spine and musculoskeletal injuries. The intent of this review is to describe the available literature on core strengthening using a theoretical framework8.
Mr Willson DE (2003) in there study the state that core stability may provide benefits to the musculoskeletal system, from maitining low back health to preventing knee ligament injury. As a result, the acquisition and maintainance of core stability is of great interest to physical therapists, atheletic trainers, and musculoskeletal researchers. Core stability is ability of the lumbopelvic hip complex to prevent buckling and to return to equilibrium after perturbation. Although static elements (bone and soft tissue) contribute to some degree, core stability is predominantly maintained by the dynamic function of muscular elements. There is a clear relationship between trunk muscle activity and lower extremity movement. Current evidence suggests that decreased core stability may predispose to injury and that appropriate training may reduce injury. Core stability can be tested using isometric, isokinetic, and isoinerial methods. Appropriate intervention may result in decreased rates of back and lower extremity injury7.
ALI, M et al (2001) Electromyographic power spectral analysis of the paraspinal muscles; Reliability study. Authors concluded that surface electromyographic power spectral analysis can reliably measure the paravertebral muscles. Iliocostalis was found to be the most reliable measure15.
6.3 Objectives of the study :
The Objectives of the studies are :
· To find the effect of Core Stability training in athelet to improve the strength and endurance of the trunk and lower extrimity
· To maintain low back health for preventing knee ligament injury
· Neromuscular control for trunk stability
7.1 Source of Data :
surat distric sports school, surat, Gujarat.
7.2 Methods of Collection of Data :
Study design :
· Experimental Study (Comparative)
Sample Size & Technique:
· Convenient Sampling Method.
· Study will be done on 30 subjects who will fulfil the inclusion and exclusion criteria in athelet.
Material used :
· Stability Ball
· Dumbbells
· Exercise Mat
· Medicine Ball
Inclusion criteria :
· Athelets with age group of 20-28 yrs
· Male & Female both are allowed.
· Age group from 20-28 years.
Exclusion Criteria :
· Athelets having unstable trunk and lower extrimity
· Atheletes having low back weakness
Evaluation Tools :
· Pressure Bio Feedback Device
Outcome Measure :
Trunk muscles endurance will be measured in the device by the dial.
7.3 Intervention to be carried on participants :
Treatment Procedure : To assess the trunk and hip, each subject underwent a battery of tests. We counterbalanced the order of testing to prevent fatigue bias, using a station format during testing. The average time for an athlete to complete data collection was 30 minutes, with approximately 1 minute's rest between tests. We completed between-day reliability testing on 30 subjects for each of the 5 tests before beginning data collection, and these findings are reported below.
· GROUP A
atheletes will be doing Core Stability exercises, stretching ,resisted exercises and including weight bearing exercises and general conditioning skills.
Core Stability exercises will be given in 5 circuits
· Arm circuit,
· Trunk circuit,
· Back circuit,
· Leg circuit,
· gluteal circuit.
Now for 1st week these circuit will be done for two days in a week and later when the muscles will be familiar with the exercises it will be done for three days in 2nd week and later will be continued for 5 days a week
All the Core Stability exercises will be given along with the general conditioning skills.
· GROUP B
atheletes will be doing the regular stretching exercises, warm up, resisted training and the weight training along will general conditining skills.
The whole session for GROUP A & B will be done for 3 weeks
7.4 Statistical Analysis:
Analysis will be done by using dependent t-test to know the
significance with in group and independent t-test the significance between the groups.
7.5 Ethical clearance:
As the study includes human subject ethical clearance is obtained ethical committee of institution and institution where the subject belongs. Also a written consent will be taken from each subject who participates in the study
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List of References :
1.ANDERSON, K.G., AND D.G. BEHM. Trunk muscle activity increases with unstable squat movements. Can J Appl Physiol. 30(1): 33 – 45. 2005.
2.ANDERSON, K.G., AND D.G. BEHM. Maintenance of EMG activity and loss of force output with instability. J Strength Cond Res. 18(3): 637 –
640. 2004.
3. AROKOSKI, J.P., T. VALTA, O. AIRAKSINEN, M. KANKAANPAA. Back and abdominal muscle function during stabilization exercises. Arch Phys
Med Rehabil. 82: 1089 – 1098. 2001.
4. BAECHLE, T.R., R.W. EARLE, AND D. WATHEN. Resistance training. In: Essentials of Strength Training and Conditioning. T.R. Beachle and
R.W. Earle, eds. Champaign, IL: Human Kinetics, 2000. pp. 395 – 425.
5. BEHM, D.G., A.M. LEONARD, W.B. YOUNG, W.A.C. BONSEY, AND S.N. MACKINNON. Trunk muscle electromyographic activity with
unstable and unilateral exercises. J Strength Cond Res. 19(1): 193 – 201. 2005.
6. BEHM, D.G., K. ANDERSON, AND R.S. CURNEW. Muscle force and activation under stable and unstable conditions. J Strength Cond Res.
16(3): 416 – 422. 2002.
7. Mr Willson DE in there study the state that core stability may provide benefits to the musculoskeletal system(2003)4(2);213-2156.
8. Akuthota Nadler SF Core strengthening has become a major trend in rehabilitation(2004)14(5)412-413.
9. Barr KP The factors that affect lumbar stability have been an area of extensive research(2005)12(1)256-257
10. Fredericson Michael Core stability is essential for proper load balance within the spine, pelvis, and kinetic chain(2008)13(4)312-313.
11. LI Chun-lei,XIACore strength training is known as functional training or core stability training in Europe and America(2009)15:412-416.
12. Christopher Standaert Although there are a wide variety of therapeutic exercises that have been proposed as treatments for low back pain (LBP)(2008)12:541
13. Krabak Brian Athletic injuries to the lumbar spine are relatively common, depending upon the specific sport(2008)
14. Willardson, Jeffrey Core stability exercises have become main stream, with rehabilitative methodologies now being applied to healthy athletes(2007)14:131-134
15. ALI, M Electromyographic power spectral analysis of the paraspinal muscles; Reliability study.(2001)
16. Griggs M Lumbar-stabilization exercise programs have become increasingly popular as a treatment for low-back pain(2007)12;532-534
17. Adams Adequate trunk muscle endurance may play an important role in injury-free performance among athletes.(2006)12:432-433
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12. / Signature of candidate:
Remarks for Guide:
Name and Designation of
(in block latter)
11.1 Guide: SIVASAKTHI . S . R
11.2 Signature:
11.3 Co-guide:
11.4 Signature:
11.5 Head of department: SAI KUMAR .N
11.6 signature:
12.1 Remark of principal:
12.2 signature:
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