Effect of Progressive Isolated Core Stability Training

Study Overview
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Brief Summary
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Forty-two adolescent female volleyball athletes (16.0±1.4 years) were randomly divided into two groups. Group 1 was the training group and, in addition to the routine volleyball training programmes, underwent an 8-week (3 days/week) progressive core stability training programme. Group 2 was the control group and only did routine volleyball training, with no core stability training. Main outcome measures: Shoulder IR and ER strength, medicine ball throw (MBT), modified push up (MPU) and closed kinetic chain (CKC) upper extremity stability tests were used to evaluate physical performance.

Detailed Description
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Most studies have focused on the effects of core stability training on injury prevention and physical performance for the lower extremities . However, little is known about its effect on upper extremity performance. Previous studies suggest that core strengthening could enhance upper extremity physical performance because it might lead to more efficient use of the extremity muscles . Core weakness in overhead athletes with shoulder pain. Insufficient power generation by the core muscles might overload the shoulder girdle to compensate for altered biomechanics during throwing, and this overload made the shoulder prone to sport injuries. A systematic review has suggested, however, that isolated core stability training cannot be the primary component of athletic performance enhancement and that the variability in exercise training protocols, testing methods, study population and sample size among the available studies leads to difficulties in understanding whether or not core stability training enhances physical performance. There has been no study in the literature investigating the effect of progressive isolated core stability training on upper extremity performance in adolescent overhead athletes. This study therefore sought to investigate the effects of progressive isolated core stability training on shoulder internal (IR) and external rotator (ER) strength and upper extremity physical performance in female adolescent volleyball players. Hypothesized that core stability training would enhance shoulder rotator strength and upper extremity physical performance in these athletes.

Official Title
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Effect of Progressive Isolated Core Stability Training on Upper Extremity Physical Performance in Adolascent Female Volleyball Athletes

Conditions
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CORE STABILITY, Upper Extremity, Physical Performance

Intervention / Treatment
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* Other: exercise training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - be between the ages of 12 and 16, enrolled in a similar training program and agree to participate in the study Exclusion Criteria: Having any surgery / serious pathology of the spinal column, Have had a lower / upper extremity injury in the last 3 months, Sports age is less than 5 years, Severe orthopedic / systemic discomfort during training, Absence from training for more than 3 sessions Family disapproval or reluctance to study Minimal Q-DASH score (0-25)

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 16 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Forty-two adolescent female volleyball athletes (16.0±1.4 years) were randomly divided into two groups. Group 1 was the training group and, in addition to the routine volleyball training programmes, underwent an 8-week (3 days/week) progressive core stability training programme. Group 2 was the control group and only did routine volleyball training, with no core stability training.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: training group<br>Group 1 (n=21) was the training group and, in addition to the routine volleyball training programmes, an 8-week (3 days/week) progressive core stability training programme was applied. | Other: exercise training<br>* The core stability training programme was performed 3 days per week over an 8-week period, and each training session lasted approximately 50 minutes.We created a special programme for our study based on the literature; the core stability training programme was divided into 3 phases: easy(1-2 weeks), moderate(3-5 weeks) and difficult(6-8 weeks In the easy phase(phase1), the athlete was intended to gain sensorimotor control that would ensure the smoothness of the neutral spine during slow movements. The participants learned the hallowing technique and how to use this technique while doing core exercises. In the moderate phase(phase2), muscular neural adaptation and neuromuscular facilitation were targeted with the transition to high threshold strength training.In the last, difficult, phase(phase3), subconscious control of movement was taught using combined movement patterns with the aim of transitioning to functional positions and activities.<br>|
| No Intervention: control group<br>Group 2 (n=21) was the control group, and they only engaged in routine volleyball training: no core stability training was given. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline Shoulder Rotator Muscle Strength at 8 weeks. | Isometric shoulder IR and ER strength was measured using a handheld dynamometer (Commander Power Track II, J-Tech, USA). The tests were performed with the athletes in a supine position. The shoulder was positioned at 45° abduction, the elbow was at 90° flexion and the forearm was in the neutral position. The supine position was chosen for the test to minimize compensatory movement of the body. At least one practice trial was given to the subjects to familiarize them with the feel of pushing against the dynamometer. Subjects were oriented to each desired action by the tester. The subject then performed the action until performed correctly. | before and after treatment (24 sessions, beginning and 8th. weeks) | 
| Change from Baseline Upper Extremity Functional Tests at 8 weeks. | The participants were positioned prone with hands shoulder width apart with the trunk held in a rigid straight position on the mat. Push-ups were performed through the full range of motion, as quickly as possible. Participants started the test with their elbows fully extended. They then flexed their elbows until the upper arm was parallel to the testing surface. The participants were instructed to limit head and trunk motion and to keep the trunk position straight. The number of push-ups completed in 30 seconds was recorded. Verbal encouragement was consistently given to all participants . | before and after treatment (24 sessions, beginning and 8th. weeks) | 
| Change from CKC upper extremity stability test at 8 weeks. | This test was performed in a modified push-up test position. There were two lines on the floor, 30 cm apart. The participants were instructed to move their hands back and forth from each line as many as possible for 15 seconds. The number of touches for each line was counted. The test was repeated 3 times, with a 2-minute rest between each trial and the average of the touches was calculated. The final score was calculated as the average number of touches/height | before and after treatment (24 sessions, beginning and 8th. weeks) | 
| Change from MBT test at 8 weeks. | The examiner used a marked line on the floor as the starting reference for this test. A mat was placed on the floor and the front of the mat was aligned with the reference line. The participants were instructed to tall kneel (90° knee flexion and neutral trunk position) on the front of the mat with the medicine ball (1.9 kg) held at their chest level against the chest wall. From this position the participants were instructed to throw the medicine ball, using a 2-handed chest pass technique, as far as they could. To minimize momentum, the participants were not allowed to rock back before beginning the throw. The first contact site of the ball was marked, and the throw distance was measured using tape. The test was repeated 3 times, and the average of the throw distances was calculated | before and after treatment (24 sessions, beginning and 8th. weeks) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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athlete, exercise, muscle strength, flexibility