Comparing the Efficacy of Dynamic Neuromuscular Stabilization Exercises and Kegel Exercises on Stress Urinary Incontinence in Women: A Pilot Study

Background and objective Stress urinary incontinence (SUI) is a prevalent condition affecting women of various age groups, significantly impacting their quality of life. To address this multifaceted issue, a comprehensive approach that goes beyond traditional pelvic floor exercises is needed. Dynamic neuromuscular stabilization (DNS) exercises, targeting the integrated spinal stabilization system, offer a promising alternative. Thus, this study aimed to compare the effectiveness of DNS exercises and Kegel exercises in managing SUI among women. Methods This single-blinded, pilot study involved 24 women aged 18-40 years with mild to moderate SUI. Participants were divided into DNS and Kegel exercise groups. Outcome measures included perineometer readings, electromyography (EMG) data, and the Urogenital Distress Inventory-6 (UDI-6). Statistical analysis compared baseline and 12-week data within and between groups, and rank-biserial correlation coefficient (r) as a measure of effect size in our study was calculated. Results At 12 weeks, the DNS group showed significant improvement in pelvic floor muscle strength compared to Kegel exercises (p = 0.005). Both groups had significantly enhanced pelvic floor muscle strength (p < 0.05). A significant change occurred for EMG average, EMG peak, and EMG maximum voluntary contraction (MVC) at 12 weeks (average p = 0.005; peak p = 0.001; MVC p = 0.009), with significant improvements in both groups (p < 0.05). For UDI-6, a significant difference emerged between the two groups at 12 weeks (p < 0.05), with significant improvements in both groups individually from baseline to 12 weeks (p < 0.05). The effect size "r" for all variables indicated a medium to large effect size, underscoring the substantial and significant impact of DNS exercises in managing SUI among women compared to Kegel exercises. Conclusion This study suggests that DNS exercises, emphasizing the coordinated activation of the diaphragm, abdominals, multifidus, and pelvic floor, may provide a more effective approach for managing SUI in women compared to traditional Kegel exercises.

The Impact of Core Complex Training on Some Basketball-Related Aspects of Physical Strength and Shooting Performance

Exercises for the core can be categorized as promoting core-stability, core-strength, or functionality, as these are crucial aspects of most sports activities. This study aimed to examine the effects of using core complex training (CCT), complex training (CT), and core exercise (CE) on some aspects of muscle strength and shooting performance in basketball players. The 36 participants were divided into three groups of 12 each, and then the experimental approach was applied to each group. The groups were labeled as follows: the core complex training group (N = 12; age, 18.58 ± 0.67 years; height, 178.08 ± 0.79 cm; weight, 76.42 ± 1.38 kg; training age, 7.42 ± 0.51 years); the complex training group (N = 12; age, 18.50 ± 0.52 years; height, 177.92 ± 1.31 cm; weight, 76.67 ± 1.78 kg; training age, 7.33 ± 0.49 years); and the core exercise group (n = 12; age, 18.42 ± 0.52 years; height, 177.75 ± 1.29 cm; weight, 76.58 ± 1.38 kg; training age, 7.42 ± 0.67 years). For ten weeks, each of the three groups participated in three training sessions every week. This study investigates the impact of core complex training on basketball shooting ability and muscle strength. The eight-week program, consisting of weight training, plyometric exercises, and core exercises, yielded improvements in muscle strength and shooting accuracy. In tests of muscular strength and basketball shooting ability, the CCT group outperformed the CE and CT groups. The F value varied from 3.75 to 58.77, which are function values with a p < 0.05 significance level. The core complex training group exhibited superior muscle strength to that of both the complex training group and the core exercise group, in some areas. This is shown in the results of the javelin quadrathlon medicine ball test, the core muscle strength and stability test, the sit-up abdomen test, the sit-up back test, the standing long jump test, the Sargent jump test, and the shooting test (p < 0.005). Due to the effect of the core complex training program on improving performance efficiency and muscle strength, which affects the results of matches, we have recommended using the proven basic strength training program at other age stages, with the objective of including the concept, importance, and design of compound basic strength training in training programs used by basketball coaches.

Superimposed vibration on suspended push-ups

Background

Superimposition of vibration has been proposed in sports training using several devices and methods to enhance muscle activation and strength adaptations. Due to the popularity of suspension training, vibration systems have recently been developed to increase the effects of this training method. The present cross-sectional study aims to examine the effects of superimposing vibration on one of the most popular exercises in strength and conditioning programs: push-ups.

Methods

Twenty-eight physically active men and women executed push-ups in three suspended conditions (non-vibration, vibration at 25 Hz, and vibration at 40 Hz). OMNI-Res scale was registered, and surface electromyographic signals were measured for the activity of the right and left external oblique, anterior deltoid, triceps brachii, sternal, and clavicular heads of the pectoralis major.

Results

A linear mixed model indicated a significant fixed effect for vibration at 25 Hz and 40 Hz on muscle activity. Suspended push-ups with superimposed vibration (25 Hz and 40 Hz) showed a significant higher activity on left (25 Hz: p = 0.036, d = 0.34; 40 Hz: p = 0.003, d = 0.48) and right external oblique (25 Hz: p = 0.004, d = 0.36; 40 Hz: p = 0.000, d = 0.59), anterior deltoid (25 Hz: p = 0.032, d = 0.44; 40 Hz: p = 0.003, d = 0.64), and global activity (25 Hz: p = 0.000, d = 0.55; 40 Hz: p = 0.000, d = 0.83) compared to non-vibration condition. Moreover, OMNI-Res significant differences were found at 25 Hz (6.04 ± 0.32, p = 0.000 d = 4.03 CI = 3.27, 4.79) and 40 Hz (6.21 ± 0.36 p = 0.00 d = 4.29 CI = 3.49, 5.08) compared to the non-vibration condition (4.75 ± 0.32).

Conclusion

Superimposing vibration is a feasible strategy to enhance the muscle activity of suspended push-ups.

Effects of Core Training in Physical Fitness of Youth Karate Athletes: A Controlled Study Design

This study aimed to analyse the impact of an 8-week core strength training (CST) programme in youth karate practitioners on core endurance, agility, flexibility, sprinting, jumping, and kick performance. This study followed a randomized parallel design. Twenty-nine participants (age: 12.86 ± 0.81 years old; height: 152.55 ± 10.37 cm; weight: 42.93 ± 8.85 kg) were allocated to a CST programme (n = 16) performed thrice weekly or to a control group (n = 13) only performing the sport-specific (karate) training. Participants were assessed three times (baseline, mid and post-intervention) for the following tests: (i) flexor endurance test (FET); (ii) back extensor test (BET); (iii) lateral musculature test (LMT); (iv) flexibility; (v) chance of direction (COD); (vi) countermovement jump (CMJ); (vii) back muscle strength (BMS); (viii) horizontal jump (LJ); (ix) sprint test; and (x) karate kick test (KKT). Between-group analysis revealed significant advantages for the CST group on the FET (p < 0.001), BET (p < 0.001), LMT (p < 0.001), 20 m sprint (p = 0.021) and KKT for right (p < 0.006) and left (p < 0.020) legs. No significant differences were found between groups in the remaining physical fitness variables (p > 0.05). The within-group changes revealed significant improvements in the CST group at flexibility (p = 0.002), COD (p < 0.001), CMJ (p < 0.001), BMS (p < 0.002), 20 m sprint (p = 0.033), and KKT (p < 0.001). In addition, within-group changes in the control group were also significant in flexibility (p = 0.024) and right kick (p < 0.042). We conclude that the CST programme improves core endurance and karate kick performance; however, it is not effective enough for other physical performance parameters in KR practitioners.

Effects of core strengthening exercise on colon transit time in young adult women

Background/objective

This study investigated the effects of core strengthening exercise (CSE) on colon transit time (CTT) in young adult women.

Methods

Eighty women (mean age 23 years) were enrolled and randomly assigned to participate in a 12-week, instructor-led group CSE program (CSE group [CSEG]; n = 40) or to maintain usual daily activities (control group [CG]; n = 40). 27 participants in the CSEG and 21 participants in the CG completed the study. The CSE program consisted of 60-min sessions, two days a week, for 12 weeks. CTT was measured using a multiple marker technique with a radio-opaque marker. Data were analyzed with a 2-way, repeated measures ANCOVA.

Results

After the 12-week intervention, The CSEG showed significant improvements in trunk flexor power (P = 0.031), peak torque (P = 0.032), and endurance (P = 0.011). The CSEG also showed improvements in the sit-up (P < 0.001) and side-step (P = 0.043) tests compared to the CG. While there was not a significant group difference between the CSEG and CG, left CTT (P = 0.021) and total CTT (P = 0.006) decreased significantly within the CSEG group only.

Conclusion

The 12-week CSE program increased abdominal strength but did not improve CTT compared to the control group. This study also provides preliminary data that CSE may reduce left CTT and total CTT, but additional clinical trials are needed.

Clinical Assessment and Thickness Changes of the Oblique and Multifidus Muscles Using a Novel Screening Tool and Exercise Program: A Randomized Controlled Trial

CONTEXT

Training and assessment of the abdominal and trunk muscles are widely used in the clinical setting. However, it is unknown what types of exercises are most effective in activation of both the global and local stabilizers in these regions.

OBJECTIVE

The purpose of this study was to establish the reliability of a novel clinical screening tool (sling screen) to assess the muscles of the abdomen and trunk. The second aim was to use the clinical screening tool and musculoskeletal ultrasound to compare the effects of a rotary-based exercise program that targets both the global and local muscles to the effects of a traditional exercise program on the activation of the abdominal and trunk muscles.

DESIGN

Double-blind, randomized controlled trial.

SETTING

Sports medicine facility.

PARTICIPANTS AND INTERVENTIONS

Thirty-one healthy participants were randomly allocated to receive a single-session rotary-based or traditional "core" exercise program.

MAIN OUTCOME MEASURES

The participants were assessed at the baseline and immediately postintervention. The primary outcome measures were muscle thickness examined by musculoskeletal ultrasound and clinical examination of muscle activation using a screening tool. The data were collected by blind assessors. Reliability and validity of a clinical screening tool (sling screen) were also assessed.

RESULTS

The analysis of the covariance tests showed a significant increase in oblique thickness for the rotary exercise group. All participants displayed a significant increase in multifidus thickness. The Wilcoxon signed-rank tests revealed a significant increase in clinical assessment scores in the rotary exercise group but not the traditional exercise group. Reliability of the sling screen ranged from moderate to good.

CONCLUSION

This clinical trial provides evidence that a rotary-based exercise program may be more effective in producing increases in oblique muscle thickness than traditional "core" exercises in young, healthy adults. The sling screen tool was able to identify these muscle thickness changes. Future studies should investigate how these results correlate to injury risk, other populations, and also how to implement the sling screen into clinical practice.

Effects of 8-week core training on core endurance and running economy

The purpose of this study was to examine the effects of 8-week core training on core endurance and running economy in college athletes. Twenty-one male college athletes were randomly divided into 2 groups: a control group (CON) (n = 10) and a core training group (CT) (n = 11). Both groups maintained their regular training, whereas CT attended 3 extra core training sessions per week for 8 weeks. The participants were assessed before and after the training program using sensory organization test (SOT), sport-specific endurance plank test (SEPT) and 4-stage treadmill incremental running test (TIRT). Compared with the pre-test, significant improvements were observed in post-test SOT (78.8 ± 4.8 vs. 85.3 ± 4.8, p = 0.012) and SEPT (193.5 ± 71.9 s vs. 241.5 ± 98.9 s, p = 0.001) performances only in CT. In the TIRT, the post-test heart rate values were lower than the pre-test values in CT in the first 3 stages. In stage 4, the post-test oxygen consumption (VO2) was lower than that in pre-test in CT (VO2: 52.4 ± 3.5 vs. 50.0 ± 2.9 ml/kg/min, p = 0.019). These results reveal that 8-week core training may improve static balance, core endurance, and running economy in college athletes.

An electromyographic comparison of a modified version of the plank with a long lever and posterior tilt versus the traditional plank exercise

The purpose of the study was to compare core muscle activation of the tradition prone plank with a modified version performed with a long-lever and posterior-tilt using surface electromyography. To further determine if a specific component of this modified plank was more effective than the other in enhancing muscle activity, the plank with a long lever and the plank with a posterior pelvic tilt were studied individually. Nineteen participants performed all four variations of the plank for 30 seconds in a randomized order with 5-minute rest between exercise bouts. Compared to the traditional prone plank, the long-lever posterior-tilt plank displayed a significantly increased activation of the upper rectus abdominis (p < 0.001), lower abdominal stabilizers (p < 0.001), and external oblique (p < 0.001). The long-lever plank showed significantly greater activity compared to the traditional plank in the upper rectus abdominis (p = 0.015) and lower abdominal stabilizers (p < 0.001), while the posterior tilt plank elicited greater activity in the external oblique (p = 0.028). In conclusion, the long-lever posterior-tilt plank significantly increases muscle activation compared to the traditional prone plank. The long-lever component tends to contribute more to these differences than the posterior-tilt component.

Lumbopelvic neuromuscular training and injury rehabilitation: a systematic review

OBJECTIVE

The aim of this systematic review was to assess the evidence for lumbopelvic neuromuscular training (LNMT) in individuals after musculoskeletal (MSK) injury.

DATA SOURCES

A literature search of PubMed and EMBASE databases was performed for English studies from January 1990 to March 2012. Search terms including and related to trunk, core, stability, injury, and LNMT were used.

STUDY SELECTION

All studies directly involving LNMT for MSK injuries were reviewed by 2 authors. These articles were assessed based on the inclusion criteria and if appropriate selected for further analysis. Expert opinion, review articles, and articles involving non-MSK injuries were excluded. Four authors then scored the selected articles for methodological quality. A total of 2312 articles were initially identified. Twenty-nine articles met the inclusion criteria for review and were divided into categories of lower extremity (LE), lumbar, and upper extremity (UE). No trials involving the UE met the inclusion criteria.

DATA EXTRACTION

Data including subject demographics (age, height, weight, gender, etc), injury type, intervention type, and outcome measurements were extracted from the relevant articles. A variety of baseline and follow-up scores were extracted including pain levels, patient satisfaction, disability questionnaires, and other functional outcomes.

DATA SYNTHESIS

Two out of 3 LE randomized controlled trials (RCTs) and 9/26 lumbar RCTs were rated with high methodological quality based on the scoring system described by van Tulder et al. The average quality score for the LE RCTs was 6.3 (range = 4-9) and for the lumbar RCTs was 5.1 (range = 2-9). The evidence for the effectiveness of the 3 LE studies was rated as conflicting, whereas 24 lumbar studies demonstrated moderate-to-strong evidence. Unfortunately, heterogeneity of populations, interventions, and outcomes precluded a quantitative meta-analysis and specific clinical recommendations.

CONCLUSIONS

High-quality evidence is lacking to make specific clinical recommendations for or against the use of LNMT in the rehabilitation of individuals after MSK injury. Based on this review, future research should focus on well-defined, homogeneous populations, interventions specifically addressing neuromuscular activation of the lumbopelvic musculature, patient-specific clinical outcomes, measures of motor control, biomechanics, and return to specific activities.