core stability

堆芯稳定性
  • 文章类型: Journal Article
    背景:太极拳(TCC)被认为是中国人的身心实践,被联合国教科文组织视为人类非物质文化遗产,并被世界卫生组织推荐为预防跌倒的治疗方法。
    目的:评估TCC对老年人平衡的影响。
    方法:由两名独立评审员使用ROB2工具对以下数据库中的偏倚风险进行系统评价:PubMed,Scopus,WebofScience,PEDro,Embase,科克伦,CINAHL,和LILACS。在2010年至2024年发表的老年人群(65岁以上)中,对动态和静态平衡标准的选定文章进行了荟萃分析。
    结果:18项随机临床试验符合标准。TCC在计时和行走和步态速度测试中改善了动态平衡,在荟萃分析中与对照组相比,单腿测试和功能达到测试中的静态平衡。只有一项研究发现了不良事件,训练参数是异质的。
    结论:TCC可以改善老年人的动态和静态平衡。参数的结果表明,为临床实践开具TCC的方向最小或没有不良反应的风险。
    BACKGROUND: Tai Chi Chuan (TCC) is considered a mind and body practice of Chinese origin, considered as an intangible cultural heritage of humanity by UNESCO, and recommended by the World Health Organization as a therapeutic approach to prevent falls.
    OBJECTIVE: To assess the effects of TCC on older adult\'s balance.
    METHODS: A systematic review of randomized clinical trials was conducted by two independent reviewers using the ROB2 tool to assess the risk of bias under the following databases: PubMed, SCOPUS, Web of Science, PEDro, Embase, Cochrane, CINAHL, and LILACS. A meta-analysis of the selected articles for the dynamic and static balance criteria was conducted in a population of older adults (over 65 years) with publications from 2010 to 2024.
    RESULTS: Eighteen randomized clinical trials fulfilled the criteria. TCC improves dynamic balance in the timed up and go and gait speeds tests, and static balance in the single-leg test and functional reach test when compared with the control group in the meta-analysis. Adverse events were found in only one study, and the training parameters were heterogeneous.
    CONCLUSIONS: TCC improves older adults with both dynamic and static balance. The results of the parameters indicate a direction in which TCC is prescribed for clinical practice with minimal or no risk of adverse effects.
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  • 文章类型: Journal Article
    下腰痛(LBP)在全球范围内带来了巨大的负担,影响所有年龄段的人,但在30-60岁的成年人和包括种族在内的人口统计学中更常见,种族,和社会经济地位。物理治疗干预通常用于管理LBP,因为它们具有非侵入性和解决潜在生物力学功能障碍的潜力。这篇综合综述旨在评估各种物理治疗策略在缓解LBP方面的疗效,考虑一系列干预措施及其相关结果。通过对2017年1月至2023年10月现有文献的全面审查,这篇综述综合了手动治疗等干预措施有效性的证据。运动疗法,电疗方式,和基于教育的方法。该综述还审查了不同物理治疗方式的相对有效性及其对特定患者人群的适用性。考虑到诸如慢性等因素,严重程度,和潜在的病理学。通过批判性地评估证据基础,这篇综述旨在提供对缓解LBP最有效的物理治疗策略的见解,慢性下腰痛(CLBP)和慢性非特异性下腰痛(CNLBP),并指导临床实践以循证干预。疼痛的视觉模拟量表和数字疼痛评分量表,Oswestry残疾指数和Roland-Morris残疾问卷,用于测量腰椎屈曲和伸展的改良Schober测试以及用于评估姿势稳定性和平衡的静态和动态平衡是用于预测疼痛增强的措施之一。残疾,balance,和LBP症状。21项符合纳入标准的研究(20至50岁,两种性别)被添加到审查中。核心稳定性练习,加强,矫形器(一种医疗设备,旨在支持,对齐,稳定,或纠正肌肉骨骼结构和功能),经皮神经电刺激,热按摩疗法,干扰电流(物理治疗中使用的电刺激的一种形式),Mulligan的动员(一种手动治疗技术),低水平激光治疗,麦吉尔稳定运动(核心运动)是治疗策略之一。麦肯齐方法(背部练习),超声,感觉运动训练,瑞士球练习,和其他技术减少疼痛和增强力量,balance,和日常活动的方便。每种治疗方法都对从最小到最大的恢复率产生影响。传统的物理疗法不如动员和锻炼等最新的先进技术有效。总之,手动技术的集成,矫形器和保守治疗方法的替代干预策略可以有效缓解疼痛,增强功能,产生更好的整体结果。为了获得有关最佳剂量的更多信息,这些治疗的治疗方式和长期效果,需要更多令人钦佩的研究。本文旨在通过探索非传统物理治疗干预措施并根据最新的WHO指南规定的严格标准评估其疗效,来扩展科学话语。
    Low back pain (LBP) presents a significant burden globally, affecting individuals of all ages, but it is more common in adults aged 30-60 years old and demographics including race, ethnicity, and socioeconomic status. Physiotherapy interventions are commonly employed to manage LBP due to their non-invasive nature and potential for addressing underlying biomechanical dysfunctions. This comprehensive review aims to evaluate the efficacy of various physiotherapy strategies in alleviating LBP, considering a range of interventions and their associated outcomes. Through a thorough examination of existing literature from January 2017 to October 2023, this review synthesises evidence on the effectiveness of interventions such as manual therapy, exercise therapy, electrotherapy modalities, and education-based approaches. The review also scrutinizes the comparative effectiveness of different physiotherapy modalities and their suitability for specific patient populations, considering factors such as chronicity, severity, and underlying pathology. By critically evaluating the evidence base, this review aims to provide insights into the most effective physiotherapy strategies for alleviating LBP, chronic low back pain (CLBP) and chronic nonspecific low back pain (CNLBP) and guiding clinical practice toward evidence-based interventions. The Visual Analogue Scale and Numerical Pain Rating Scale for pain, Oswestry Disability Index and Roland-Morris Disability Questionnaire for disability, Modified-Modified Schober Test for measurement of lumbar flexion and extension and static and dynamic balance for assessing postural stability and balance were among the measures used to foresee enhancements in pain, disability, balance, and LBP symptoms. Twenty-one studies that fulfilled the criteria for inclusion (aged 20 to 50 years and of both genders) were added to the review. Exercises for core stability, strengthening, orthosis (a medical device designed to support, align, stabilise, or correct musculoskeletal structures and functions), transcutaneous electrical nerve stimulation, heat massage therapy, interferential current (a form of electrical stimulation used in physical therapy), Mulligan\'s mobilization (a manual therapy technique), low-level laser therapy, and McGill stabilization exercises (core exercises) were among the therapeutic strategies. The McKenzie method (back exercises), ultrasound, sensory-motor training, Swiss ball exercises, and other techniques reduced pain and enhanced strength, balance, and ease of daily activities. Every therapeutic approach has an impact on recovery rates ranging from minimal to maximal. Conventional physical therapy is less effective than most recent advanced techniques like mobilisation and exercises. In summary, the integration of manual techniques, orthoses and alternative intervention strategies with conservative therapeutic approaches can effectively alleviate pain, enhance function and yield better overall outcomes. To get more information about the optimal dosage, therapeutic modalities and long-term effects of these treatments, more admirable research is required. This paper aims to expand the scientific discourse by exploring non-traditional physiotherapy interventions and assessing their efficacy in light of the rigorous standards set forth by the latest WHO guidelines.
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  • 文章类型: Journal Article
    背景:核心稳定性是临床康复(包括下腰痛康复)和竞技运动训练中的重要概念。核心包括一个复杂的髋关节网络,躯干和颈部肌肉,包括隔膜。
    目的:本文旨在讨论隔膜在岩心稳定性中的作用,总结目前的证据,并提出理想的核心训练策略涉及隔膜。
    方法:叙事综述结果:膈肌具有呼吸和姿势控制的双重作用。有证据表明,目前治疗腰背痛的核心稳定性锻炼优于最少治疗或不治疗。然而,没有比一般锻炼和/或手动治疗更有益的。似乎对腹横肌和多离肌的关注更高,而对the肌的关注却很少。我们建议任何形式的用于下腰痛康复的核心稳定练习都应考虑隔膜。核心稳定计划可以从促进正常呼吸模式和逐步系统地恢复the肌的姿势控制作用开始。
    结论:隔膜的作用在研究和实践中经常被忽视。注意膈肌可以提高核心稳定性运动在腰背痛康复中的有效性。
    Core stabilization is a vital concept in clinical rehabilitation (including low back pain rehabilitation) and competitive athletic training. The core comprises of a complex network of hip, trunk and neck muscles including the diaphragm.
    The paper aims to discuss the role of the diaphragm in core stability, summarize current evidence and put forth ideal core training strategies involving the diaphragm.
    Narrative review RESULTS: The diaphragm has a dual role of respiration and postural control. Evidence suggests that current core stability exercises for low back pain are superior than minimal or no treatment, however, no more beneficial than general exercises and/or manual therapy. There appears to be a higher focus on the transversus abdominis and multifidi muscles and minimal attention to the diaphragm. We propose that any form of core stabilization exercises for low back pain rehabilitation should consider the diaphragm. Core stabilization program could commence with facilitation of normal breathing patterns and progressive systematic restoration of the postural control role of the diaphragm muscle.
    The role of the diaphragm is often overlooked in both research and practice. Attention to the diaphragm may improve the effectiveness of core stability exercise in low back pain rehabilitation.
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  • 文章类型: Journal Article
    目的是尽可能多地综合科学证据,以确定核心训练对平衡的影响,投掷/击球速度或距离,在健康的受试者中跳跃,确定孤立的和组合的核心训练与研究训练和与绩效相关的样本变量之间的可能差异。遵循PRISMA准则,在Scopus进行了系统的搜索,WebofScience,体育讨论,和PubMed数据库在2022年11月之前没有日期限制。这些研究被认为是在PICO之后进行的这项荟萃分析;a)健康受试者和>12岁的随机对照试验和随机分配研究;b)长度至少为4周的独立或联合核心训练计划;c)平衡的运动表现结果,投掷/命中,和跳跃变量应该被测量;d)足够的数据来计算效应大小。偏差工具的Cochrane协作风险和建议评估分级,发展,采用评价方法对方法学质量进行评价。总共确定了3223项研究,系统评价包括22项研究,荟萃分析包括21项研究。我们观察到核心训练改善了平衡结果(ES=1.17;p<0.0001),投掷/击球速度(ES=0.30;p=0.14),投掷/击球距离(ES=3.42;p=0.03),垂直跳跃(ES=0.69;p=0.0003),和水平跳跃(ES=0.84;p=0.01)。我们的研究结果表明,核心训练改善了不同的绩效变量,如平衡,投掷/命中,以及垂直和水平跳跃。
    The purposes were to synthesize as much scientific evidence as possible to determine the effect of core training on balance, throwing/hitting velocity or distance, and jumping in healthy subjects, identify the possible differences between isolated and combined core training on performance and study training and sample variables related to performance. PRISMA guidelines were followed, and a systematic search was performed in the Scopus, Web of Science, Sports Discuss, and PubMed databases with no date restrictions until November 2022. The studies were considered for this meta-analysis following PICO; a) randomized control trials and randomized allocation studies with healthy subjects and > 12 years old b)isolated or combined core training programs with a minimum of 4 weeks in length; c) athletic performance outcomes for balance, throw/hit, and jump variables should be measured; d) sufficient data to calculate effect sizes. The Cochrane Collaboration Risk of Bias Tool and the Grading of Recommendations Assessment, Development, and Evaluation approach were used for assessing methodological quality. A total of 3223 studies were identified, 22 studies were included in the systematic review and 21 for the meta-analysis. We observed that core training improved balance outcomes (ES = 1.17; p < 0.0001), throwing/hitting velocity (ES = 0.30; p = 0.14), throwing/hitting distance (ES = 3.42; p = 0.03), vertical jumping (ES = 0.69; p = 0.0003), and horizontal jump (ES = 0.84; p = 0.01). Our findings indicate that core training improved different variables of performance such as balance, throw/hit, and vertical and horizontal jump.
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  • 文章类型: Systematic Review
    运动已被证明对慢性腰背痛的治疗有效。多年来,核心稳定性运动(CSE)已越来越受欢迎,但对最佳运动治疗缺乏共识。
    回顾核心稳定性练习或常规练习在慢性下腰痛(CLBP)管理中的有效性。
    这项研究是对随机临床试验的系统评价,这些试验通过使用Google学者检查有关核心稳定性和常规锻炼的研究,Medline,PEDro和Cochrane从2010年到2021年。使用PEDro量表评价方法学质量。纳入的研究将参与者随机分为两个不同的运动组。
    从58项潜在相关试验中,本分析共纳入14项试验.数据表明,核心稳定性运动在短期疼痛缓解方面优于常规运动。十项研究包括自我报告的特定功能状态,与常规锻炼相比,核心稳定性锻炼导致功能显著改善。
    与常规锻炼相比,核心稳定性运动是更有效的减轻疼痛和改善身体功能的个人与CLBP在短期内,然而,只有两项试验进行了干预后的随访评估.
    Exercise has been proven to be effective in the management of chronic low back pain. Over the years, core stability exercise (CSE) has gained popularity however there is lack of consensus on the best exercise treatment.
    UNASSIGNED: To review the effectiveness of core stability exercises or conventional exercises in the management of chronic low back pain (CLBP).
    UNASSIGNED: This study is a systematic review of randomized clinical trials which examined studies regarding core stability and conventional exercise by using Google scholar, Medline, PEDro and Cochrane from 2010 to 2021. The Methodological quality was evaluated using the PEDro scale. The included studies randomized participants into two different exercise groups.
    UNASSIGNED: From the 58 potentially relevant trials, a total of 14 trials were included in the current analysis. The data indicated that core stability exercise was better than conventional exercise for short term pain relief. Ten studies included self reported back specific functional status, and compared to conventional exercise, core stability exercise resulted in significant improvement in function.
    UNASSIGNED: Compared to conventional exercise, core stability exercise is more effective in pain reduction and improved physical function in individuals with CLBP in the short term however, only two trials carried out follow-up assessments post intervention.
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  • 文章类型: Meta-Analysis
    OBJECTIVE: To analyze the effect of trunkfocused exercise programs (TEPs) and moderator factors on chronic nonspecific low back pain (LBP). DESIGN: Systematic review with meta-analyses. LITERATURE SEARCH: We searched the PubMed, Scopus, Embase, SPORTDiscus, and CENTRAL databases from their inception to June 2022. STUDY SELECTION CRITERIA: We included randomized controlled trials comparing TEPs to control or general exercises. DATA SYNTHESIS: We used random-effects models to calculate the standardized mean difference (SMD) plus confidence interval (CI) and heterogeneity (I2) for pain, disability, quality of life, and trunk performance. The impact of moderator factors was analyzed through meta-regression. RESULTS: Forty randomized controlled trials (n = 2391) were included. TEPs showed positive effects for all outcomes versus control (SMD 0.90-2.46; 95% CI, -0.04 to 4.96; I2 61%-98%). There were small effects in favor of TEPs versus general exercises for pain (SMD = 0.20; 95% CI, 0.03-0.37; I2 = 13.4%) and disability (SMD = 0.20; 95% CI, 0.02-0.38; I2 = 0%). Trunk and/or hip range-of-motion improvements were associated with greater reductions in pain (P<.01; β = 0.56; 95% CI, 0.25-0.87) and disability (P<.01; β = 0.66; 95% CI, 0.27-1.05). Low body mass was associated with higher pain reduction (P = .03; β = -0.17; 95% CI, -0.32 to -0.02). CONCLUSIONS: Trunk-focused exercise programs had positive effects on pain, disability, quality of life, and trunk performance compared to control groups, and on pain and disability compared to general exercises. Increasing trunk and/or hip range of motion was associated with greater pain and disability reduction, and lower body mass with higher pain reduction. J Orthop Sports Phys Ther 2023;53(2):64-93. Epub: 16 January 2023. doi:10.2519/jospt.2023.11091.
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  • 文章类型: Journal Article
    前十字韧带(ACL)是足球运动员最关注的伤害之一。这篇综述的目的是研究基于运动的干预措施在降低成人足球运动员ACL损伤率或减轻ACL损伤风险因素方面的效果。按照PRISMA准则,在CINAHL中进行了系统的搜索,科克伦图书馆,PubMed,Scopus,SPORTDiscus和WebofScience。包括评估基于运动的干预措施对成人足球运动员ACL损伤发生率或可改变的危险因素的影响的研究。29项研究评估了4502名男性和1589名女性球员(15项RCT,8NRCT,6单臂):14包括热身,7阻力训练,4混合训练,3平衡,1个核心稳定性和1个技术修改干预措施。29项研究中有6项调查了干预措施对ACL损伤发生率的影响,其余23人调查了它们对危险因素的影响。只有21%和13%的评估伤害变量风险的研究报告了可靠性措施和/或最小的有价值的变化数据。热身,堆芯稳定性,平衡和技术修改似乎有效和可行的干预措施被包括在足球队。然而,需要使用更具生态有效性的测试和针对特定ACL损伤机制的个性化干预措施.
    Anterior cruciate ligament (ACL) is one of the most concerning injuries for football players. The aim of this review is to investigate the effects of exercise-based interventions targeting at reducing ACL injury rate or mitigating risk factors of ACL injury in adult football players. Following PRISMA guidelines, a systematic search was conducted in CINAHL, Cochrane Library, PubMed, Scopus, SPORTDiscus and Web of Science. Studies assessing the effect of exercise-based interventions in ACL injury incidence or modifiable risk factors in adult football players were included. 29 studies evaluating 4502 male and 1589 female players were included (15 RCT, 8 NRCT, 6 single-arm): 14 included warm-up, 7 resistance training, 4 mixed training, 3 balance, 1 core stability and 1 technique modification interventions. 6 out of 29 studies investigated the effect of interventions on ACL injury incidence, while the remaining 23 investigated their effect on risk factors. Only 21% and 13% studies evaluating risk of injury variables reported reliability measures and/or smallest worthwhile change data. Warm-up, core stability, balance and technique modification appear effective and feasible interventions to be included in football teams. However, the use of more ecologically valid tests and individually tailored interventions targeting specific ACL injury mechanisms are required.
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  • 文章类型: Journal Article
    BACKGROUND: Motor control exercise (MCEs), spinal stabilization or core stability exercises were developed with the aim of restoring the coordination, control, and capacity of the trunk muscles and systematic reviews (SR) evaluating their effectiveness has shown conflicting results. This we hypothesized was due to the non-consideration of principles of neuroplasticity. The objective of this review was to review the operating definitions used in these reviews for these exercises and evaluate if these reviews have considered and satisfied the principles of these exercises in persons with NSLBP, both acute and chronic.
    METHODS: The available evidence to address the research question was sought in the reviews published in English between January 2006 and April 2019 using the population, intervention, comparison, and outcome format. Data were extracted against the following factors: satisfy the principles of specific inclusion criteria; interventions; experience-dependent plasticity; and measure any one of the concepts of motor control. The quality of the evidence obtained was graded using the National Institute for Health and Care Excellence protocol and the quality of SRs evaluated using the R-AMSTAR.
    RESULTS: Eleven reviews on core stability/spinal stabilization exercises and four reviews on MCE were considered in this review. The results showed that most of the studies considered by the reviews did not adhere to the principles of these exercises.
    CONCLUSIONS: There is wide heterogeneity in the understanding, administration, and progression of exercises. The exercises were implemented without considering the potential for neuroplasticity of the nervous system and the principles of motor learning.
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  • 文章类型: Journal Article
    这篇系统综述的目的是分析如何,在额外的以树干为中心的培训计划(ATEP)之后,中风后的运动恢复是由潜在的影响调整。包括进行ATEP的20项随机对照研究。结果显示中等至高的效果有利于ATEP对躯干功能的影响,平衡能力,步态表现,和功能流动性。初始躯干损伤较高的研究对躯干功能和平衡有较高的影响;对年龄较大的参与者的研究对躯干功能有较高的影响,稳定性极限,和功能移动性,但不是平衡能力。年龄更大、受影响更大的患者是,还有,那些早些时候开始干预的人,这也与对躯干功能的更高影响有关,balance,和步态表现。较长的ATEP对躯干功能和平衡能力有很高的影响。潜在效果调节剂似乎在调节ATEP的有效性方面很重要,应在康复计划的设计中予以考虑。因此,因为潜在效应调节剂似乎可以调节ATEP的有效性,未来的研究应在实验设计中考虑它们,以更好地了解它们对卒中康复的影响.
    The aim of this systematic review is to analyze how, after additional trunk-focused training programs (ATEP), motor recovery after a stroke is modulated by potential effect modifiers. Twenty randomized controlled studies that carried out ATEP were included. Results showed moderate-to-high effects in favor of ATEP for trunk function, balance ability, gait performance, and functional mobility. Studies with a higher initial trunk impairment obtained a higher effect on trunk function and balance; studies with older participants had a higher effect on trunk function, limit of stability, and functional mobility, but not on balance ability. Older and more affected patients were, as well, those who started the intervention earlier, which was also linked with higher effects on trunk function, balance, and gait performance. Longer ATEP found a high effect on trunk function and balance ability. The potential effect modifiers seem to be important in the modulation of the effectiveness of ATEP and should be considered in the design of rehabilitation programs. Thus, since potential effect modifiers seem to modulate ATEP effectiveness, future studies should consider them in their experimental designs to better understand their impact on stroke rehabilitation.
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  • 文章类型: Journal Article
    足球是世界上最实践的运动,与球员受伤的风险有关。已经发表了一些研究,确定了伤害预防计划,但是没有对足球教练使用的伤害预防计划的全部证据进行审查。本文的目的是对已发表的有关成年男性足球运动员伤害预防计划的研究进行系统回顾,确定共同理解点,并建立在设计伤害预防策略时应考虑的建议。
    PubMed和EMBASE数据库用于使用以下关键字识别相关已发表的文章:\"足球\"和\"伤害\"和\"预防\"。
    最初总共确定了2512项研究,但只有11项研究符合纳入标准,并介绍了它们的结果。结果显示,足球中的伤害预防计划侧重于力量训练,本体感受训练,多组分程序(平衡,堆芯稳定性,和功能强度和流动性),和热身计划。
    根据分析的研究结果,足球运动员可以通过参加动态热身计划来降低比赛和训练受伤的发生率,其中包括在比赛前或训练期间进行预防性锻炼,通过增加力量,balance,和流动性培训到培训课程。
    Football is the most practised sport in the world and is associated with the risk of injuries in the players. Some studies have been published that identify injury prevention programs, but there is no review of the full body of evidence on injury prevention programs for use by football coaches. The aim of this article was to carry out a systematic review of published studies on injury prevention programs for adult male footballers, identify points of common understanding and establish recommendations that should be considered in the design of injury prevention strategies.
    PubMed and EMBASE databases were used to identify relevant published articles using the following keywords: \"soccer\" AND \"injury\" AND \"prevention\".
    A total of 2512 studies were identified initially, but only 11 studies met the inclusion criteria, and their outcomes are presented. Results revealed that injury prevention programs in football have focused on strength training, proprioceptive training, multicomponent programs (balance, core stability, and functional strength and mobility), and warm-up programs.
    Based on results from the studies analyzed, football players can lower the incidence of match and training injuries by participating in dynamic warm-up programs that include preventive exercises before games or during training sessions, and by adding strength, balance, and mobility training to the training sessions.
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